角膜共聚焦显微镜用于诊断外围神经病变:系统性审查和元分析
Ioannis N Petropoulos1, Omar A Madani1, Hoda Y Gad1
1Research Division, Weill Cornell Medicine-Qatar, Doha, Qatar.
European journal of neurology
|November 7, 2025
概括
用角膜共聚焦显微镜 (CCM) 测量角膜神经纤维长度 (CNFL) 可以帮助诊断外围神经病变. 这一分析证实了CNFL的说法.
科学领域:
- 眼科医生 眼科 眼科
- 神经学 神经学
- 医学诊断 医学诊断 医学诊断
背景情况:
- 周围神经病变 (PN) 往往是晚期诊断或错过的.
- 角膜共聚焦显微镜 (CCM) 测量角膜神经纤维长度 (CNFL).
- CNFL显示出诊断糖尿病和其他外围神经病变的潜力.
研究的目的:
- 系统地审查和元分析关于CNFL在外围神经病变中的诊断效益的研究.
- 评估健康对照组和患有亚临床或临床PN的患者之间的CNFL差异.
- 评估PN诊断中CNFL测量的可靠性.
主要方法:
- 在CENTRAL,Embase和PubMed中搜索同行评审的文献.
- 包括ProQuest论文和论文的灰色文献.
- 应用PRISMA指南进行查和数据提取;两位作者独立工作.
- 使用标准化平均差异和95%置信区间分析了CNFL.
- 进行敏感性分析以评估偏差和模型选择 (随机/固定的效应).
主要成果:
- 包括52项研究,涉及34种疾病的2995名参与者.
- 在临床PN中发现明显较低的CNFL与健康对照组相比 (SMD-1.12).
- 在亚临床PN与健康对照中观察到明显较低的CNFL (SMD -0.78).
- 在临床PN与亚临床PN (SMD -0.93) 中报告的CNFL显著降低.
- 在敏感性分析后,无论使用哪种统计模型,结果仍然显著.
结论:
- 通过CCM测量CNFL是对外围神经病变的有价值的诊断工具.
- 这一系统性审查和元分析支持CNFL在PN诊断中的实用性.
- CNFL为识别神经病变提供了可靠的生物标志物.
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