Association of corneal nerve parameters with nerve abnormalities and neuropathic pain in prediabetes and type 2 diabetes: the Maastricht Study
Authors' conclusion
The study found associations between the axonal degeneration EMG score and WF-CCM, but no associations were observed between neuropathic pain and WF-CCM parameters, suggesting that WF-CCM has limited value in assessing neuropathic pain.
Study context
- Population
- Adults with and without (pre)diabetes, Maastricht Study; mean age 59.2 years, 51.6% female, 15% prediabetes, 19% T2D; median diabetes duration 3.0 years
- Participants
- 3,425 adults
- Outcome
- Association of corneal nerve parameters (CNFL, CNFD, CNBD by WF-CCM) with EMG axonal degeneration score and neuropathic pain (modified DN4 score ≥3)
Methodological detailspopulation-based (Maastricht Study), fully automated wide-field corneal confocal microscopy (WF-CCM) analysis
- Population-based (Maastricht Study)
- Fully automated WF-CCM analysis
Main finding
As reported in the abstract
- Axonal degeneration electromyography (EMG) score vs corneal nerve fibre length (CNFL): β
- −0.51 (95% CI −0.78, −0.24)
- Axonal degeneration EMG score vs corneal nerve fibre density (CNFD): β
- −1.56 (95% CI −3.04, −0.08)
- Axonal degeneration EMG score vs corneal nerve branch density (CNBD): β
- −3.08 (95% CI −5.51, −0.64)
- Neuropathic pain vs CNFL: β
- −0.06
- Neuropathic pain vs CNFD: β
- −1.15
- Neuropathic pain vs CNBD: β
- −0.22
Observational data: associations, not effects.
Original publication
Association of corneal nerve parameters with nerve abnormalities and neuropathic pain in prediabetes and type 2 diabetes: the Maastricht Study. Diabetologia. Published 10 February 2026. doi:10.
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