Corneal sensitivity as an ophthalmic marker of diabetic neuropathy

Nicola Pritchard, Katie Edwards, Dimitrios Vagenas, Ayda M. Shahidi, Geoff P. Sampson, Anthony W. Russell, Rayaz Malik, Nathan Efron

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Purpose.: The objective of this study was to explore the discriminative capacity of non-contact corneal esthesiometry (NCCE) when compared with the neuropathy disability score (NDS) score - a validated, standard method of diagnosing clinically significant diabetic neuropathy. Methods.: Eighty-one participants with type 2 diabetes, no history of ocular disease, trauma, or surgery and no history of systemic disease that may affect the cornea were enrolled. Participants were ineligible if there was history of neuropathy due to non-diabetic cause or current diabetic foot ulcer or infection. Corneal sensitivity threshold was measured on the eye of dominant hand side at a distance of 10 mm from the center of the cornea using a stimulus duration of 0.9 s. The NDS was measured producing a score ranging from 0 to 10. To determine the optimal cutoff point of corneal sensitivity that identified the presence of neuropathy (diagnosed by NDS), the Youden index and "closest-to-(0,1)" criteria were used. Results.: The receiver-operator characteristic curve for NCCE for the presence of neuropathy (NDS >3) had an area under the curve of 0.73 (p = 0.001) and, for the presence of moderate neuropathy (NDS >6), area of 0.71 (p = 0.003). By using the Youden index, for an NDS >3, the sensitivity of NCCE was 70% and specificity was 75%, and a corneal sensitivity threshold of 0.66 mbar or higher indicated the presence of neuropathy. When NDS > 6 (indicating risk of foot ulceration) was applied, the sensitivity was 52% with a specificity of 85%. Conclusions.: NCCE is a sensitive test for the diagnosis of minimal and more advanced diabetic neuropathy and may serve as a useful surrogate marker for diabetic and perhaps other neuropathies.

Original languageEnglish
Pages (from-to)1003-1008
Number of pages6
JournalOptometry and Vision Science
Volume87
Issue number12
DOIs
Publication statusPublished - Dec 2010
Externally publishedYes

Fingerprint

Diabetic Neuropathies
Cornea
Diabetic Foot
Eye Diseases
Contact Dermatitis
Type 2 Diabetes Mellitus
Area Under Curve
Foot
Hand
Biomarkers
Wounds and Injuries
Infection

Keywords

  • corneal sensitivity
  • diabetic neuropathy
  • neuropathy disability score
  • non-contact corneal esthesiometry
  • ophthalmic markers

ASJC Scopus subject areas

  • Ophthalmology
  • Optometry

Cite this

Pritchard, N., Edwards, K., Vagenas, D., Shahidi, A. M., Sampson, G. P., Russell, A. W., ... Efron, N. (2010). Corneal sensitivity as an ophthalmic marker of diabetic neuropathy. Optometry and Vision Science, 87(12), 1003-1008. https://doi.org/10.1097/OPX.0b013e3181fd6188

Corneal sensitivity as an ophthalmic marker of diabetic neuropathy. / Pritchard, Nicola; Edwards, Katie; Vagenas, Dimitrios; Shahidi, Ayda M.; Sampson, Geoff P.; Russell, Anthony W.; Malik, Rayaz; Efron, Nathan.

In: Optometry and Vision Science, Vol. 87, No. 12, 12.2010, p. 1003-1008.

Research output: Contribution to journalArticle

Pritchard, N, Edwards, K, Vagenas, D, Shahidi, AM, Sampson, GP, Russell, AW, Malik, R & Efron, N 2010, 'Corneal sensitivity as an ophthalmic marker of diabetic neuropathy', Optometry and Vision Science, vol. 87, no. 12, pp. 1003-1008. https://doi.org/10.1097/OPX.0b013e3181fd6188
Pritchard N, Edwards K, Vagenas D, Shahidi AM, Sampson GP, Russell AW et al. Corneal sensitivity as an ophthalmic marker of diabetic neuropathy. Optometry and Vision Science. 2010 Dec;87(12):1003-1008. https://doi.org/10.1097/OPX.0b013e3181fd6188
Pritchard, Nicola ; Edwards, Katie ; Vagenas, Dimitrios ; Shahidi, Ayda M. ; Sampson, Geoff P. ; Russell, Anthony W. ; Malik, Rayaz ; Efron, Nathan. / Corneal sensitivity as an ophthalmic marker of diabetic neuropathy. In: Optometry and Vision Science. 2010 ; Vol. 87, No. 12. pp. 1003-1008.
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