Natural history of corneal nerve morphology in mild neuropathy associated with type 1 diabetes: development of a potential measure of diabetic peripheral neuropathy

Dehghani, Cirous, Pritchard, Nicola, Edwards, Katie, Vagenas, Dimitrios, Russell, Anthony W., Malik, Rayaz A. and Efron, Nathan (2014) Natural history of corneal nerve morphology in mild neuropathy associated with type 1 diabetes: development of a potential measure of diabetic peripheral neuropathy. Investigative Ophthalmology and Visual Science, 55 12: 7982-7990. doi:10.1167/iovs.14-15605

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Author Dehghani, Cirous
Pritchard, Nicola
Edwards, Katie
Vagenas, Dimitrios
Russell, Anthony W.
Malik, Rayaz A.
Efron, Nathan
Title Natural history of corneal nerve morphology in mild neuropathy associated with type 1 diabetes: development of a potential measure of diabetic peripheral neuropathy
Journal name Investigative Ophthalmology and Visual Science   Check publisher's open access policy
ISSN 1552-5783
0146-0404
Publication date 2014-12-10
Year available 2014
Sub-type Article (original research)
DOI 10.1167/iovs.14-15605
Open Access Status File (Publisher version)
Volume 55
Issue 12
Start page 7982
End page 7990
Total pages 9
Place of publication Rockville, MD, United States
Publisher Association for Research in Vision and Ophthalmology
Collection year 2015
Language eng
Formatted abstract
Purpose. To investigate longitudinal changes of subbasal nerve plexus (SNP) morphology and its relationship with conventional measures of neuropathy in individuals with diabetes.

Methods. A cohort of 147 individuals with type 1 diabetes and 60 age-balanced controls underwent detailed assessment of clinical and metabolic factors, neurologic deficits, quantitative sensory testing, nerve conduction studies, and corneal confocal microscopy at baseline and four subsequent annual visits. The SNP parameters included corneal nerve fiber density (CNFD), branch density (CNBD), and fiber length (CNFL), and were quantified using a fully automated algorithm. Linear mixed models were fitted to examine the changes in corneal nerve parameters over time.

Results. At baseline, 27% of the participants had mild diabetic neuropathy. All SNP parameters were significantly lower in the neuropathy group compared with controls (P < 0.05). Overall, 89% of participants examined at baseline also completed the final visit. There was no clinically significant change to health and metabolic parameters and neuropathy measures from baseline to the final visit. Linear mixed model revealed a significant linear decline of CNFD (annual change rate, −0.9 nerve/mm2, P = 0.01) in the neuropathy group compared with controls, which was associated with age (β = −0.06, P = 0.04) and duration of diabetes (β = −0.08, P = 0.03). In the neuropathy group, absolute changes of CNBD and CNFL showed moderate correlations with peroneal conduction velocity and cold sensation threshold, respectively (r, 0.38 and 0.40, P < 0.05).

Conclusions. This study demonstrates dynamic small fiber damage at the SNP, thus providing justification for our ongoing efforts to establish corneal nerve morphology as an appropriate adjunct to conventional measures of diabetic peripheral neuropathy.
Keyword Corneal confocal microscopy
Diabetes
Natural history
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Medicine Publications
 
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