1. Corneal Confocal Microscopy as surrogate marker in Inflammatory Neuropathies
Inn Lee, Lena Hinrichs, Rayaz A. Malik,
Christoph Kleinschnitz, Bernd C. Kieseier,
and Mark Stettner
EAN Amsterdam, 26. Juli 2017
Mark Stettner; MD, PhD
Department of Neurology
University Hospital Essen
Germany

2. Corneal Confocal Microscopy
rapid (2 min)
non-invasive (in vivo)
reiterative
images corneal structures

3. Corneal Confocal Microscopy
Stettner et al. 2015

4. Corneal Confocal Microscopy
Patients with CIDP and MMN revealed a reduction in corneal nerve fiber (CNF) measures and an enlargement in corneal immune cell infiltrates. In CIDP, CNF parameters decreased with longer disease duration. The number of dendritic cells in proximity to corneal nerve fibers was increased in patients with early disease and correlated with the degree of motor affection. Cranial nerve affection was associated with increased corneal cell infiltrates. Neuritis activity correlated with the number of dendritic cells in proximity to CNF.
In painful neuropathies a further reduction in CNF parameters and an increase in non-dendritic cells became apparent. In CIDP patients presenting with anti-neuronal antibodies the number of non-dendritic cells was increased.
Stettner et al. 2015

5. Corneal Confocal Microscopy

6. Corneal Confocal Microscopy

7. Corneal Confocal Microscopy
Considerable potential as a surrogate marker for CIDP
Corneal nerve fiber loss may reflect severity of neuropathy
Quantification of distinct cells around the CNF plexus may stratify CIDP subtypes, clinical course and disease activity