Peripheral neuropathy in chronic renal failure: an in vivo confocal microscopy study

Purpose To analyse corneal nerve morphology alterations in patients with chronic renal failure by in vivo corneal confocal microscopy (CCM). Methods A prospective study was conducted in 30 patients (30 eyes) with pre-dialysis chronic renal failure (CRF) and 30 aged-matched healthy volunteers (30 eyes). A complete ophthalmologic examination, esthesiometry (Cochet-Bonnet esthesiometer), in vivo CCM (Heidelberg Retina Tomograph II/Rostock Cornea Module) and neurological evaluation were performed. Results Corneal sensation was reduced in pre-dialysis CRF patients compared with control subjects. Nerve fiber density, length and branch density were reduced and tortuosity was increased in the CRF group (p<0,05). These parameters were related with severity of neuropathy. Conclusion In vivo CCM may be a valuable method for diagnosis of uremic neuropathy and may be used to grade its severity.