Corneal confocal microscopy detects corneal nerve damage in patients admitted with acute ischemic stroke

Adnan Khan, Naveed Akhtar, Saadat Kamran, Georgios Ponirakis, Ioannis N. Petropoulos, Nahel A. Tunio, Soha R. Dargham, Yahia Imam, Faheem Sartaj, Aijaz Parray, Paula Bourke, Rabia Khan, Mark Santos, Sujatha Joseph, Ashfaq Shuaib, Rayaz A. Malik

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13 Citations (Scopus)

Abstract

Background and Purpose-Corneal confocal microscopy can identify corneal nerve damage in patients with peripheral and central neurodegeneration. However, the use of corneal confocal microscopy in patients presenting with acute ischemic stroke is unknown. Methods-One hundred thirty patients (57 without diabetes mellitus [normal glucose tolerance], 32 with impaired glucose tolerance, and 41 with type 2 diabetes mellitus) admitted with acute ischemic stroke, and 28 age-matched healthy control participants underwent corneal confocal microscopy to quantify corneal nerve fiber density, corneal nerve branch density, and corneal nerve fiber length. Results-There was a significant reduction in corneal nerve fiber density, corneal nerve branch density, and corneal nerve fiber length in stroke patients with normal glucose tolerance (P<0.001, P<0.001, P<0.001), impaired glucose tolerance (P=0.004, P<0.001, P=0.002), and type 2 diabetes mellitus (P<0.001, P<0.001, P<0.001) compared with controls. HbA1c and triglycerides correlated with corneal nerve fiber density (r=-0.187, P=0.03; r=-0.229 P=0.01), corneal nerve fiber length (r=-0.228, P=0.009; r=-0.285; P=0.001), and corneal nerve branch density (r=-0.187, P=0.033; r=-0.229, P=0.01). Multiple linear regression showed no independent associations between corneal nerve fiber density, corneal nerve branch density, and corneal nerve fiber length and relevant risk factors for stroke. Conclusions-Corneal confocal microscopy is a rapid noninvasive ophthalmic imaging technique that identifies corneal nerve fiber loss in patients with acute ischemic stroke.

Original languageEnglish
Pages (from-to)3012-3018
Number of pages7
JournalStroke
Volume48
Issue number11
DOIs
Publication statusPublished - Nov 2017

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Keywords

  • Blood pressure
  • Corneal nerve
  • Diabetes mellitus
  • Stroke
  • Triglycerides

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialised Nursing

Cite this

Khan, A., Akhtar, N., Kamran, S., Ponirakis, G., Petropoulos, I. N., Tunio, N. A., Dargham, S. R., Imam, Y., Sartaj, F., Parray, A., Bourke, P., Khan, R., Santos, M., Joseph, S., Shuaib, A., & Malik, R. A. (2017). Corneal confocal microscopy detects corneal nerve damage in patients admitted with acute ischemic stroke. Stroke, 48(11), 3012-3018. https://doi.org/10.1161/STROKEAHA.117.018289