Recognize diabetic neuropathy on the eye

The eye provides indications of impending diabetic foot

13/09/2013

Diabetic neuropathy - and as a consequence the diabetic foot - are among the most serious side effects of the widespread disease diabetes. A cure of the damage is not possible until today, but it can only prevent the further progression of the symptoms. Not infrequently, an amputation of the foot is required. Early diagnosis is therefore crucial. But so far there was a lack of reliable diagnostic procedures. Scientists at the University Eye Hospital in Rostock have now developed a method in which the eye can detect existing nerve damage in the early stages of neuropathy.

In the run-up to the annual meeting of the German Ophthalmological Society (DOG) in Berlin from 19 to 22 September, the Director of the University Eye Hospital Rostock, Professor med. Rudolf Guthoff, on Thursday that with the „Rostock Laser Scanning Microscope“ For the first time a gentle diagnostic procedure for diabetic neuropathy is available. One in four diabetics, according to the researchers, is affected by the disease of the nervous system, which is considered to be a major cause of diabetic foot. „With the microscope, we can diagnose diabetic neuropathy early, before it comes to serious damage“, Prof. Guthoff explained the advantages of the new diagnostic procedure.

Diabetic foot a dreaded sequelae in diabetes
The neuropathy is according to the DOG „a dreaded after-effect of diabetes, which affects about 1.5 million people in Germany.“ The permanently elevated blood glucose levels cause damage to the nervous system, often to the sensory and movement nerves under the skin. Possible consequences include pain, numbness and discomfort such as tingling in the limbs. Due to the nerve damage, sufferers often do not perceive minor foot injuries. Since at the same time the self-healing powers of diabetics are impaired, chronic inflammation and non-healing open wounds develop. The tissue begins to die, which in the worst case requires amputation of individual toes or the entire foot. If neuropathy is detected early, appropriate preventive measures can minimize the risk of such complications.

Eyes show nerve damage to the entire nervous system
So far, however, suitable diagnostic methods were missing in order to detect diabetic neuropathy at an early stage. „Tissue samples from affected areas of the leg were previously required as an invasive, but not always reliable method“, explained Prof. Rudolf Guthoff. However, as the cornea of ​​the eye provides information on damage to the entire nervous system, his team, together with Heidelberg Engineering, have now developed a procedure that uses this property of the cornea for the diagnosis of diabetic neuropathy. „We know that the eye reflects nerve damage throughout the body“, Now with the help of the „Rostock Laser Scanning Microscope“ (RLSM) measure the nerve fiber network of the entire cornea. According to the expert „Parameters such as nerve fiber length, nerve fiber density, and number of branches“ when „direct gauge of the extent of neuropathy“ used. With eye drops, the patients are prepared for the examination and then touched that microscope briefly the ocular surface, creating an image of the nerve fiber structure.

Hope for the development of new neuropathic drugs
Although there is no effective treatment for diabetes-related neuropathy even with early diagnosis, „but you can prevent it by the patient on a well-adjusted blood sugar pays attention to trivial injuries on foot and regularly goes to the pedicure“, emphasized the director of the University Eye Hospital Rostock. Furthermore, the new diagnostics „also significantly advance the development of a neuropathic drug“, so the hope of the scientists. According to the DOG, the US thinks „Food and Drug Administration“ (FDA) already about it, „to introduce the Rostock microscope as a diagnostic marker for future studies.“ In this way, it is possible for the pharmaceutical companies to demonstrate the effectiveness of a neuropathic preparation for the first time clearly and early. However, the new nerve fiber analysis is currently being offered at a few specialized university eye hospitals. However, with the soon to be available more comfortable analysis software will „a broad clinical application allows“, This is the opinion of Prof. Guthoff.

Diagnosis of diseases by eye
Naturopathy also uses the patient's eye to diagnose existing diseases in the so-called iris diagnosis. Although the iris is deliberately considered instead of the cornea, the latest technological findings otherwise show some parallels to the approaches of naturopathy. Structural changes of the eye are considered as reliable indications of certain diseases, since all organs are connected via nerve tracts with the eyes. A finding that has now been confirmed in the diagnosis of diabetic neuropathy. (Fp)