Neurodegenerative Sequelae in Diabetes: New Optical Imaging Methods

Optical coherence tomography (OCT) and corneal confocal microscopy (CCM) examinations allow reproducible detection of neurodegenerative changes in diabetic patients. Both methods are non-invasive, and therefore suitable for regular follow-up. Optical coherence tomography has shown significant thinning in the retinal nerve fibre layer even in diabetics without retinopathy, and corneal confocal microscopy provides high-resolution images of the corneal sub-basal nerve plexus revealing significantly reduced nerve fibre density in type 2 diabetic patients that had not yet developed clinical signs of polyneuropathy compared to the control group. Previous studies have demonstrated the apparent superiority of confocal microscopy over optical coherence tomography in detecting early neurodegenerative damage. The aim is to improve diabetic polyneuropathy diagnostics using CCM with a view to developing a surrogate parameter.