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Sub-basal Corneal Nerve Plexus Analysis Using a New Software Technology.

Hatim Batawi1, Nabeel Shalabi, Madhura Joag

  • 1Bascom Palmer Eye Institute (H.B., N.S., M.J., C.L.K., A.G.), University of Miami, Miami, FL; Ophthalmology Department (H.B., N.S., A.G.), Miami Veterans Affairs Medical Center, Miami, FL; Department of Public Health Sciences (H.B., N.S., T.K.-S.), University of Miami Miller School of Medicine, Miami, FL; Ophthalmology Department (H.B.), King Abdulaziz University, Jeddah, Saudi Arabia; Ophthalmology Department (N.S.), University of Hail, Hail, Saudi Arabia; Nidek, Inc. (J.R., P.T.G.), Fremont, CA; and Nidek Technologies, SRL (M.C.), Italy.

Eye & Contact Lens
|March 28, 2017
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Summary
This summary is machine-generated.

New software reliably measures corneal nerves, finding that older age, diabetes, and high HbA1c levels reduce sub-basal corneal nerve plexus (SCNP) parameters. This research highlights key factors affecting corneal nerve morphology.

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Area of Science:

  • Ophthalmology
  • Neuroscience
  • Medical Technology

Background:

  • The sub-basal corneal nerve plexus (SCNP) is crucial for corneal sensation and health.
  • Assessing SCNP morphology can provide insights into neurological conditions and systemic diseases like diabetes.
  • Novel software technologies are needed for accurate and reproducible SCNP analysis.

Purpose of the Study:

  • To evaluate SCNP parameters using a new in vivo corneal confocal microscopy software.
  • To investigate the influence of demographic factors and diabetes mellitus (DM) on SCNP morphology.
  • To establish the reproducibility of a new nerve analysis software for SCNP assessment.

Main Methods:

  • A cross-sectional study involving 84 participants using Confoscan 4 corneal confocal microscopy.
  • Images of the SCNP were analyzed with a semiautomated nerve analysis software (Corneal Nerve Analysis tool).
  • Nine SCNP parameters, including nerve fiber length (NFL) and density (NFLD), were evaluated and correlated with age, DM status, and HbA1c levels.

Main Results:

  • The Corneal Nerve Analysis tool demonstrated good interoperator and intraoperator reproducibility (ICCs 0.73-0.97).
  • Older age was associated with reduced SCNP parameters, with significant negative correlations for NFL and NFLD with age (P<0.01).
  • Patients with diabetes exhibited significantly lower NFL and NFLD compared to non-diabetic individuals (P<0.05), with higher HbA1c levels showing inverse correlations with NFL and NFLD (P<0.05).

Conclusions:

  • The Corneal Nerve Analysis tool is a reproducible and reliable method for analyzing SCNP with confocal microscopy.
  • Advanced age, presence of diabetes mellitus, and elevated HbA1c levels are significantly associated with diminished SCNP parameters.
  • This software aids in understanding the impact of systemic conditions on corneal nerve health.