Corneal Confocal Microscopy: a Surrogate Endpoint for Neurodegeneration in Clinical Trials


Corneal Confocal Microscopy in Small Fiber Pathology: Fibromyalgia Syndrome and Small Fiber Neuropathy

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Small fiber pathology is frequently reported in painful but also painless conditions. In this presentation, CCM data obtained in very well characterized large and monocentric patient cohorts will be presented: fibromyalgia syndrome (FMS) and small fiber neuropathy (SFN). FMS is a chronic pain syndrome with additional symptoms such as fatigue, depressed mood, and sleep disturbance of unknown pathophysiology. SFN is diverse in etiology and mostly manifests with acral burning pain without additional symptoms. Evidence is increasing for small fiber pathology in subgroups of patient with FMS. Using diverse small fiber tests alterations in small fiber morphology, function, and conduction was shown. In this presentation, the focus will be on findings collected in FMS and SFN patients using corneal confocal microscopy (CCM). Data will be compared with those obtained with other small fiber tests. Besides analysis of established CCM parameters, data on corneal immune cells will be provided comparing FMS patients with SFN patients and healthy controls. A critical appraisal will be given on CCM findings in both diverse conditions including the question on differential pathophysiology of small fiber pathology.