324-OR: Rapid Corneal Nerve Fibre Loss Predicts Neuropathy Progression in Diabetes: A Longitudinal Multinational Consortium Study

Background/AimsLong COVID is characterised by a range of potentially debilitating symptoms which develop in at least 10% of people who have recovered from acute SARS-CoV-2 infection. This study has quantified corneal sub-basal nerve plexus morphology and dendritic cell (DC) density in patients with and without long COVID.MethodsForty subjects who had recovered from COVID-19 and 30 control participants were included in this cross-sectional comparative study undertaken at a university hospital. All patients underwent assessment with the National Institute for Health and Care Excellence (NICE) long COVID, Douleur Neuropathique 4 (DN4) and Fibromyalgia questionnaires, and corneal confocal microscopy (CCM) to quantify corneal nerve fibre density (CNFD), corneal nerve branch density (CNBD), corneal nerve fibre length (CNFL), and total, mature and immature DC density.ResultsThe mean time after the diagnosis of COVID-19 was 3.7±1.5 months. Patients with neurological symptoms 4 weeks after acute COVID-19 had a lower CNFD (p=0.032), CNBD (p=0.020), and CNFL (p=0.012), and increased DC density (p=0.046) compared with controls, while patients without neurological symptoms had comparable corneal nerve parameters, but increased DC density (p=0.003). There were significant correlations between the total score on the NICE long COVID questionnaire at 4 and 12 weeks with CNFD (ρ=−0.436; p=0.005, ρ=−0.387; p=0.038, respectively) and CNFL (ρ=−0.404; p=0.010, ρ=−0.412; p=0.026, respectively).ConclusionCorneal confocal microscopy identifies corneal small nerve fibre loss and increased DCs in patients with long COVID, especially those with neurological symptoms. CCM could be used to objectively identify patients with long COVID.

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The Reference Distribution of Annual Change in Corneal Nerve Fibre Length in Diabetes

Canadian Journal of Diabetes ◽

10.1016/j.jcjd.2018.08.029 ◽

2018 ◽

Vol 42 (5) ◽

pp. S10

Author(s):

Evan Jh Lewis ◽

Mitra Tavakoli ◽

Leif E. Lovblom ◽

Elise M. Halpern ◽

Maria Jeziorska ◽

...

Keyword(s):

Nerve Fibre ◽

Fibre Length ◽

Annual Change ◽

Reference Distribution ◽

Corneal Nerve

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Bilateral morphometric analysis of corneal sub-basal nerve plexus in patients undergoing unilateral cataract surgery: a preliminary in vivo confocal microscopy study

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2019-315449 ◽

2020 ◽

pp. bjophthalmol-2019-315449 ◽

Cited By ~ 3

Author(s):

Giuseppe Giannaccare ◽

Federico Bernabei ◽

Marco Pellegrini ◽

Fabio Guaraldi ◽

Federica Turchi ◽

...

Keyword(s):

Confocal Microscopy ◽

Cataract Surgery ◽

Nerve Fibre ◽

Fibre Length ◽

Nerve Plexus ◽

In Vivo Confocal Microscopy ◽

Corneal Nerve ◽

Branch Density ◽

Unilateral Cataract

AimsTo evaluate bilateral morphometric changes of corneal sub-basal nerve plexus (CSNP) occurring after unilateral cataract surgery by in vivo confocal microscopy (IVCM) images analysed with automated software.MethodsIVCM was performed before (V0) and 1 month after surgery (V1) in both operated eyes (OEs) and unoperated eyes (UEs) of 30 patients. Thirty age and sex-matched subjects acted as controls. Corneal nerve fibre density (CNFD), corneal nerve branch density (CNBD), corneal nerve fibre length (CNFL), corneal nerve total branch density (CTBD), corneal nerve fibre area (CNFA), corneal nerve fibre width, corneal nerve fractal dimension (CNFrD) and dendritic cells density were calculated.ResultsMean CNFD, CNBD, CNFL, CTBD, CNFA and CNFrD significantly decreased at V1 versus V0 in both eyes (respectively, 15.35±7.00 vs 21.21±6.56 n/mm2 in OEs and 20.11±6.69 vs 23.20±7.26 in UEs; 13.57±12.16 vs 26.79±16.91 n/mm2 in OEs and 24.28±14.88 vs 29.76±15.25 in UEs; 9.67±3.44 mm/mm2 vs 13.49±3.42 in OEs and 12.53±3.60 vs 14.02±3.82 in UEs; 22.81±18.77 vs 42.25±24.64 n/mm2 in OEs and 38.06±20.52 vs 43.93±22.27 in UEs; 0.0040±0.0021 vs 0.0058±0.0020 mm2/mm2 in OEs and 0.0049±0.0016 vs 0.0057±0.0019 in UEs; 1.418±0.058 vs 1.470±0.037 in OEs and 1.466±0.040 vs 1.477±0.036 in UEs; always p<0.049).ConclusionPatients undergoing cataract surgery exhibit bilateral alterations of CSNP. This finding could have broad implications in the setting of sequential cataract surgery.

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Reduced corneal nerve fibre length in prediabetes and type 2 diabetes: The Maastricht Study

Acta Ophthalmologica ◽

10.1111/aos.14359 ◽

2020 ◽

Vol 98 (5) ◽

pp. 485-491 ◽

Cited By ~ 1

Author(s):

Eline E.B. De Clerck ◽

Jan S.A.G. Schouten ◽

Tos T.J.M. Berendschot ◽

Renée S. Koolschijn ◽

Rudy M.M.A. Nuijts ◽

...

Keyword(s):

Type 2 Diabetes ◽

Nerve Fibre ◽

Fibre Length ◽

Corneal Nerve

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Using corneal confocal microscopy to compare Mecobalamin intramuscular injections vs oral tablets in treating diabetic peripheral neuropathy: a RCT

Scientific Reports ◽

10.1038/s41598-021-94284-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yuanjin Zhang ◽

Dongsheng Fan ◽

Yixuan Zhang ◽

Shuo Zhang ◽

Haikun Wang ◽

...

Keyword(s):

Peripheral Neuropathy ◽

Confocal Microscopy ◽

Nerve Fibre ◽

Diabetic Peripheral Neuropathy ◽

Controlled Study ◽

Oral Tablet ◽

Injection Treatment ◽

Intramuscular Injections ◽

Corneal Confocal Microscopy ◽

Corneal Nerve

AbstractThis randomized controlled study used corneal confocal microscopy (CCM) to compare the efficacy of Mecobalamin intramuscular injections vs oral tablets in treating mild to moderate diabetic peripheral neuropathy (DPN) by detecting early nerve fiber repair. Enrolled patients were randomized approximately 1:1 to receive Mecobalamin intramuscular injections (0.5 mg/day, 3 times/week) or Mecobalamin oral tablets (1.5 mg/day) for 8 weeks. Primary outcome was change of inferior whorl length (IWL) from baseline. Secondary outcomes included changes of corneal nerve fibre length (CNFL), corneal nerve fibre density (CNFD), corneal nerve branch density (CNBD) and the Survey of Autonomic Symptoms (SAS). 15 (93.75%) patients in the injection group and 17 (89.47%) patients in the tablet group completed the study. The injection treatment significantly improved patients’ IWL from baseline (21.64 ± 3.00 mm/mm2 vs 17.64 ± 4.83 mm/mm2, P < 0.01) while the tablet treatment didn’t. Additionally, the injection treatment led to significantly improved CNFL, CNBD and SAS from baseline (all P < 0.05) while the tablet treatment did not. No patient experienced any adverse events. In conclusion, CCM is sensitive enough to detect the superior efficacy of 8-week Mecobalamin intramuscular injection treatment for DPN compared to the oral tablet treatment.ClinicalTrials.gov registration number: NCT04372316 (30/04/2020).

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Combining efficient hand-crafted features with learned filters for fast and accurate corneal nerve fibre centreline detection

2015 37th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) ◽

10.1109/embc.2015.7319675 ◽

2015 ◽

Cited By ~ 1

Author(s):

Roberto Annunziata ◽

Ahmad Kheirkhah ◽

Pedram Hamrah ◽

Emanuele Trucco

Keyword(s):

Nerve Fibre ◽

Corneal Nerve

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Selective nerve fibre loss in glaucoma: Magnocellular or parvocellular

Australian and New Zealand Journal of Ophthalmology ◽

10.1111/j.1442-9071.1997.tb01390.x ◽

1997 ◽

Vol 25 ◽

pp. 189-191 ◽

Cited By ~ 4

Author(s):

Stuart L. Graham

Keyword(s):

Nerve Fibre ◽

Fibre Loss

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Perineurial cell basement membrane thickening and myelinated nerve fibre loss in diabetic and nondiabetic peripheral nerve

Journal of the Neurological Sciences ◽

10.1016/j.jns.2003.09.011 ◽

2004 ◽

Vol 217 (2) ◽

pp. 157-163 ◽

Cited By ~ 29

Author(s):

Rebecca E. Hill ◽

Pamela E. Williams

Keyword(s):

Basement Membrane ◽

Peripheral Nerve ◽

Nerve Fibre ◽

Myelinated Nerve Fibre ◽

Myelinated Nerve ◽

Perineurial Cell ◽

Basement Membrane Thickening ◽

Fibre Loss

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A novel investigation method for axonal damage in neuromyelitis optica spectrum disorder: In vivo corneal confocal microscopy

Multiple Sclerosis Journal - Experimental Translational and Clinical ◽

10.1177/2055217321998060 ◽

2021 ◽

Vol 7 (1) ◽

pp. 205521732199806

Author(s):

Ayşe Altıntaş ◽

Ayse Yildiz-Tas ◽

Sezen Yilmaz ◽

Betul N Bayraktutar ◽

Melis Cansu Comert ◽

...

Keyword(s):

Confocal Microscopy ◽

Nerve Fibre ◽

Disease Severity ◽

Neuromyelitis Optica ◽

Spectrum Disorder ◽

Neuromyelitis Optica Spectrum Disorder ◽

Rnfl Thickness ◽

Corneal Confocal Microscopy ◽

Corneal Nerve

Background Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory autoimmune disorder that damages optic nerves, brainstem, and spinal cord. In vivo corneal confocal microscopy (IVCM) is a noninvasive technique that provides corneal images with dendritic cells (DCs) and corneal subbasal nerve plexus (SBP), which arises from the trigeminal nerve. Objective We investigated corneal SBP changes in NMOSD and proposed IVCM as a potential new disease severity biomarker for NMOSD. Methods Seventeen age-sex matched NMOSD patients and 19 healthy participants underwent complete neurologic and ophthalmologic examinations. The duration of disease, first symptom, presence of optic neuritis attack, antibody status, Expanded Disability Status Scale(EDSS) score and disease severity score(DSS) were recorded. Retinal nerve fibre layer (RNFL) thickness was measured with optical coherence tomography, and corneal SBP images were taken with IVCM. Results NMOSD patients had significantly reduced corneal nerve fibre lenght-density and corneal nerve branch lenght-density compared with controls, while DC density was increased. NMOSD patients also showed significantly reduced RNFL thickness compared with controls. EDSS,DSS levels were inversely correlated with IVCM parameters. Conclusion We observed significant corneal nerve fibre loss in NMOSD patients in relation to disease severity. IVCM can be a candidate noninvasive imaging method for axonal damage assessment in NMOSD that warrants further investigation.

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