COMPUTER DENSITOMETRY OF RETINAL NERVE FIBRE ATROPHY

Diabetic peripheral neuropathy (DPN) is the most common complication of both type 1 and 2 diabetes. As a result, neuropathic pain, diabetic foot ulcers and lower-limb amputations impact drastically on quality of life, contributing to the individual, societal, financial and healthcare burden of diabetes. DPN is diagnosed at a late, often pre-ulcerative stage due to a lack of early systematic screening and the endorsement of monofilament testing which identifies advanced neuropathy only. Compared to the success of the diabetic eye and kidney screening programmes there is clearly an unmet need for an objective reliable biomarker for the detection of early DPN. This article critically appraises research and clinical methods for the diagnosis or screening of early DPN. In brief, functional measures are subjective and are difficult to implement due to technical complexity. Moreover, skin biopsy is invasive, expensive and lacks diagnostic laboratory capacity. Indeed, point-of-care nerve conduction tests are convenient and easy to implement however questions are raised regarding their suitability for use in screening due to the lack of small nerve fibre evaluation. Corneal confocal microscopy (CCM) is a rapid, non-invasive, and reproducible technique to quantify small nerve fibre damage and repair which can be conducted alongside retinopathy screening. CCM identifies early sub-clinical DPN, predicts the development and allows staging of DPN severity. Automated quantification of CCM with AI has enabled enhanced unbiased quantification of small nerve fibres and potentially early diagnosis of DPN. Improved screening tools will prevent and reduce the burden of foot ulceration and amputations with the primary aim of reducing the prevalence of this common microvascular complication.

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Bariatric surgery leads to an improvement in small nerve fibre damage in subjects with obesity

International Journal of Obesity ◽

10.1038/s41366-020-00727-9 ◽

2021 ◽

Vol 45 (3) ◽

pp. 631-638

Author(s):

Shazli Azmi ◽

Maryam Ferdousi ◽

Yifen Liu ◽

Safwaan Adam ◽

Zohaib Iqbal ◽

...

Keyword(s):

Bariatric Surgery ◽

Nerve Fibre ◽

Small Nerve

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Evolution Of Motor, Ia And Cutaneous Nerve-Fibre Conduction Velocities In Premature And Fullterm Newborns

Developmental Medicine & Child Neurology ◽

10.1111/j.1469-8749.1989.tb08411.x ◽

2008 ◽

Vol 31 (1) ◽

pp. 47-55 ◽

Cited By ~ 1

Author(s):

Josette Khater-Boidin ◽

Bernard Duron

Keyword(s):

Nerve Fibre ◽

Cutaneous Nerve ◽

Conduction Velocities

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Retinal nerve fibre layer thickness measurements in childhood glaucoma: the role of scanning laser polarimetry and optical coherence tomography

Graefe s Archive for Clinical and Experimental Ophthalmology ◽

10.1007/s00417-021-05276-z ◽

2021 ◽

Author(s):

Mael Lever ◽

Christian Halfwassen ◽

Jan Darius Unterlauft ◽

Nikolaos E. Bechrakis ◽

Anke Manthey ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Nerve Fibre ◽

Retinal Nerve Fibre Layer ◽

Scanning Laser ◽

Optical Coherence ◽

Scanning Laser Polarimetry ◽

Laser Polarimetry ◽

Nerve Fibre Layer ◽

Thickness Measurements ◽

Inferior Quadrant

Abstract Purpose A central diagnostic tool in adult glaucoma is the peripapillary retinal nerve fibre layer (pRNFL) thickness. It can be assessed by scanning laser polarimetry (SLP) or optical coherence tomography (OCT). However, studies investigating the relevance of pRNFL measurements in children are rare. This study aims to compare the glaucoma diagnosing ability of SLP and OCT pRNFL thickness measurements in a paediatric population. Methods This retrospective study included 105 children (glaucoma: 22 (21.0%); healthy glaucoma suspects: 83 (79.0%)) aged 4–18 years, examined with SLP (GDxPro/ECC, Carl Zeiss Meditec) and spectral-domain OCT (SPECTRALIS®, Heidelberg Engineering). The thickness of pRNFL sectors was compared between diseased and healthy participants. Areas under the receiver-operating characteristic curves (AUC) and logistic regression results were used to compare the glaucoma discriminative capacity between SLP and OCT measurements. Results Using OCT, pRNFL thickness was decreased in the superior, nasal, and inferior quadrants of glaucoma patients compared to healthy controls (P < 0.001, each). With SLP, such a difference was only observed in the inferior quadrant (P = 0.011). A correlation between glaucoma diagnosis and OCT-measured pRNFL thickness was found in all quadrants (P < 0.001) other than the temporal. With SLP, a correlation was found for the total average thickness (P = 0.037) and inferior quadrant (P = 0.0019). Finally, the AUCs of OCT measurements were markedly higher than those of SLP (e.g., inferior quadrant: OCT 0.83, SLP 0.68). Conclusion pRNFL thickness measurements using both OCT and SLP, correlate notably with the presence of glaucoma. In general, the diagnostic performance of pRNFL thickness measurements seems higher for OCT than for SLP. Thus, pRNFL thickness measurements could provide important information, complementing conventional clinical and functional parameters in the diagnostic process of paediatric glaucoma.

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