Automated software analysis of corneal micrographs for peripheral neuropathy

Area of Science:

• Ophthalmology
• Neurology
• Medical Imaging

Background:

• Peripheral neuropathy is a common, debilitating condition often diagnosed via invasive intramuscular electromyography (EMG).
• A link exists between peripheral neuropathy and the density/shape of corneal nerve fibers.
• Corneal imaging offers a virtually noninvasive alternative to EMG.

Purpose of the Study:

• To investigate the potential of corneal nerve fiber analysis as an alternative or adjunct diagnostic tool for peripheral neuropathy.
• To explore if corneal nerve fiber morphology can serve as a biomarker for neuropathy.
• To develop a less invasive method for neuropathy assessment compared to EMG.

Main Methods:

• Developed automated software to trace and measure corneal nerve fibers from confocal laser scanning microscopy images.
• Applied the software to images from diabetic subjects with varying neuropathy levels (assessed by EMG) and healthy controls.
• Analyzed trends in nerve fiber density and shape parameters.

Main Results:

• Observed preliminary statistical trends correlating corneal nerve fiber measures with neuropathy.
• Identified potential for using these measures to corroborate symptoms or confirm evaluations.
• Explored the utility of nerve fiber analysis for assessing neuropathy risk factors.

Conclusions:

• Corneal nerve fiber analysis shows potential as a clinical tool for measuring neuropathy severity and assessing risk.
• Further development and clinical validation are required to establish repeatability and reliability.
• This noninvasive approach may enable more frequent and earlier neuropathy screening.