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Table 2 Studies investigating corneal confocal microscopy (CCM) in central nervous system disorders

From: Potential use of corneal confocal microscopy in the diagnosis of Parkinson’s disease associated neuropathy

CategoryStudiesAimsStudy cohortMain findingsReference
MSBitirgen et al. (2017)To assess corneal sub-basal nerve plexus morphologic features, corneal DC density in patients with MS.cross-sectional (87 subjects: 57 MS, 30 controls)CNFD、CNBD、CNFL were reduced but DC density was increased in patients with MS compared with healthy controls.[68]
Mikolajczak et al. (2017)To investigate the effect of MS on corneal nerve fibers and DC in the sub-basal nerve plexus using in CCM.cross-sectional (52 subjects: 26 MS, 26 controls)significant reduction in total corneal nerve fiber density in MS patients compared to controls. DC density was similar in both groups.[69]
Petropoulos et al. (2017)To evaluate whether CCM detects axonal degeneration and whether this is associated with retinal nerve fiber degeneration and clinical disability in patients with MS.cross-sectional (50 subjects: 25 MS, 25 controls)CNFD、CNBD、CNFL were reduced patients with MS compared with healthy controls. The EDSS and MSSS correlated significantly with CNBD.[70]
DementiaPonirakis et al. (2019)To determine whether there is any association of corneal nerve fiber measures with cognitive function and functional independence in patients with MCI and dementia.cross-sectional (76 subjects: 30 MCI, 26 dementias, 20 controls)CNFD、CNBD、CNFL were reduced in patients with MCI and dementia compared to controls. CNFD、CNBD、CNFL were significantly associated with cognitive function and functional independence in MCI and dementia.[25]
ALSFerrari et al. (2014)To examine a group of sporadic ALS patients with CCM.cross-sectional (15 subjects: 8 ALS, 7 controls)CNFD、CNFL were reduced but CNT was increased in ALS patients compared with healthy controls. ALS-SS-bulbar score was significantly related to CNFL and CNFD.[71]
FRDAPagovich et al. (2018)To evaluated the severity of neurological manifestations in FRDA with CCM.cross-sectional (37 subjects, 23 FRDA, 14 controls)CNFD、CNFL were reduced in FRDA compared to healthy controls.[75]
WDSturniolo et al. (2015)to investigate central corneal changes and in particular to assess the parameters of corneal SBNP in patients affected by WD.cross-sectional (48 subjects: 24 WD, 24 controls)NFLD, NF, NBe and NFr were lower, whereas FT was significantly higher in WD subjects compared to controls.[72]
ISKhan et al. (2017)To investigate the use of CCM in patients presenting with acute IS.cross-sectional (158 subjects: 130 acute IS, 28 controls)CNFD、CNBD、CNFL were reduced in patients with acute IS compared with healthy controls.[73]
Gad et al. (2019)To determine if CCM can identify corneal nerve and endothelial cell abnormalities with TIA or minor IS.cross-sectional (54subjects: 14 TIA, 22 minor IS, 18 controls)CCM identifies corneal nerve fiber loss and endothelial cell abnormalities in patients with TIA and minor IS.[74]
  1. MS Multiple Sclerosis, DC dendritic cell, CNFD corneal nerve fiber density, CNBD corneal nerve branch density, CNFL corneal nerve fiber length, CCM corneal confocal microscopy, EDSS expanded disability status scale, MSSS multiple sclerosis severity score, MCI mild cognitive impairment, ALS amyotrophic lateral sclerosis, ALS-SS-bulbar score Amyotrophic lateral sclerosis- Functional Rating Scale-bulbar score, CNT corneal nerve tortuosity, FRDA Friedreich’s ataxia, WD Wilson Disease, SBNP sub-basal nerve plexus, NFLD nerve fiber length density, NF number of fibers, NBe number of beadings, NBr number of branchings, FT fiber tortuosity, IS ischemic stroke, TIA transient ischemic Attack