Purpose: Neurotrophic keratitis may result from a variety of ocular or systemic diseases. Chronic inflammatory demyelinating polyneuropathy (CIDP) is an autoimmune neuropathy that affects any nerve plexus but with no known association with corneal disease. We observed 2 patients with CIDP and visually compromising neurotrophic corneal ulcers. This study was performed to determine the prevalence of neurotrophic corneas in patients with CIDP to identify a subpopulation of asymptomatic patients who are at risk for vision loss.
Methods: This is an observational case series of 2 patients with CIDP with visually compromising neurotrophic corneal ulcers and a prospective clinical study comparing corneal sensitivity in 9 patients with CIDP versus 9 age- and sex-matched controls. Corneal sensitivity was tested with an esthesiometer. Statistical analyses were performed to determine patterns or significances in relation to the subject's age, gender, and duration and severity of the disease.
Results: The overall median corneal sensitivity was 5.7 for patients with CIDP and 6.0 for controls (P = 0.09). The mean corneal sensitivity was 5.6 ± 0.4 in patients with CIDP compared with 5.8 ± 0.3 in controls. No specific pattern was found with age, gender, or duration and severity of the disease among patients with CIDP.
Conclusions: Although the case series demonstrated decreased corneal sensitivity in both patients with CIDP, the prospective study detected reduced corneal sensitivity in patients with CIDP when compared with controls, but did not reach statistical significance. Ophthalmic examinations with measurement of corneal sensitivity should be considered in the management of patients with CIDP.
Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT01379833.
*Department of Ophthalmology, School of Medicine and Biomedical Sciences, Ross Eye Institute, The State University of New York at Buffalo, Buffalo, NY;
†Department of Social and Preventive Medicine, School of Public Health and Health Professions, The State University of New York at Buffalo, Buffalo, NY;
‡Department of Epidemiology and Environmental Health, Dent Neurologic Institute, Buffalo, NY;
§SUNY Eye Institute, New York, NY; and
¶Research Service, Veterans Administration Western New York Healthcare System, Buffalo, NY.
Reprints: Sangita P. Patel, Department of Ophthalmology, Ross Eye Institute, 1176 Main Street, Buffalo, NY 14209 (e-mail: firstname.lastname@example.org).
The authors have no conflicts of interest to disclose.
Supported in part by Ralph Hochstetter Medical Research Fund in honor of Dr. Henry C. and Bertha H. Buswell (S.P.P.), by an unrestricted grant from the Research to Prevent Blindness (New York, NY), and by facilities and resources provided by the Veterans Administration Western New York Healthcare System.
The opinions expressed herein do not necessarily represent those of the Veterans Administration or the US Government.
Received March 05, 2014
Accepted April 01, 2014