{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T14:49:35Z","timestamp":1789915775623,"version":"4.0.1"},"reference-count":50,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T00:00:00Z","timestamp":1762473600000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008982","name":"Qatar National Research Fund","doi-asserted-by":"publisher","award":["BMRP20038654"],"award-info":[{"award-number":["BMRP20038654"]}],"id":[{"id":"10.13039\/100008982","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2025,11]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background and Objectives<\/jats:title>\n \n Peripheral neuropathy (\n PN<\/jats:styled-content>\n ) may be diagnosed late or may remain undiagnosed. Studies have shown that measurement of corneal nerve fiber length (\n CNFL<\/jats:styled-content>\n ) using corneal confocal microscopy (\n CCM<\/jats:styled-content>\n ) may have diagnostic utility in diabetic and other peripheral neuropathies.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n The main databases [\n CENTRAL<\/jats:styled-content>\n , Embase (Ovid), and\n PubMed<\/jats:styled-content>\n ] were searched for peer\u2010reviewed literature. Gray literature searching was undertaken using the\n ProQuest<\/jats:styled-content>\n Dissertations & Theses database. The updated Preferred Reporting Items for Systematic Reviews and Meta\u2010Analysis guidelines were used by two authors independently for screening and data extraction. The primary outcome of\n CNFL<\/jats:styled-content>\n was represented by the standardized mean difference and 95% confidence interval, and differences between healthy controls (\n HC<\/jats:styled-content>\n ), patients with sub\u2010clinical (\n PN<\/jats:styled-content>\n \u2212), and clinical (\n PN<\/jats:styled-content>\n +) peripheral neuropathy were assessed. Sensitivity analysis was performed to assess the risk of bias.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n We identified\n n<\/jats:italic>\n \u2009=\u200952 eligible studies (\n n<\/jats:italic>\n \u2009=\u20092995 participants) reporting\n CNFL<\/jats:styled-content>\n across 34 different conditions associated with\n PN<\/jats:styled-content>\n .\n CNFL<\/jats:styled-content>\n was significantly lower in\n PN<\/jats:styled-content>\n + patients compared to\n HC<\/jats:styled-content>\n (standardized mean difference \u22121.12, 95% confidence interval \u22121.32 to \u22120.33,\n p<\/jats:italic>\n \u2009<\u20090.00001), in\n PN<\/jats:styled-content>\n \u2212 patients compared to\n HC<\/jats:styled-content>\n (\u22120.78, \u22120.99 to \u22120.57,\n p<\/jats:italic>\n \u2009<\u20090.00001), and in\n PN<\/jats:styled-content>\n + compared to\n PN<\/jats:styled-content>\n \u2212 patients (\u22120.93, \u22121.53 to \u22120.33,\n p<\/jats:italic>\n \u2009=\u20090.002). The results remained significant following sensitivity analysis to adjust for the risk of potential detection bias. The results remained significant independent of the choice of a random or fixed effects model.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n This systematic review and meta\u2010analysis shows that\n CNFL<\/jats:styled-content>\n has utility in the diagnosis of peripheral neuropathies.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ene.70396","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T13:36:53Z","timestamp":1762522613000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Corneal Confocal Microscopy to Diagnose Peripheral Neuropathy: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"32","author":[{"given":"Ioannis N.","family":"Petropoulos","sequence":"first","affiliation":[{"name":"Research Division Weill Cornell Medicine\u2010Qatar Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar A.","family":"Madani","sequence":"additional","affiliation":[{"name":"Research Division Weill Cornell Medicine\u2010Qatar Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoda Y.","family":"Gad","sequence":"additional","affiliation":[{"name":"Research Division Weill Cornell Medicine\u2010Qatar Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziyad R.","family":"Mahfoud","sequence":"additional","affiliation":[{"name":"Division of Medical Education Weill Cornell Medicine Doha Qatar"},{"name":"Division of Epidemiology, Department of Population Health Sciences Weill Cornell Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6936-1248","authenticated-orcid":false,"given":"Georgios","family":"Ponirakis","sequence":"additional","affiliation":[{"name":"Research Division Weill Cornell Medicine\u2010Qatar Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross","family":"MacDonald","sequence":"additional","affiliation":[{"name":"Health Sciences Library Weill Cornell Medicine\u2010Qatar Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7188-8903","authenticated-orcid":false,"given":"Rayaz A.","family":"Malik","sequence":"additional","affiliation":[{"name":"Research Division Weill Cornell Medicine\u2010Qatar Doha Qatar"},{"name":"Institute of Cardiovascular Medicine University of Manchester Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,7]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.62.4.310"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2004.08.012"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2010.03023.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci9110320"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-003-1086-8"},{"key":"e_1_2_9_7_1","first-page":"2915","article-title":"Corneal Structure and Sensitivity in Type 1 Diabetes Mellitus","volume":"41","author":"Rosenberg M. 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