Corneal Confocal Microscopy CCM

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The cornea is the most densely innervated part of the human body, containing A8-fibres and unmyelinated C-fibres. CCM permits sequential observations of the corneal subbasal nerve plexus comparable or even superior to those obtained with histopathological examination (Oliviera-Soto & Efron 2001). CCM detects significant alterations in corneal nerve fibre density, branching and tortuosity in patients with mild diabetic neuropathy, and these alterations relate to the severity of somatic neuropathy (Malik et al. 2003; Kallinikos et al. 2004).

Corneal nerve fibre density has recently been shown to improve with improved glycaemic control (Iqbal et al. 2005). Therefore, the ability of CCM to visualise and define the extent of nerve damage and repair occurring in diabetic patients is significant (Hossain et al. 2005). The noninvasive facility of CCM provides a means of expediting drug development programmes for therapies deemed to be beneficial in the treatment of diabetic peripheral neuropathy.

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Peripheral Neuropathy Natural Treatment Options

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