Small nerve fibre quantification in the diagnosis of diabetic sensorimotor polyneuropathy: comparing corneal confocal microscopy with intraepidermal nerve fibre density
OBJECTIVE: Quantitative assessment of small fiber damage is key to the early diagnosis and assessment of progression or regression of diabetic sensorimotor polyneuropathy (DSPN). Intraepidermal nerve fiber density (IENFD) is the current gold standard, but corneal confocal microscopy (CCM), an in viv...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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American Diabetes Association
2015
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| Online Access: | https://eprints.nottingham.ac.uk/45033/ |
| _version_ | 1848797053485842432 |
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| author | Chen, Xin Graham, Jim Dabbah, Mohammad Petropoulos, Ioannis N. Ponirakis, Georgis Asghar, Omar Alam, Uazman Marshall, Andrew Fadavi, Hassan Ferdousi, Maryam Azmir, Shazli Tavakoli, Mitra Efron, Nathan Jeziorska, Maria Malik, Rayaz |
| author_facet | Chen, Xin Graham, Jim Dabbah, Mohammad Petropoulos, Ioannis N. Ponirakis, Georgis Asghar, Omar Alam, Uazman Marshall, Andrew Fadavi, Hassan Ferdousi, Maryam Azmir, Shazli Tavakoli, Mitra Efron, Nathan Jeziorska, Maria Malik, Rayaz |
| author_sort | Chen, Xin |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | OBJECTIVE: Quantitative assessment of small fiber damage is key to the early diagnosis and assessment of progression or regression of diabetic sensorimotor polyneuropathy (DSPN). Intraepidermal nerve fiber density (IENFD) is the current gold standard, but corneal confocal microscopy (CCM), an in vivo ophthalmic imaging modality, has the potential to be a noninvasive and objective image biomarker for identifying small fiber damage. The purpose of this study was to determine the diagnostic performance of CCM and IENFD by using the current guidelines as the reference standard.
RESEARCH DESIGN AND METHODS: Eighty-nine subjects (26 control subjects and 63 patients with type 1 diabetes), with and without DSPN, underwent a detailed assessment of neuropathy, including CCM and skin biopsy.
RESULTS: Manual and automated corneal nerve fiber density (CNFD) (P < 0.0001), branch density (CNBD) (P < 0.0001) and length (CNFL) (P < 0.0001), and IENFD (P < 0.001) were significantly reduced in patients with diabetes with DSPN compared with control subjects. The area under the receiver operating characteristic curve for identifying DSPN was 0.82 for manual CNFD, 0.80 for automated CNFD, and 0.66 for IENFD, which did not differ significantly (P = 0.14).
CONCLUSIONS: This study shows comparable diagnostic efficiency between CCM and IENFD, providing further support for the clinical utility of CCM as a surrogate end point for DSPN. |
| first_indexed | 2025-11-14T19:57:46Z |
| format | Article |
| id | nottingham-45033 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T19:57:46Z |
| publishDate | 2015 |
| publisher | American Diabetes Association |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-450332017-10-18T18:06:31Z https://eprints.nottingham.ac.uk/45033/ Small nerve fibre quantification in the diagnosis of diabetic sensorimotor polyneuropathy: comparing corneal confocal microscopy with intraepidermal nerve fibre density Chen, Xin Graham, Jim Dabbah, Mohammad Petropoulos, Ioannis N. Ponirakis, Georgis Asghar, Omar Alam, Uazman Marshall, Andrew Fadavi, Hassan Ferdousi, Maryam Azmir, Shazli Tavakoli, Mitra Efron, Nathan Jeziorska, Maria Malik, Rayaz OBJECTIVE: Quantitative assessment of small fiber damage is key to the early diagnosis and assessment of progression or regression of diabetic sensorimotor polyneuropathy (DSPN). Intraepidermal nerve fiber density (IENFD) is the current gold standard, but corneal confocal microscopy (CCM), an in vivo ophthalmic imaging modality, has the potential to be a noninvasive and objective image biomarker for identifying small fiber damage. The purpose of this study was to determine the diagnostic performance of CCM and IENFD by using the current guidelines as the reference standard. RESEARCH DESIGN AND METHODS: Eighty-nine subjects (26 control subjects and 63 patients with type 1 diabetes), with and without DSPN, underwent a detailed assessment of neuropathy, including CCM and skin biopsy. RESULTS: Manual and automated corneal nerve fiber density (CNFD) (P < 0.0001), branch density (CNBD) (P < 0.0001) and length (CNFL) (P < 0.0001), and IENFD (P < 0.001) were significantly reduced in patients with diabetes with DSPN compared with control subjects. The area under the receiver operating characteristic curve for identifying DSPN was 0.82 for manual CNFD, 0.80 for automated CNFD, and 0.66 for IENFD, which did not differ significantly (P = 0.14). CONCLUSIONS: This study shows comparable diagnostic efficiency between CCM and IENFD, providing further support for the clinical utility of CCM as a surrogate end point for DSPN. American Diabetes Association 2015-06-05 Article PeerReviewed application/pdf en https://eprints.nottingham.ac.uk/45033/1/XChenDiabetes.pdf Chen, Xin, Graham, Jim, Dabbah, Mohammad, Petropoulos, Ioannis N., Ponirakis, Georgis, Asghar, Omar, Alam, Uazman, Marshall, Andrew, Fadavi, Hassan, Ferdousi, Maryam, Azmir, Shazli, Tavakoli, Mitra, Efron, Nathan, Jeziorska, Maria and Malik, Rayaz (2015) Small nerve fibre quantification in the diagnosis of diabetic sensorimotor polyneuropathy: comparing corneal confocal microscopy with intraepidermal nerve fibre density. Diabetes Care, 38 (6). pp. 1138-1144. ISSN 1935-5548 http://care.diabetesjournals.org/content/38/6/1138 doi:10.2337%2Fdc14-2422 doi:10.2337%2Fdc14-2422 |
| spellingShingle | Chen, Xin Graham, Jim Dabbah, Mohammad Petropoulos, Ioannis N. Ponirakis, Georgis Asghar, Omar Alam, Uazman Marshall, Andrew Fadavi, Hassan Ferdousi, Maryam Azmir, Shazli Tavakoli, Mitra Efron, Nathan Jeziorska, Maria Malik, Rayaz Small nerve fibre quantification in the diagnosis of diabetic sensorimotor polyneuropathy: comparing corneal confocal microscopy with intraepidermal nerve fibre density |
| title | Small nerve fibre quantification in the diagnosis of diabetic sensorimotor polyneuropathy: comparing corneal confocal microscopy with intraepidermal nerve fibre density |
| title_full | Small nerve fibre quantification in the diagnosis of diabetic sensorimotor polyneuropathy: comparing corneal confocal microscopy with intraepidermal nerve fibre density |
| title_fullStr | Small nerve fibre quantification in the diagnosis of diabetic sensorimotor polyneuropathy: comparing corneal confocal microscopy with intraepidermal nerve fibre density |
| title_full_unstemmed | Small nerve fibre quantification in the diagnosis of diabetic sensorimotor polyneuropathy: comparing corneal confocal microscopy with intraepidermal nerve fibre density |
| title_short | Small nerve fibre quantification in the diagnosis of diabetic sensorimotor polyneuropathy: comparing corneal confocal microscopy with intraepidermal nerve fibre density |
| title_sort | small nerve fibre quantification in the diagnosis of diabetic sensorimotor polyneuropathy: comparing corneal confocal microscopy with intraepidermal nerve fibre density |
| url | https://eprints.nottingham.ac.uk/45033/ https://eprints.nottingham.ac.uk/45033/ https://eprints.nottingham.ac.uk/45033/ |