Greater corneal nerve loss at the inferior whorl is related to the presence of diabetic neuropathy and painful diabetic neuropathy

Alise Kalteniece, Maryam Ferdousi, Ioannis Petropoulos, Shazli Azmi, Safwaan Adam, Hassan Fadavi, Andrew Marshall, Andrew J.M. Boulton, Nathan Efron, Catharina G. Faber, Giuseppe Lauria, Handrean Soran, Rayaz Malik

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

We assessed whether a measure of more distal corneal nerve fibre loss at the inferior whorl(IW) region is better than proximal measures of central corneal nerve damage in relation to the diagnosis of diabetic peripheral neuropathy(DPN), painful DPN and quality of life(QoL). Participants underwent detailed assessment of neuropathy, QoL using the SF36 questionnaire, pain visual analogue score(VAS), and corneal confocal microscopy(CCM). Corneal nerve fibre density (CNFD), branch density (CNBD) and length (CNFL) at the central cornea and inferior whorl length (IWL) and average(ANFL) and total(TNFL) nerve fibre length were compared in patients with and without DPN and between patients with and without painful DPN and in relation to QoL. All CCM parameters were significantly reduced, but IWL was reduced ~three-fold greater than CNFL in patients with and without DPN compared to controls. IWL(p = 0.001), ANFL(p = 0.01) and TNFL(p = 0.02) were significantly lower in patients with painful compared to painless DPN. The VAS score correlated with IWL(r =-0.36, P = 0.004), ANFL(r =-0.32, P = 0.01) and TNFL(r =-0.32, P = 0.01) and QoL correlated with CNFL(r = 0.35, P = 0.01) and IWL(r = 0.4, P = 0.004). Corneal nerve fibre damage is more prominent at the IW, lower in patients with painful compared to painless neuropathy and relates to their QoL. IWL may provide additional clinical utility for CCM in patients with DPN.

Original languageEnglish
Article number3283
JournalScientific Reports
Volume8
Issue number1
DOIs
Publication statusPublished - 1 Dec 2018

Fingerprint

Diabetic Neuropathies
Peripheral Nervous System Diseases
Nerve Fibers
Quality of Life
Confocal Microscopy
Cornea
Pain

ASJC Scopus subject areas

  • General

Cite this

Greater corneal nerve loss at the inferior whorl is related to the presence of diabetic neuropathy and painful diabetic neuropathy. / Kalteniece, Alise; Ferdousi, Maryam; Petropoulos, Ioannis; Azmi, Shazli; Adam, Safwaan; Fadavi, Hassan; Marshall, Andrew; Boulton, Andrew J.M.; Efron, Nathan; Faber, Catharina G.; Lauria, Giuseppe; Soran, Handrean; Malik, Rayaz.

In: Scientific Reports, Vol. 8, No. 1, 3283, 01.12.2018.

Research output: Contribution to journalArticle

Kalteniece, A, Ferdousi, M, Petropoulos, I, Azmi, S, Adam, S, Fadavi, H, Marshall, A, Boulton, AJM, Efron, N, Faber, CG, Lauria, G, Soran, H & Malik, R 2018, 'Greater corneal nerve loss at the inferior whorl is related to the presence of diabetic neuropathy and painful diabetic neuropathy', Scientific Reports, vol. 8, no. 1, 3283. https://doi.org/10.1038/s41598-018-21643-z
Kalteniece, Alise ; Ferdousi, Maryam ; Petropoulos, Ioannis ; Azmi, Shazli ; Adam, Safwaan ; Fadavi, Hassan ; Marshall, Andrew ; Boulton, Andrew J.M. ; Efron, Nathan ; Faber, Catharina G. ; Lauria, Giuseppe ; Soran, Handrean ; Malik, Rayaz. / Greater corneal nerve loss at the inferior whorl is related to the presence of diabetic neuropathy and painful diabetic neuropathy. In: Scientific Reports. 2018 ; Vol. 8, No. 1.
@article{f8f71de1fd5c45639a31223e3a42c96d,
title = "Greater corneal nerve loss at the inferior whorl is related to the presence of diabetic neuropathy and painful diabetic neuropathy",
abstract = "We assessed whether a measure of more distal corneal nerve fibre loss at the inferior whorl(IW) region is better than proximal measures of central corneal nerve damage in relation to the diagnosis of diabetic peripheral neuropathy(DPN), painful DPN and quality of life(QoL). Participants underwent detailed assessment of neuropathy, QoL using the SF36 questionnaire, pain visual analogue score(VAS), and corneal confocal microscopy(CCM). Corneal nerve fibre density (CNFD), branch density (CNBD) and length (CNFL) at the central cornea and inferior whorl length (IWL) and average(ANFL) and total(TNFL) nerve fibre length were compared in patients with and without DPN and between patients with and without painful DPN and in relation to QoL. All CCM parameters were significantly reduced, but IWL was reduced ~three-fold greater than CNFL in patients with and without DPN compared to controls. IWL(p = 0.001), ANFL(p = 0.01) and TNFL(p = 0.02) were significantly lower in patients with painful compared to painless DPN. The VAS score correlated with IWL(r =-0.36, P = 0.004), ANFL(r =-0.32, P = 0.01) and TNFL(r =-0.32, P = 0.01) and QoL correlated with CNFL(r = 0.35, P = 0.01) and IWL(r = 0.4, P = 0.004). Corneal nerve fibre damage is more prominent at the IW, lower in patients with painful compared to painless neuropathy and relates to their QoL. IWL may provide additional clinical utility for CCM in patients with DPN.",
author = "Alise Kalteniece and Maryam Ferdousi and Ioannis Petropoulos and Shazli Azmi and Safwaan Adam and Hassan Fadavi and Andrew Marshall and Boulton, {Andrew J.M.} and Nathan Efron and Faber, {Catharina G.} and Giuseppe Lauria and Handrean Soran and Rayaz Malik",
year = "2018",
month = "12",
day = "1",
doi = "10.1038/s41598-018-21643-z",
language = "English",
volume = "8",
journal = "Scientific Reports",
issn = "2045-2322",
publisher = "Nature Publishing Group",
number = "1",

}

TY - JOUR

T1 - Greater corneal nerve loss at the inferior whorl is related to the presence of diabetic neuropathy and painful diabetic neuropathy

AU - Kalteniece, Alise

AU - Ferdousi, Maryam

AU - Petropoulos, Ioannis

AU - Azmi, Shazli

AU - Adam, Safwaan

AU - Fadavi, Hassan

AU - Marshall, Andrew

AU - Boulton, Andrew J.M.

AU - Efron, Nathan

AU - Faber, Catharina G.

AU - Lauria, Giuseppe

AU - Soran, Handrean

AU - Malik, Rayaz

PY - 2018/12/1

Y1 - 2018/12/1

N2 - We assessed whether a measure of more distal corneal nerve fibre loss at the inferior whorl(IW) region is better than proximal measures of central corneal nerve damage in relation to the diagnosis of diabetic peripheral neuropathy(DPN), painful DPN and quality of life(QoL). Participants underwent detailed assessment of neuropathy, QoL using the SF36 questionnaire, pain visual analogue score(VAS), and corneal confocal microscopy(CCM). Corneal nerve fibre density (CNFD), branch density (CNBD) and length (CNFL) at the central cornea and inferior whorl length (IWL) and average(ANFL) and total(TNFL) nerve fibre length were compared in patients with and without DPN and between patients with and without painful DPN and in relation to QoL. All CCM parameters were significantly reduced, but IWL was reduced ~three-fold greater than CNFL in patients with and without DPN compared to controls. IWL(p = 0.001), ANFL(p = 0.01) and TNFL(p = 0.02) were significantly lower in patients with painful compared to painless DPN. The VAS score correlated with IWL(r =-0.36, P = 0.004), ANFL(r =-0.32, P = 0.01) and TNFL(r =-0.32, P = 0.01) and QoL correlated with CNFL(r = 0.35, P = 0.01) and IWL(r = 0.4, P = 0.004). Corneal nerve fibre damage is more prominent at the IW, lower in patients with painful compared to painless neuropathy and relates to their QoL. IWL may provide additional clinical utility for CCM in patients with DPN.

AB - We assessed whether a measure of more distal corneal nerve fibre loss at the inferior whorl(IW) region is better than proximal measures of central corneal nerve damage in relation to the diagnosis of diabetic peripheral neuropathy(DPN), painful DPN and quality of life(QoL). Participants underwent detailed assessment of neuropathy, QoL using the SF36 questionnaire, pain visual analogue score(VAS), and corneal confocal microscopy(CCM). Corneal nerve fibre density (CNFD), branch density (CNBD) and length (CNFL) at the central cornea and inferior whorl length (IWL) and average(ANFL) and total(TNFL) nerve fibre length were compared in patients with and without DPN and between patients with and without painful DPN and in relation to QoL. All CCM parameters were significantly reduced, but IWL was reduced ~three-fold greater than CNFL in patients with and without DPN compared to controls. IWL(p = 0.001), ANFL(p = 0.01) and TNFL(p = 0.02) were significantly lower in patients with painful compared to painless DPN. The VAS score correlated with IWL(r =-0.36, P = 0.004), ANFL(r =-0.32, P = 0.01) and TNFL(r =-0.32, P = 0.01) and QoL correlated with CNFL(r = 0.35, P = 0.01) and IWL(r = 0.4, P = 0.004). Corneal nerve fibre damage is more prominent at the IW, lower in patients with painful compared to painless neuropathy and relates to their QoL. IWL may provide additional clinical utility for CCM in patients with DPN.

UR - http://www.scopus.com/inward/record.url?scp=85042230979&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85042230979&partnerID=8YFLogxK

U2 - 10.1038/s41598-018-21643-z

DO - 10.1038/s41598-018-21643-z

M3 - Article

AN - SCOPUS:85042230979

VL - 8

JO - Scientific Reports

JF - Scientific Reports

SN - 2045-2322

IS - 1

M1 - 3283

ER -