Corneal nerve fiber size adds utility to the diagnosis and assessment of therapeutic response in patients with small fiber neuropathy

Michael Brines, Daniel A. Culver, Maryam Ferdousi, Martijn R. Tannemaat, Monique Van Velzen, Albert Dahan, Rayaz Malik

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Small fiber neuropathy (SFN) is a common feature of many inflammatory diseases, often presenting with pain and disability. SFN is diagnosed using symptoms, thermal threshold testing, and intra-epidermal nerve fiber quantification. Corneal confocal microscopy (CCM) is an ophthalmic imaging technique which non-invasively quantifies corneal nerve fiber (CNF) density, branch density and length, and has comparable diagnostic and superior ability to identify nerve regeneration compared to skin biopsy. CNF size (width and area) depends upon the number of fibers within each nerve, as well as pathology (e.g., swelling), and may provide additional sensitivity to diagnose SFN and identify nerve repair. We have compared the utility of the standard CCM variables employed to CNF size in patients with diabetic sensorimotor polyneuropathy or sarcoidosis-associated SFN, and in patients with SFN following cibinetide administration, an agent which promotes nerve repair. The results show that: 1) CNF width distribution and area depend upon neuropathy severity; 2) CNF area, density, branch density and length possess comparable discriminatory power for diagnosing neuropathy; 3) CNF area is related to length by a quadratic function which is predictive for both healthy subjects and those with SFN; 4) CNF area is a useful variable for quantifying change in CNF morphology.

Original languageEnglish
Article number4734
JournalScientific Reports
Volume8
Issue number1
DOIs
Publication statusPublished - 1 Dec 2018

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Nerve Fibers
Therapeutics
Confocal Microscopy
Small Fiber Neuropathy
Nerve Regeneration
Aptitude
Diabetic Neuropathies
Sarcoidosis
Healthy Volunteers
Hot Temperature
Pathology
Biopsy
Pain
Skin

ASJC Scopus subject areas

  • General

Cite this

Corneal nerve fiber size adds utility to the diagnosis and assessment of therapeutic response in patients with small fiber neuropathy. / Brines, Michael; Culver, Daniel A.; Ferdousi, Maryam; Tannemaat, Martijn R.; Van Velzen, Monique; Dahan, Albert; Malik, Rayaz.

In: Scientific Reports, Vol. 8, No. 1, 4734, 01.12.2018.

Research output: Contribution to journalArticle

Brines, Michael ; Culver, Daniel A. ; Ferdousi, Maryam ; Tannemaat, Martijn R. ; Van Velzen, Monique ; Dahan, Albert ; Malik, Rayaz. / Corneal nerve fiber size adds utility to the diagnosis and assessment of therapeutic response in patients with small fiber neuropathy. In: Scientific Reports. 2018 ; Vol. 8, No. 1.
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