Standard Criteria for Chemotherapy-Induced Peripheral Neuropathy Diagnosis Lacking

New Vision clinic, main center for refractive surgery in France, with cutting-edge technology for all eye laser operations. Pre-op diagnosis carried out by an optometrist who specializes in measuring the visual system, refraction). Optical coherence tomography, OCT, clich_ of a normal cornea. (Photo by: BSIP/Universal Images Group via Getty Images)
A uniform approach could help control pain in this densely innervated region of the body.

Physicians must develop a standardized approach for recognizing and monitoring the ocular changes caused by chemotherapy-induced peripheral neuropathy (CIPN), according to a review article published in The Ocular Surface. Once defined, these markers can be observed and monitored via in vivo corneal confocal microscopy.

Neurotoxic anticancer drugs have been linked to peripheral nerve damage and neuropathic changes on the ocular surface, particularly in the cornea. Investigators examined peer-reviewed articles, including original studies and published case reports published between January 2000 and May 2021. They found that there’s no standardized protocol for diagnosing CIPN because there is no reliable, objective method of observing nerve damage structurally.

To stalling the impact of CIPN patients, the first step is to develop an agreed-upon, standardized approach to defining the key changes to look for and monitor. Then, researchers can study the benefits of using in-vivo corneal confocal microscopy to monitor the development and progression of CIPN.

“Other gaps in knowledge and issues that should be addressed in relation to neuropathic changes with neurotoxic chemotherapy and CIPN include other potential changes in the sub-basal corneal nerve plexus, such as corneal dendritic cells, microneuromas and tortuosity,” the research adds.


Chiang JCB, Goldstein D, Park SB, et al. Corneal nerve changes following treatment with neurotoxic anticancer drugs. Ocul Surf. 2021;21(6):221-237. doi:10.1016/j.jtos.2021.06.007