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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

Corneal nerve fractal dimension: a novel corneal nerve metric for the diagnosis of diabetic sensorimotor polyneuropathy Thumbnail


Authors

XIN CHEN XIN.CHEN@NOTTINGHAM.AC.UK
Associate Professor

Jim Graham

Ioannis N. Petropoulos

Georgios Ponirakis

Omar Asghar

Uazman Alam



Abstract

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.

Citation

Chen, X., Graham, J., Petropoulos, I. N., Ponirakis, G., Asghar, O., & Alam, U. (2018). Corneal nerve fractal dimension: a novel corneal nerve metric for the diagnosis of diabetic sensorimotor polyneuropathy. Investigative Ophthalmology & Visual Science, 59(2), https://doi.org/10.1167/iovs.17-23342

Journal Article Type Article
Acceptance Date Jan 21, 2018
Publication Date Feb 28, 2018
Deposit Date Mar 27, 2018
Publicly Available Date Mar 28, 2024
Journal Investigative Opthalmology & Visual Science
Print ISSN 0146-0404
Electronic ISSN 1552-5783
Publisher Association for Research in Vision and Ophthalmology
Peer Reviewed Peer Reviewed
Volume 59
Issue 2
DOI https://doi.org/10.1167/iovs.17-23342
Public URL https://nottingham-repository.worktribe.com/output/916939
Publisher URL http://iovs.arvojournals.org/article.aspx?articleid=2673889

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