title: Corneal confocal microscopy for assessment of diabetic peripheral neuropathy: a meta-analysis.
abstract: OBJECTIVE
  To evaluate the diagnostic performance of corneal confocal microscopy (CCM) in assessing corneal nerve parameters in patients with diabetic peripheral neuropathy (DPN).
  
  
  METHODS
  Studies in the literature that focused on CCM and DPN were retrieved by searching PubMed, Excerpt Medica Database (EMBASE) and China National Knowledge Infrastructure (CNKI) databases. RevMan V.5.3 software was used for the meta-analysis. The results are presented as weighted mean difference (WMD) with a corresponding 95% CI.
  
  
  RESULTS
  13 studies with a total of 1680 participants were included in the meta-analysis. The pooled results showed that the corneal nerve fibre density, nerve branch density and nerve fibre length were significantly reduced (all p<0.00001) in the patients with DPN compared with healthy controls ((WMD=-18.07, 95% CI -21.93 to -14.20), (WMD=-25.35, 95% CI -30.96 to -19.74) and (WMD=-6.37, 95% CI -7.44 to -5.30)) and compared with the diabetic patients without DPN ((WMD=-8.83, 95% CI -11.49 to -6.17), (WMD=-13.54, 95% CI -20.41 to -6.66) and (WMD=-4.19, 95% CI -5.35 to -3.04)), respectively. No significant difference was found in the corneal nerve fibre tortuosity coefficient between diabetic patients with DPN and healthy controls (p=0.80) or diabetic patients without DPN (p=0.61).
  
  
  CONCLUSIONS
  This meta-analysis suggested that CCM may be valuable for detecting and assessing early nerve damage in DPN patients.
authors: Shanghai Key Lab of Modern Optical Systems, Engineering Research Center of Optical Instruments and Systems, Ministry of Education, University of Shanghai for Science and Technology, Shanghai, China Department of Biomedical Engineering, Florida International University, Miami, Florida, USA.
authors: Min-Shan
authors: MS
authors: Jiang
authors: Department of Radiology, Shanghai Ninth People's Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China.
authors: Ying
authors: Y
authors: Yuan
authors: Department of Nuclear Medicine, Huadong Hospital, Fudan University, Shanghai, China.
authors: Zhao-Xiang
authors: ZX
authors: Gu
authors: Shanghai Key Lab of Modern Optical Systems, Engineering Research Center of Optical Instruments and Systems, Ministry of Education, University of Shanghai for Science and Technology, Shanghai, China.
authors: Song-Lin
authors: SL
authors: Zhuang
mesh_terms: D003315:Cornea / Q000294:innervation*; D003929:Diabetic Neuropathies / Q000175:diagnosis*; D006801:Humans; D018613:Microscopy, Confocal; D009412:Nerve Fibers / Q000473:pathology; D020433:Trigeminal Nerve Diseases / Q000175:diagnosis*
keywords: Cornea; Diagnostic tests/Investigation; Imaging