Corneal Confocal Microscopy as a Measure of Diabetic Neuropathy

Distal symmetric polyneuropathy is the mostcommon pattern of nerve injury in patients withdiabetes (1,2). In fact, up to 50 % of patients withdiabetes will develop distal symmetric poly-neuropathy at some point during their illness (3). Currently, the only effective treatment to prevent this prevalent con-dition is glucose control (4). Unfortunately, demonstrating an improvement in neuropathy over time has been much more difficult to achieve than preventing progression (5). Possible explanations for the lack of improvement in out-come measures include a lack of an effective treatment and/ or a lack of a sensitive test for nerve fiber repair. No consensus exists as to which neuropathy outcomes should be obtained after a therapeutic intervention, and all currently available options have advantages and disadvan-tages. Clinical assessments and scales have the advantage of taking into account patients ’ symptoms and neurologic ex-amination, but recent work has indicated that this approach