期刊
INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE
卷 59, 期 2, 页码 1113-1118出版社
ASSOC RESEARCH VISION OPHTHALMOLOGY INC
DOI: 10.1167/iovs.17-23342
关键词
corneal confocal microscopy; diabetic neuropathy; image segmentation; nerve fiber quantification
资金
- Manchester Comprehensive Local Research Network
- National Institute for Health Research/Wellcome Trust Clinical Research Facility in Manchester, National Institutes of Health [R105991]
- Juvenile Diabetes Research Foundation International [27-2008-362]
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.
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