XIN CHEN XIN.CHEN@NOTTINGHAM.AC.UK
Associate Professor
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; Azmi, Shazli; Tavakoli, Mitra; Efron, Nathan; Jeziorska, Maria; Malik, Rayaz A.
Authors
Jim Graham
Mohammad Dabbah
Ioannis N. Petropoulos
Georgis Ponirakis
Omar Asghar
Uazman Alam
Andrew Marshall
Hassan Fadavi
Maryam Ferdousi
Shazli Azmi
Mitra Tavakoli
Nathan Efron
Maria Jeziorska
Rayaz A. Malik
Abstract
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.
Citation
Chen, X., Graham, J., Dabbah, M., Petropoulos, I. N., Ponirakis, G., Asghar, O., …Malik, R. A. (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), 1138-1144. https://doi.org/10.2337/dc14-2422
Journal Article Type | Article |
---|---|
Acceptance Date | Feb 26, 2015 |
Publication Date | Jun 5, 2015 |
Deposit Date | Aug 31, 2017 |
Publicly Available Date | Aug 31, 2017 |
Journal | Diabetes Care |
Print ISSN | 0149-5992 |
Electronic ISSN | 1935-5548 |
Publisher | American Diabetes Association |
Peer Reviewed | Peer Reviewed |
Volume | 38 |
Issue | 6 |
Pages | 1138-1144 |
DOI | https://doi.org/10.2337/dc14-2422 |
Public URL | https://nottingham-repository.worktribe.com/output/755076 |
Publisher URL | http://care.diabetesjournals.org/content/38/6/1138 |
Files
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(798 Kb)
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