Clinical Trial: Prevalence of Decreased Corneal Sensation in Patients With Chronic Inflammatory Demyelinating Polyneuropathy

Study Status: Completed
Recruit Status: Unknown status
Study Type: Observational

Official Title: Prevalence of Decreased Corneal Sensation in Patients With Chronic Inflammatory Demyelinating Polyneuropathy

Brief Summary: Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a demyelinating chronic progressive or relapsing neuropathy believed to be secondary to an autoimmune response against peripheral nerve antigens.5 We have observed two patients with CIDP with decreased corneal sensation who also suffered neurotrophic corneal ulcers and severe visual loss in the affected eyes. We want to explore the relationship of CIDP and corneal sensitivity. Our hypothesis is that people with CIDP have decreased corneal sensation compared to those without. We plan to perform a prospective study measuring corneal sensation in patients (proposed n=10) with CIDP and without to determine (1) if a difference exists in patients with CIDP compared to controls and (2) the magnitude of the difference. If a difference is detected in corneal sensitivity in patients with CIDP, this awareness amongst physicians and patients may help prevent blinding complications.

Detailed Summary:

INTRODUCTION The prevalence of CIDP ranges from 0.8 to 8.4 per 100 000.5 This broad range may reflect the use of different diagnostic criteria, as recently confirmed by an epidemiologic study on UK population. Over 50% of the patients may have temporary severe disability during the course of their disease and approximately 10% eventually become persistently disabled or die because of the illness.

CIDP may affect any nerve plexus in the body. However, diagnostic criteria leans towards nerve conduction studies in the limbs and denervation in other organ systems might be overlooked. Sensory innervation of the cornea is provided by the ophthalmic branch of the trigeminal nerve via the anterior ciliary nerves. A relatively small number (50-450) of primary sensory neurons from the ipsilateral trigeminal ganglion send their peripheral axons to the cornea and branch extensively within the corneal tissue. To maintain corneal transparency, all peripheral axons of corneal neurons lose the myelin sheath when they enter the corneal stroma. Fibers spread in a radial fashion parallel to the corneal surface.1

Our proposed study will explore the relationship of decreased corneal sensation, a potentially devastating eye condition secondary to CIDP. Decreased corneal sensation may lead to neurotrophic keratitis; which describes corneal diseases due to impairment or loss of corneal sensation leading to epithelial defects and corneal ulcers. This may be caused by many ocular and systemic diseases such as Diabetes or Stroke. Corneal innervation is important for the maintenance of corneal structure and function, and provides protective mechanisms against factors that might be potentially damaging to the cornea. Innervation also plays an important trophic function in corneal repair in relation to disease, trauma or surgery. Denervation and decrea
Sponsor: State University of New York at Buffalo

Current Primary Outcome: Corneal Sensitivity

The most important variable here is corneal sensitivity in study subjects vs. controls. This is a prospective screen to determine if a difference exists before pursuing larger studies. The endpoint for this investigation will be analysis of 10 patients with CIDP and 10 age-matched controls.


Original Primary Outcome: Same as current

Current Secondary Outcome: Corneal nerve density

If there is a difference observed in corneal sensation between subjects and controls, then corneal nerve densities in respective corneas will be measured.


Original Secondary Outcome: Same as current

Information By: State University of New York at Buffalo

Dates:
Date Received: June 16, 2011
Date Started: May 2011
Date Completion: May 2012
Last Updated: June 21, 2011
Last Verified: June 2011