Prospects of using confocal microscopy of the cornea

Relevance Corneal confocal microscopy (CCM) can be attributed to one of the popular methods for studying the cornea and its nerve fibers. The CCM method allows obtaining detailed, fast, non-invasive information about the structure of the cornea at a level close to the morphological one [1–5]. Objective To analyze the prospects for using corneal confocal microscopy in diagnosing the state of corneal nerve fibers. Material and methods To achieve this goal, available literature data on corneal confocal microscopy and the features of its use in patients with signs of systemic polyneuropathy were selected, studied and analyzed. Results Recently, an increase in the number of diseases accompanied by the development of polyneuropathy has been recorded. First of all, we are talking about such nosologies as diabetes mellitus (DM), Parkinson's disease (PD) and fine-fiber polyneuropathy. Diagnosis of these diseases is difficult and often requires careful collection of anamnesis, as well as regular invasive interventions, such as skin biopsy, electroneuromyography and quantitative sensory testing. The above diagnostic methods are expensive and invasive, patients often refuse to perform diagnostic manipulations, thereby increasing the risk of disease progression. CMR allows for the analysis of thin unmyelinated nerve fibers in real time, without special preparation. A number of researchers have established changes in the structure of nerve fibers in patients with signs of polyneuropathy (in diabetes and PD). Thus, an increase in tortuosity, a decrease in the length and density of NVR have been recorded, while there is a correlation between these changes and the age of the subjects. However, the changes recorded in CMR are not pathognomonic. Conclusion The above information indicates the important role of corneal confocal microscopy as a method for diagnosing corneal nerve fibers. CMR allows to analyze the state of corneal nerve fibers in various systemic pathologies, identifying predictors of polyneuropathy development. Keywords: corneal confocal microscopy; corneal nerve fibers; systemic polyneuropathy