Corneal and Epidermal Nerve Quantification in Chemotherapy Induced Peripheral Neuropathy

Frontiers in Medicine

Philippe Fonteyne¹  Filippo Bonelli¹  Romina Mayra Lasagni Vitar¹  Giulio Ferrari¹  Paolo Rama¹  Marco Barbariga¹  Fabio Scarpa²  Michele Reni³  Angelo Quattrini⁴  Teuta Domi⁴  Magda Marcatti⁵  Federica Agosta⁶  Nilo Riva⁷  Ignazio Diego Lopez⁷  Alfredo Ruggeri⁸ 

[1] Cornea and Ocular Surface Disease Unit, Eye Repair Laboratory, IRCCS San Raffaele Scientific Institute, Milan, Italy;Department of Information Engineering, University of Padua, Padua, Italy;Department of Oncology, Medical Oncology Unit, San Raffaele Scientific Institute, Milan, Italy;Experimental Neuropathology Unit, Division of Neuroscience, Institute of Experimental Neurology (INSPE), IRCCS San Raffaele Scientific Institute, Milan, Italy;Hematology and Bone Marrow Transplantation Unit, Department of Oncohematology, San Raffaele Scientific Institute, Milan, Italy;Neuroimaging Research Unit, Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy;Neurology and Neurorehabilitation Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy;Resono Ophthalmic srl, Trieste, Italy;Vita-Salute San Raffaele University, Milan, Italy;

关键词: corneal confocal microscopy;    chemotherapy-induced neuropathy;    skin biopsy;    nerves;    neurotoxicity;    cornea;   

DOI  :  10.3389/fmed.2022.832344

来源: DOAJ

【 摘 要 】

Chemotherapy-induced neurotoxicity is an increasingly recognized clinical issue in oncology. in vivo confocal microscopy (IVCM) of corneal nerves has been successfully used to diagnose peripheral neuropathies, including diabetic neuropathy. The purpose of this study was to test if the combination of corneal nerve density and morphology assessed by IVCM is useful to monitor the neurotoxic effects of chemotherapy compared to epidermal nerve quantification. Overall, 95 adult patients with different cancer types were recruited from the oncology and hematology departments of the San Raffaele Hospital. Neurological examination, including clinical Total Neuropathy Score, and in vivo corneal confocal microscopy (IVCM), were performed before and after chemotherapy. In a group of 14 patients, skin biopsy was performed at the first and last visit. In the group of 14 patients who underwent both skin biopsy and corneal nerve imaging, clinical worsening (+69%, p = 0.0018) was paralleled by corneal nerve fiber (CNF) density reduction (−22%, p = 0.0457). Clinical Total neuropathy score significantly worsened from the first to the last visit (+62%, p < 0.0001). CNF length was not significantly reduced overall. However, CNF density/tortuosity ratio significantly decreased after therapy. Correlation analysis showed that the CNF density/tortuosity ratio was also correlated with the number of chemotherapy cycles (r = −0.04790, P = 0.0009). Our data confirm that in vivo corneal confocal microscopy is a helpful, non-invasive tool which shows promise for the diagnosis of chemotherapy-induced peripheral neuropathies. IVCM could allow a rapid, reproducible and non-invasive quantification of peripheral nerve pathology in chemotherapy-associated neuropathy.

【 授权许可】

Unknown