Natural History of Corneal Nerve Morphology in Mild Neuropathy Associated With Type 1 Diabetes: Development of a Potential Measure of Diabetic Peripheral Neuropathy

Abstract

This study demonstrates dynamic small fiber damage at the SNP, thus providing justification for our ongoing efforts to establish corneal nerve morphology as an appropriate adjunct to conventional measures of diabetic peripheral neuropathy.

Ocular Biomarkers of Alzheimer's Disease: The Role of Anterior Eye and Potential Future Directions

“…68 Interestingly, by using this technique longitudinally, CCM had the capability for predicting future incident diabetic neuropathy 69 and tracking progressive corneal axonal degeneration in patients with neuropathy. 70 By demonstrating the corneal nerve alterations, CCM also has been able to reveal chemotherapy-induced peripheral neuropathy. 71,72 Microstructural assessment of the SNP also has shown promise for some central nervous system (CNS) diseases.…”

Distal Sensorimotor Neuropathy: Improvements in Diagnosis

“…Upcoming studies are demonstrating progression of SFN to higher degrees of neuropathy in diabetes, but evidence from more longitudinal studies is required to draw definite conclusions [35][36].…”

A fully automatic nerve segmentation and morphometric parameter quantification system for early diagnosis of diabetic neuropathy in corneal images

“…Morphological alterations in the epithelium, stroma and endothelium provide insights into a variety of corneal diseases [3,4] and assessment of the effects of wearing contact lenses [1], LASIK or PRK [5], fungal keratitis [6], corneal transplantation [7] or conditions such as keratoconus [8,9]. CCM has also been used in the assessment of peripheral neuropathies [10,11,12,13,14,15,16,17,18,19]. The development of automated imaging algorithms for the processing of CCM images [20,21,22,23] is a necessary accompaniment to such work.…”

“…Diabetes is the main cause of neuropathy complications and in the present work patients with a known history of cancer, chemotherapy, alcoholism, celiac disease or a deficiency of vitamin B12 or folate, abnormality in ANA or immunoglobulins were excluded to remove other causes of peripheral neuropathy from the input data. Diabetes can result in nerve disorders and nerve damage that affect various parts of the human body, such as the digestive tract and the cardiovascular system [15,17]. Quantifying corneal nerve morphology has been shown to have promise as an imaging biomarker for early diagnosis of subclinical diabetic neuropathy [11,12,17,18] and to have value in predicting those who develop clinical neuropathy [16,24] and response to therapy [25].…”