Adnan Khan1, Naveed Akhtar1, Saadat Kamran1, Georgios Ponirakis1, Ioannis N Petropoulos1, Nahel A Tunio1, Soha R Dargham1, Yahia Imam1, Faheem Sartaj1, Aijaz Parray1, Paula Bourke1, Rabia Khan1, Mark Santos1, Sujatha Joseph1, Ashfaq Shuaib1, Rayaz A Malik2. 1. From the Department of Medicine (A.K., G.P., I.N.P., N.A.T., R.A.M.) and Biostatistics, Epidemiology, and Biomathematics Research Core (S.R.D.), Weill Cornell Medicine-Qatar, Doha; Department of Neurology, Institute of Neurosciences, Hamad Medical Corporation, Doha, Qatar (N.A., S.K., Y.I., F.S., A.P., P.B., R.K., M.S., S.J., A.S.); and Stroke Program, Department of Neurology, University of Alberta, Edmonton, Canada (A.S.). 2. From the Department of Medicine (A.K., G.P., I.N.P., N.A.T., R.A.M.) and Biostatistics, Epidemiology, and Biomathematics Research Core (S.R.D.), Weill Cornell Medicine-Qatar, Doha; Department of Neurology, Institute of Neurosciences, Hamad Medical Corporation, Doha, Qatar (N.A., S.K., Y.I., F.S., A.P., P.B., R.K., M.S., S.J., A.S.); and Stroke Program, Department of Neurology, University of Alberta, Edmonton, Canada (A.S.). ram2045@qatar-med.cornell.edu.
Abstract
BACKGROUND AND PURPOSE: Corneal confocal microscopy can identify corneal nerve damage in patients with peripheral and central neurodegeneration. However, the use of corneal confocal microscopy in patients presenting with acute ischemic stroke is unknown. METHODS: One hundred thirty patients (57 without diabetes mellitus [normal glucose tolerance], 32 with impaired glucose tolerance, and 41 with type 2 diabetes mellitus) admitted with acute ischemic stroke, and 28 age-matched healthy control participants underwent corneal confocal microscopy to quantify corneal nerve fiber density, corneal nerve branch density, and corneal nerve fiber length. RESULTS: There was a significant reduction in corneal nerve fiber density, corneal nerve branch density, and corneal nerve fiber length in stroke patients with normal glucose tolerance (P<0.001, P<0.001, P<0.001), impaired glucose tolerance (P=0.004, P<0.001, P=0.002), and type 2 diabetes mellitus (P<0.001, P<0.001, P<0.001) compared with controls. HbA1c and triglycerides correlated with corneal nerve fiber density (r=-0.187, P=0.03; r=-0.229 P=0.01), corneal nerve fiber length (r=-0.228, P=0.009; r=-0.285; P=0.001), and corneal nerve branch density (r=-0.187, P=0.033; r=-0.229, P=0.01). Multiple linear regression showed no independent associations between corneal nerve fiber density, corneal nerve branch density, and corneal nerve fiber length and relevant risk factors for stroke. CONCLUSIONS: Corneal confocal microscopy is a rapid noninvasive ophthalmic imaging technique that identifies corneal nerve fiber loss in patients with acute ischemic stroke.
BACKGROUND AND PURPOSE: Corneal confocal microscopy can identify corneal nerve damage in patients with peripheral and central neurodegeneration. However, the use of corneal confocal microscopy in patients presenting with acute ischemic stroke is unknown. METHODS: One hundred thirty patients (57 without diabetes mellitus [normal glucose tolerance], 32 with impaired glucose tolerance, and 41 with type 2 diabetes mellitus) admitted with acute ischemic stroke, and 28 age-matched healthy control participants underwent corneal confocal microscopy to quantify corneal nerve fiber density, corneal nerve branch density, and corneal nerve fiber length. RESULTS: There was a significant reduction in corneal nerve fiber density, corneal nerve branch density, and corneal nerve fiber length in strokepatients with normal glucose tolerance (P<0.001, P<0.001, P<0.001), impaired glucose tolerance (P=0.004, P<0.001, P=0.002), and type 2 diabetes mellitus (P<0.001, P<0.001, P<0.001) compared with controls. HbA1c and triglycerides correlated with corneal nerve fiber density (r=-0.187, P=0.03; r=-0.229 P=0.01), corneal nerve fiber length (r=-0.228, P=0.009; r=-0.285; P=0.001), and corneal nerve branch density (r=-0.187, P=0.033; r=-0.229, P=0.01). Multiple linear regression showed no independent associations between corneal nerve fiber density, corneal nerve branch density, and corneal nerve fiber length and relevant risk factors for stroke. CONCLUSIONS: Corneal confocal microscopy is a rapid noninvasive ophthalmic imaging technique that identifies corneal nerve fiber loss in patients with acute ischemic stroke.
Authors: Xin Chen; Jim Graham; Ioannis N Petropoulos; Georgios Ponirakis; Omar Asghar; Uazman Alam; Andrew Marshall; Maryam Ferdousi; Shazli Azmi; Nathan Efron; Rayaz A Malik Journal: Invest Ophthalmol Vis Sci Date: 2018-02-01 Impact factor: 4.799
Authors: Hoda Gad; Adnan Khan; Naveed Akhtar; Saadat Kamran; Ahmed El-Sotouhy; Soha R Dargham; Ioannis N Petropoulos; Georgios Ponirakis; Ashfaq Shuaib; Leopold J Streletz; Rayaz A Malik Journal: PLoS One Date: 2019-03-15 Impact factor: 3.240
Authors: Adnan Khan; Ajay Menon; Naveed Akhtar; Saadat Kamran; Ahmad Muhammad; Georgios Ponirakis; Hoda Gad; Ioannis N Petropoulos; Faisal Wadiwala; Blessy Babu; Adeeb M Narangoli; Pablo G Bermejo; Hanadi Al Hamad; Marwan Ramadan; Peter Woodruff; Mark Santos; Maher Saqqur; Ashfaq Shuaib; Rayaz A Malik Journal: Sci Rep Date: 2021-10-05 Impact factor: 4.379