Corneal confocal microscopy in chronic inflammatory demyelinating polyneuropathy

Area of Science:

• Neuroscience
• Ophthalmology
• Immunology

Background:

• Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and multifocal motor neuropathy (MMN) are heterogeneous neuropathies requiring better diagnostic tools.
• Corneal confocal microscopy (CCM) offers a noninvasive method for nerve imaging.

Purpose of the Study:

• To evaluate CCM's potential as a diagnostic surrogate in CIDP and MMN.
• To assess corneal nerve damage and immune cell infiltration in these conditions.

Main Methods:

• A cross-sectional prospective study involving 182 patients and healthy controls.
• Quantification of corneal nerve fiber (CNF) measures and immune cell infiltrates using CCM.

Main Results:

• Patients with CIDP and MMN exhibited reduced CNF measures and increased corneal immune cell infiltrates.
• In CIDP, decreased CNF parameters correlated with disease duration; increased dendritic cells were seen in early disease.
• Distinct cell populations correlated with neuropathy severity, pain, and antibody status.

Conclusions:

• CNF loss and corneal immune cell quantification may aid in stratifying CIDP subtypes, clinical course, and disease activity.
• Further longitudinal studies are necessary to validate CCM as a surrogate endpoint for CIDP and MMN.