Shyam Sunder Tummanapalli1, Tushar Issar2, Natalie Kwai2, Ann Poynten3, Arun V Krishnan2, Mark Willcox4, Maria Markoulli4. 1. School of Optometry & Vision Science, University of New South Wales, Australia. Electronic address: s.tummanapalli@unsw.edu.au. 2. Prince of Wales Clinical School, University of New South Wales, Australia. 3. Department of Endocrinology, Prince of Wales Hospital, Australia. 4. School of Optometry & Vision Science, University of New South Wales, Australia.
Abstract
OBJECTIVE: Corneal confocal microscopy (CCM) has been identified as a non-invasive technique to assess corneal nerve fiber morphology. It is not known how corneal nerve changes relate to measures of peripheral nerve function in diabetic peripheral neuropathy (DPN). The present study investigates the relationship between nerve structure and function in DPN. METHODS: Fifty participants with type 1 diabetes (T1DM) and 29 healthy controls underwent CCM to assess corneal nerve fiber density (CNFD), branch density (CNBD), fiber length (CNFL), total branch density (CTBD), nerve fractal dimension (CNFrD) and inferior whorl length (IWL). The severity of DPN was assessed as Total Neuropathy Score (TNS). Motor nerve axonal excitability tests were conducted to assess axonal function. RESULTS: Significant correlations were noted between CNFD (rho = -0.783; P < 0.01) or superexcitability (rho = 0.435; P < 0.01) and TNS. CNFrD was significantly correlated with peak response to stimulus (r = 0.414; P < 0.01) and superexcitability (r = -0.467; P < 0.01) measurements. CONCLUSION: Corneal nerve loss demonstrates a significant association with axonal ion channel dysfunction in T1DM. SIGNIFICANCE: Detection of altered corneal nerve morphology may lead to the earlier diagnosis of DPN.
OBJECTIVE: Corneal confocal microscopy (CCM) has been identified as a non-invasive technique to assess corneal nerve fiber morphology. It is not known how corneal nerve changes relate to measures of peripheral nerve function in diabetic peripheral neuropathy (DPN). The present study investigates the relationship between nerve structure and function in DPN. METHODS: Fifty participants with type 1 diabetes (T1DM) and 29 healthy controls underwent CCM to assess corneal nerve fiber density (CNFD), branch density (CNBD), fiber length (CNFL), total branch density (CTBD), nerve fractal dimension (CNFrD) and inferior whorl length (IWL). The severity of DPN was assessed as Total Neuropathy Score (TNS). Motor nerve axonal excitability tests were conducted to assess axonal function. RESULTS: Significant correlations were noted between CNFD (rho = -0.783; P < 0.01) or superexcitability (rho = 0.435; P < 0.01) and TNS. CNFrD was significantly correlated with peak response to stimulus (r = 0.414; P < 0.01) and superexcitability (r = -0.467; P < 0.01) measurements. CONCLUSION:Corneal nerve loss demonstrates a significant association with axonal ion channel dysfunction in T1DM. SIGNIFICANCE: Detection of altered corneal nerve morphology may lead to the earlier diagnosis of DPN.
Authors: Irene Abicca; Daniela Giannini; Marta Gilardi; Anna Maria Roszkowska; Mariacristina Parravano; Fabiana Picconi; Simona Frontoni; Domenico Schiano-Lomoriello Journal: Front Med (Lausanne) Date: 2022-05-12
Authors: Osama Alsheikh; Sultan Alzaaidi; Jose M Vargas; Eman Al-Sharif; Mohammed Alrajeh; Mohammad A AlSemari; Abdulrahman Alhommadi; Anoud Alsaati; Nouf Aljwaiser; Eman Alshahwan; Mona Abdulhafiz; Rashad Elsayed; Wolfgang G K Müller-Lierheim Journal: Saudi J Ophthalmol Date: 2022-06-13