Potential use of corneal confocal microscopy in the diagnosis of Parkinson’s disease associated neuropathy

Parkinson’s disease (PD) is a chronic, progressive neurodegenerative disease affecting about 2–3% of population above the age of 65. In recent years, Parkinson’s research has mainly focused on motor and non-motor symptoms while there are limited studies on neurodegeneration which is associated with balance problems and increased incidence of falls. Corneal confocal microscopy (CCM) is a real-time, non-invasive, in vivo ophthalmic imaging technique for quantifying nerve damage in peripheral neuropathies and central neurodegenerative disorders. CCM has shown significantly lower corneal nerve fiber density (CNFD) in patients with PD compared to healthy controls. Reduced CNFD is associated with decreased intraepidermal nerve fiber density in PD. This review provides an overview of the ability of CCM to detect nerve damage associated with PD.