Lupus & antiphospholipid syndrome
Corneal confocal microscopy: a novel biomarker of small fibre neuropathy in SLE
Authors' conclusion
This study demonstrates that CCM detects peripheral neurodegeneration in patients with SLE, which relates to disease activity, sustained neuropathic pain and quality of life.
Study context
- Population
- Participants with SLE (age 38.6±9.6 years; mean SLEDAI 3.4±4.2) and healthy controls
- Participants
- 59 vs 17
- Exposure
- SLE vs healthy controls
- SLEn = 59
- Healthy controlsn = 17reference
- Outcome
- Corneal nerve parameters on corneal confocal microscopy (CCM)
Methodological detailscase-control
- Case-control
Main finding
As reported in the abstract
| Group | Value | Corneal nerve branch density (CNBD) | Corneal nerve fibre length (CNFL) (mm/mm²) | Corneal nerve fibre density (CNFD) (fibres/mm²) | Corneal nerve fibre tortuosity (CNFT) | Inferior whorl length (IWL) (mm/mm²) |
|---|---|---|---|---|---|---|
| SLE | 41.5 ± 21.3 branches/mm² | 41.5±21.3 | 18.5±4.3 | 31.7±7.1 | 15.0±4.0 | 38.5±8.0 |
| Healthy controls | 72.1 ± 29.4 branches/mm² | 72.1±29.4 | 24.2±4.4 | 34.0±6.9 | 14.3±3.1 | 35.6±5.9 |
Value
SLE41.5 ± 21.3 branches/mm²
Healthy controls72.1 ± 29.4 branches/mm²
Corneal nerve branch density (CNBD)
SLE41.5±21.3
Healthy controls72.1±29.4
Corneal nerve fibre length (CNFL) (mm/mm²)
SLE18.5±4.3
Healthy controls24.2±4.4
Corneal nerve fibre density (CNFD) (fibres/mm²)
SLE31.7±7.1
Healthy controls34.0±6.9
Corneal nerve fibre tortuosity (CNFT)
SLE15.0±4.0
Healthy controls14.3±3.1
Inferior whorl length (IWL) (mm/mm²)
SLE38.5±8.0
Healthy controls35.6±5.9
- SLE vs Healthy controls: P = 0.0001 — significantly lower in SLE
- SLE vs Healthy controls: P = 0.0001 — significantly lower in SLE
- SLE vs Healthy controls: P = 0.25 — comparable
- SLE vs Healthy controls: P = 0.55 — comparable
- SLE vs Healthy controls: P = 0.16 — comparable
Observational data: associations, not effects.
Further findings
VPT · elevated in SLE
P < 0.01
- DN4 Score in SLE
- 3.5 · ± 2.5
Sudomotor function of hands and feet
- Comparable between SLE and healthy controls (p=0.28-0.42)
Active SLE and CNBD/CNFD ratio
- Active SLE associated with lower CNBD/CNFD ratio (p<0.05)
Sustained neuropathic pain (subgroup, 17.2%)
- Significantly lower CNFD, CNFL and IWL than transient (p<0.05-0.0001) and recurrent (p<0.05-0.01) pain
- Comparable vibration perception threshold (VPT) (p=0.27) and sudomotor function (p=0.14)
CNFL and quality of life
- Reduced CNFL associated with bodily pain, affecting quality of life (p<0.05)
Original publication
Corneal confocal microscopy: a novel biomarker of small fibre neuropathy in SLE. Lupus Sci Med. Published 23 October 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →