Survival rates of cancer has improved with the development of anticancer drugs including systemic chemotherapeutic agents. However, long-lasting side effects could impact treated patients. Neurotoxic anticancer drugs are specific agents which cause chemotherapy-induced peripheral neuropathy (CIPN), a debilitating condition that severely deteriorates quality of life of cancer patients and survivors. The ocular surface is also prone to neurotoxicity but investigation into the effects of neurotoxic chemotherapy on the ocular surface has been more limited compared to other systemic etiologies such as diabetes. There is also no standardized protocol for CIPN diagnosis with an absence of a reliable, objective method of observing nerve damage structurally. As the cornea is the most densely innervated region of the body, researchers have started to focus on corneal neuropathic changes that are associated with neurotoxic chemotherapy treatment. In-vivo corneal confocal microscopy enables rapid and objective structural imaging of ocular surface microscopic structures such as corneal nerves, while esthesiometers provide means of functional assessment by examining corneal sensitivity. The current article explores the current guidelines and gaps in our knowledge of CIPN diagnosis and the potential role of in-vivo corneal confocal microscopy as a diagnostic or prognostic tool. Corneal neuropathic changes with neurotoxic anticancer drugs from animal research progressing through to human clinical studies are also discussed, with a focus on how these data inform our understanding of CIPN.

随着包括全身化疗药物在内的抗癌药物的开发，癌症的存活率有所提高。然而，长期的副作用可能会影响接受治疗的患者。神经毒性抗癌药物是导致化疗引起的周围神经病变 (CIPN) 的特异性药物，这是一种严重恶化癌症患者和幸存者生活质量的衰弱状况。眼表也容易出现神经毒性，但与其他全身性病因（如糖尿病）相比，对神经毒性化疗对眼表的影响的研究更为有限。由于缺乏从结构上观察神经损伤的可靠、客观的方法，因此也没有用于 CIPN 诊断的标准化协议。由于角膜是人体神经支配最密集的区域，研究人员已开始关注与神经毒性化疗治疗相关的角膜神经病变。体内角膜共聚焦显微镜能够对眼表显微结构（如角膜神经）进行快速客观的结构成像，而感觉仪通过检查角膜敏感性提供功能评估的手段。本文探讨了当前的指南和我们在 CIPN 诊断知识方面的差距，以及体内角膜共聚焦显微镜作为诊断或预后工具的潜在作用。还讨论了从动物研究进展到人类临床研究的神经毒性抗癌药物引起的角膜神经病变变化，重点是这些数据如何帮助我们了解 CIPN。