June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Confocal Microscopy of Corneal Nerves for Early Detection of Diabetic Neuropathy in Recently Diagnosed Type 2 Diabetic Patients
Author Affiliations & Notes
  • Andrey Zhivov
    Ophthalmology Department, University of Rostock, Rostock, Germany
  • Dan Ziegler
    Institute for Clinical Diabetology, German Diabetes Center at Heinrich Heine University, Düsseldorf, Germany
    Department of Metabolic Diseases, University Hospital, Heinrich Heine University, Düsseldorf, Germany
  • Sabine Peschel
    Ophthalmology Department, University of Rostock, Rostock, Germany
  • Stephan Allgeier
    Institute for Applied Computer Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
  • Karsten Winter
    Translational Centre for Regenerative Medicine (TRM), University of Leipzig, Leipzig, Germany
  • Bernd Koehler
    Institute for Applied Computer Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
  • Nikolaos Papanas
    Institute for Clinical Diabetology, German Diabetes Center at Heinrich Heine University, Düsseldorf, Germany
  • Oliver Stachs
    Ophthalmology Department, University of Rostock, Rostock, Germany
  • Michael Roden
    Institute for Clinical Diabetology, German Diabetes Center at Heinrich Heine University, Düsseldorf, Germany
    Department of Metabolic Diseases, University Hospital, Heinrich Heine University, Düsseldorf, Germany
  • Rudolf Guthoff
    Ophthalmology Department, University of Rostock, Rostock, Germany
  • Footnotes
    Commercial Relationships Andrey Zhivov, None; Dan Ziegler, None; Sabine Peschel, None; Stephan Allgeier, Heidelberg Engineering GmbH (F); Karsten Winter, None; Bernd Koehler, None; Nikolaos Papanas, None; Oliver Stachs, None; Michael Roden, None; Rudolf Guthoff, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 3577. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Andrey Zhivov, Dan Ziegler, Sabine Peschel, Stephan Allgeier, Karsten Winter, Bernd Koehler, Nikolaos Papanas, Oliver Stachs, Michael Roden, Rudolf Guthoff, ; Confocal Microscopy of Corneal Nerves for Early Detection of Diabetic Neuropathy in Recently Diagnosed Type 2 Diabetic Patients. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3577.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose: Detection of the earliest stage of diabetes at which neuropathy starts to develop is of major interest to prevent the feared sequelae of advanced neuropathy. In-vivo confocal laser scanning microscopy (CLSM) of the cornea enables nerve fiber quantification in the corneal sub-basal nerve plexus (SNP). The study was performed to determine whether SNP alterations may be detected in subjects with recently diagnosed type 2 diabetes in comparison to healthy volunteers.

Methods: 86 recently diagnosed (duration 2.1±1.8 yrs., Hba1c 6.8+/-1.1) diabetic patients aged 57.8 ± 9.1 yrs. and 48 healthy volunteers aged 53.7±13.4 yrs. were enrolled in an observer masked study. Both groups underwent in-vivo CLSM in the central cornea unilaterally and assessment of corneal sensation. In-house developed automated algorithms for image reconstruction and analysis were used to quantify the morphological quantities of SNP. Intraepidermal nerve fiber density (IENFD) was evaluated in skin specimens gained with 3-mm punch biopsy from the distal leg using PGP 9.5 antibody immunohistochemistry. Peripheral and autonomic nerve function was evaluated.

Results: CLSM parameters were reduced in the diabetic group as compared to the controls (nerve fiber density (p<0.001), number of branches (p=0.008), number of connecting points (p=0.005), and thickness of nerve fibers (p=0.032)). There was no difference in corneal sensation between diabetic patients and healthy volunteers. IENFD correlated with nerve fiber density of SNP (r=0.23; p=0.014) as well with the results of peripheral and autonomic nerve function tests. There was no correlation between SNP parameters and any nerve function tests.

Conclusions: This study demonstrated that corneal SNP parameters may be used as an early marker of small fiber neuropathy in recently diagnosed diabetes. The applied diagnostic technology has the potential to detect nerve damage at early stages of diabetes and to establish clinical end-user instrumentation for non-invasive diagnosis and follow-up.

Keywords: 479 cornea: clinical science • 550 imaging/image analysis: clinical • 498 diabetes  
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×