Utility of assessing nerve morphology in central cornea versus whorl area for diagnosing diabetic peripheral neuropathy

Pritchard, Nicola, Dehghani, Cirous, Edwards, Katie, Burgin, Edward, Cheang, Nick, Kim, Hannah, Mikhaiel, Merna, Stanton, Gemma, Russell, Anthony W, Malik, Rayaz A and Efron, Nathan (2015) Utility of assessing nerve morphology in central cornea versus whorl area for diagnosing diabetic peripheral neuropathy. Cornea, 34 7: 756-761. doi:10.1097/ICO.0000000000000447


Author Pritchard, Nicola
Dehghani, Cirous
Edwards, Katie
Burgin, Edward
Cheang, Nick
Kim, Hannah
Mikhaiel, Merna
Stanton, Gemma
Russell, Anthony W
Malik, Rayaz A
Efron, Nathan
Title Utility of assessing nerve morphology in central cornea versus whorl area for diagnosing diabetic peripheral neuropathy
Journal name Cornea   Check publisher's open access policy
ISSN 1536-4798
0277-3740
Publication date 2015-07
Year available 2015
Sub-type Article (original research)
DOI 10.1097/ICO.0000000000000447
Volume 34
Issue 7
Start page 756
End page 761
Total pages 6
Place of publication Philadelphia, United States
Publisher Lippincott Williams and Wilkins
Language eng
Subject 2731 Ophthalmology
Formatted abstract
Purpose: To compare small nerve fiber damage in the central cornea and whorl area in participants with diabetic peripheral neuropathy (DPN) and to examine the accuracy of evaluating these 2 anatomical sites for the diagnosis of DPN.

Methods: A cohort of 187 participants (107 with type 1 diabetes and 80 controls) was enrolled. The neuropathy disability score (NDS) was used for the identification of DPN. The corneal nerve fiber length at the central cornea (CNFLcenter) and whorl (CNFLwhorl) was quantified using corneal confocal microscopy and a fully automated morphometric technique and compared according to the DPN status. Receiver operating characteristic analyses were used to compare the accuracy of the 2 corneal locations for the diagnosis of DPN.

Results: CNFLcenter and CNFLwhorl were able to differentiate all 3 groups (diabetic participants with and without DPN and controls) (P < 0.001). There was a weak but significant linear relationship for CNFLcenter and CNFLwhorl versus NDS (P < 0.001); however, the corneal location × NDS interaction was not statistically significant (P = 0.17). The area under the receiver operating characteristic curve was similar for CNFLcenter and CNFLwhorl (0.76 and 0.77, respectively, P = 0.98). The sensitivity and specificity of the cutoff points were 0.9 and 0.5 for CNFLcenter and 0.8 and 0.6 for CNFLwhorl.

Conclusions: Small nerve fiber pathology is comparable at the central and whorl anatomical sites of the cornea. Quantification of CNFL from the corneal center is as accurate as CNFL quantification of the whorl area for the diagnosis of DPN.
Keyword corneal confocal microscopy
corneal subbasal nerve plexus
diabetic peripheral neuropathy
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Medicine Publications
 
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