The Inferior Whorl For Detecting Diabetic Peripheral Neuropathy Using Corneal Confocal Microscopy

Investigative Ophthalmology & Visual Science
Ioannis N PetropoulosR A Malik

Abstract

In vivo corneal confocal microscopy (CCM) is increasingly used as a surrogate endpoint in studies of diabetic polyneuropathy (DPN). However, it is not clear whether imaging the central cornea provides optimal diagnostic utility for DPN. Therefore, we compared nerve morphology in the central cornea and the inferior whorl, a more distal and densely innervated area located inferior and nasal to the central cornea. A total of 53 subjects with type 1/type 2 diabetes and 15 age-matched control subjects underwent detailed assessment of neuropathic symptoms (NPS), deficits (neuropathy disability score [NDS]), quantitative sensory testing (vibration perception threshold [VPT], cold and warm threshold [CT/WT], and cold- and heat-induced pain [CIP/HIP]), and electrophysiology (sural and peroneal nerve conduction velocity [SSNCV/PMNCV], and sural and peroneal nerve amplitude [SSNA/PMNA]) to diagnose patients with (DPN+) and without (DPN-) neuropathy. Corneal nerve fiber density (CNFD) and length (CNFL) in the central cornea, and inferior whorl length (IWL) were quantified. Comparing control subjects to DPN- and DPN+ patients, there was a significant increase in NDS (0 vs. 2.6 ± 2.3 vs. 3.3 ± 2.7, P < 0.01), VPT (V; 5.4 ± 3.0 vs. 10.6 ± 10....Continue Reading

Citations

Sep 17, 2016·Journal of Neuropathology and Experimental Neurology·Matthew S YorekMark A Yorek
Oct 25, 2016·The Ocular Surface·Andrea CruzatPedram Hamrah
Sep 27, 2018·Endocrine Reviews·Gidon J BönhofDan Ziegler
Sep 12, 2019·Current Eye Research·Shyam Sunder TummanapalliMaria Markoulli
Apr 17, 2020·Diabetic Medicine : a Journal of the British Diabetic Association·T IssarA V Krishnan
May 23, 2020·Eye & Contact Lens·Whitney L StuardDanielle M Robertson
Aug 4, 2020·Journal of Diabetes Investigation·Meijian WangXinguo Hou
Mar 6, 2019·Clinical & Experimental Optometry : Journal of the Australian Optometrical Association·Ioannis N PetropoulosRayaz A Malik
Apr 2, 2020·Investigative Ophthalmology & Visual Science·Maryam FerdousiRayaz A Malik
Mar 21, 2017·Nutrition & Diabetes·K Co ShihL Tong
Aug 24, 2018·Diabetes & Metabolism Journal·Ioannis N PetropoulosRayaz A Malik
Dec 4, 2019·Investigative Ophthalmology & Visual Science·Carl MarfurtJoseph L Mankowski
Jun 4, 2020·Journal of Diabetes Investigation·Hoda GadRayaz A Malik
Jul 19, 2019·Frontiers in Endocrinology·Margarida BarbosaDavide M Carvalho
Sep 17, 2020·Translational Vision Science & Technology·Ioannis N PetropoulosRayaz A Malik
Jul 3, 2020·Translational Neurodegeneration·Ning-Ning Che, Hong-Qi Yang
Nov 6, 2020·Investigative Ophthalmology & Visual Science·Matthew T McPheetersMichael W Jenkins
Dec 10, 2020·Journal of Clinical Medicine·Hassan MansoorYu-Chi Liu
Mar 9, 2021·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·Tushar IssarArun V Krishnan
Apr 13, 2021·Journal of Diabetes Science and Technology·Sanjeev SharmaGerry Rayman
May 10, 2021·Clinical Therapeutics·Ioannis N PetropoulosRayaz A Malik
Jun 15, 2021·Frontiers in Endocrinology·Josie CarmichaelMitra Tavakoli
Nov 27, 2019·The Ocular Surface·Shyam Sunder TummanapalliMaria Markoulli
Nov 6, 2021·Scientific Reports·Ioannis N PetropoulosRayaz A Malik

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