Corneal nerve fractal dimension: a novel corneal nerve metric for the diagnosis of diabetic sensorimotor polyneuropathy
Objective: Corneal confocal microscopy (CCM), an in vivo ophthalmic imaging modality, is a noninvasive and objective imaging biomarker for identifying small nerve fiber damage. We have evaluated the diagnostic performance of previously established CCM parameters to a novel automated measure of corne...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Association for Research in Vision and Opthalmology
2018
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| Online Access: | https://eprints.nottingham.ac.uk/50722/ |
| _version_ | 1848798324010778624 |
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| author | Chen, Xin Graham, Jim Petropoulos, Ioannis N. Ponirakis, Georgios Asghar, Omar Alam, Uazman Marshall, Andrew Ferdousi, Maryam Azmi, Shazli Efron, Nathan Malik, Rayaz A. |
| author_facet | Chen, Xin Graham, Jim Petropoulos, Ioannis N. Ponirakis, Georgios Asghar, Omar Alam, Uazman Marshall, Andrew Ferdousi, Maryam Azmi, Shazli Efron, Nathan Malik, Rayaz A. |
| author_sort | Chen, Xin |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Objective: Corneal confocal microscopy (CCM), an in vivo ophthalmic imaging modality, is a noninvasive and objective imaging biomarker for identifying small nerve fiber damage. We have evaluated the diagnostic performance of previously established CCM parameters to a novel automated measure of corneal nerve complexity called the corneal nerve fiber fractal dimension (ACNFrD).
Methods: A total of 176 subjects (84 controls and 92 patients with type 1 diabetes) with and without diabetic sensorimotor polyneuropathy (DSPN) underwent CCM. Fractal dimension analysis was performed on CCM images using purpose-built corneal nerve analysis software, and compared with previously established manual and automated corneal nerve fiber measurements.
Results: Manual and automated subbasal corneal nerve fiber density (CNFD) (P < 0.0001), length (CNFL) (P < 0.0001), branch density (CNBD) (P < 0.05), and ACNFrD (P < 0.0001) were significantly reduced in patients with DSPN compared to patients without DSPN. The areas under the receiver operating characteristic curves for identifying DSPN were comparable: 0.77 for automated CNFD, 0.74 for automated CNFL, 0.69 for automated CNBD, and 0.74 for automated ACNFrD.
Conclusions: ACNFrD shows comparable diagnostic efficiency to identify diabetic patients with and without DSPN. |
| first_indexed | 2025-11-14T20:17:57Z |
| format | Article |
| id | nottingham-50722 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T20:17:57Z |
| publishDate | 2018 |
| publisher | Association for Research in Vision and Opthalmology |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-507222018-03-28T12:25:22Z https://eprints.nottingham.ac.uk/50722/ Corneal nerve fractal dimension: a novel corneal nerve metric for the diagnosis of diabetic sensorimotor polyneuropathy Chen, Xin Graham, Jim Petropoulos, Ioannis N. Ponirakis, Georgios Asghar, Omar Alam, Uazman Marshall, Andrew Ferdousi, Maryam Azmi, Shazli Efron, Nathan Malik, Rayaz A. Objective: Corneal confocal microscopy (CCM), an in vivo ophthalmic imaging modality, is a noninvasive and objective imaging biomarker for identifying small nerve fiber damage. We have evaluated the diagnostic performance of previously established CCM parameters to a novel automated measure of corneal nerve complexity called the corneal nerve fiber fractal dimension (ACNFrD). Methods: A total of 176 subjects (84 controls and 92 patients with type 1 diabetes) with and without diabetic sensorimotor polyneuropathy (DSPN) underwent CCM. Fractal dimension analysis was performed on CCM images using purpose-built corneal nerve analysis software, and compared with previously established manual and automated corneal nerve fiber measurements. Results: Manual and automated subbasal corneal nerve fiber density (CNFD) (P < 0.0001), length (CNFL) (P < 0.0001), branch density (CNBD) (P < 0.05), and ACNFrD (P < 0.0001) were significantly reduced in patients with DSPN compared to patients without DSPN. The areas under the receiver operating characteristic curves for identifying DSPN were comparable: 0.77 for automated CNFD, 0.74 for automated CNFL, 0.69 for automated CNBD, and 0.74 for automated ACNFrD. Conclusions: ACNFrD shows comparable diagnostic efficiency to identify diabetic patients with and without DSPN. Association for Research in Vision and Opthalmology 2018-02-28 Article PeerReviewed application/pdf en cc_by_nc_nd https://eprints.nottingham.ac.uk/50722/1/i1552-5783-59-2-1113.pdf Chen, Xin, Graham, Jim, Petropoulos, Ioannis N., Ponirakis, Georgios, Asghar, Omar, Alam, Uazman, Marshall, Andrew, Ferdousi, Maryam, Azmi, Shazli, Efron, Nathan and Malik, Rayaz A. (2018) Corneal nerve fractal dimension: a novel corneal nerve metric for the diagnosis of diabetic sensorimotor polyneuropathy. Investigative Opthalmology & Visual Science, 59 (2). pp. 1113-1118. ISSN 1552-5783 http://iovs.arvojournals.org/article.aspx?articleid=2673889 doi:10.1167/iovs.17-23342 doi:10.1167/iovs.17-23342 |
| spellingShingle | Chen, Xin Graham, Jim Petropoulos, Ioannis N. Ponirakis, Georgios Asghar, Omar Alam, Uazman Marshall, Andrew Ferdousi, Maryam Azmi, Shazli Efron, Nathan Malik, Rayaz A. Corneal nerve fractal dimension: a novel corneal nerve metric for the diagnosis of diabetic sensorimotor polyneuropathy |
| title | Corneal nerve fractal dimension: a novel corneal nerve metric for the diagnosis of diabetic sensorimotor polyneuropathy |
| title_full | Corneal nerve fractal dimension: a novel corneal nerve metric for the diagnosis of diabetic sensorimotor polyneuropathy |
| title_fullStr | Corneal nerve fractal dimension: a novel corneal nerve metric for the diagnosis of diabetic sensorimotor polyneuropathy |
| title_full_unstemmed | Corneal nerve fractal dimension: a novel corneal nerve metric for the diagnosis of diabetic sensorimotor polyneuropathy |
| title_short | Corneal nerve fractal dimension: a novel corneal nerve metric for the diagnosis of diabetic sensorimotor polyneuropathy |
| title_sort | corneal nerve fractal dimension: a novel corneal nerve metric for the diagnosis of diabetic sensorimotor polyneuropathy |
| url | https://eprints.nottingham.ac.uk/50722/ https://eprints.nottingham.ac.uk/50722/ https://eprints.nottingham.ac.uk/50722/ |