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Hatim Ismail Batawi, Nabeel Shalabi, Madhura Joag, Tulay Koru-Sengul, Jorge Rodriguez, Parke Green, Mauro Campigotto, Carol Karp, Anat Galor; Confocal microscopy for the analysis of the sub-basal corneal nerve plexus alternations in elderly and diabetic patients using a new software technology.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1919. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To study corneal sub-basal nerve plexus parameters by in-vivo corneal confocal microscopy using a new software technology and examine the effect of demographics and diabetes mellitus on corneal nerve morphology.
A Confoscan4 (Nidek Technologies Srl, Padova, Italy) was used to image the corneal sub-basal nerve plexus in 60 right eyes. Images were analyzed using a new semi-automated nerve analysis software program (The Corneal Nerve Analysis tool) which evaluated 9 factors including nerve fibers length (NFL), nerve fibers length density (NFLD), number of fibers, number of branches, number of bifurcations, number of trunks, number of beadings, beading density and nerve tortuosity. The main outcome measure was the examination of sub-basal corneal nerve plexus morphology by demographic factors and co-morbidities.
Inter- and intra- operator reproducibility was good for the 9 parameters studied (Intraclass Correlations 0.73 to 0.97). Image variability between two images within the same scan was good for all parameters (ICC 0.66 to 0.80). Overall, older individuals had lower nerve densities with several confocal parameters negatively correlating with age (NFL, NFLD, number of fibers and trunks, and number of beadings), (r= -0.37 to -0.52, p<0.05 for all). In a similar manner, diabetic patients also had lower nerve densities than non-diabetes with noted differences in NFL, NFLD, number of fibers and trunks and number of beadings (p<0.05 for all). On the other hand, diabetics had more tortuous nerves than their non-diabetic counterparts (p=0.03).
The Corneal Nerve Analysis tool is a reproducible diagnostic technique for analysis of the sub-basal corneal nerve plexus. Older age and diabetes mellitus are associated with a significant reduction in several sub-basal corneal nerve plexus parameters.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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