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Quantifying the Corneal Nerve Whorl Pattern.

Maryse Lapierre-Landry1, Eric Y Lu1, Matthew T McPheeters1

  • 1Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA.

Translational Vision Science & Technology
|December 10, 2024
PubMed
Summary
This summary is machine-generated.

Corneal nerve whorl patterns, analyzed using a new automated algorithm, did not differ significantly between diabetic and control patients. This suggests whorl patterns may not be a reliable noninvasive marker for diabetic neuropathy.

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Area of Science:

  • Ophthalmology
  • Neuroscience
  • Medical Imaging

Background:

  • The sub-basal nerve plexus (SBNP) in the cornea exhibits a unique whorl-like pattern.
  • This dynamic structure has been proposed as a potential noninvasive marker for diseases like diabetic neuropathy.
  • Previous studies reported conflicting results regarding changes in corneal nerve whorl density in diabetic patients.

Purpose of the Study:

  • To develop and validate an automated algorithm for characterizing corneal nerve whorl shape.
  • To test the hypothesis that diabetic neuropathy affects corneal whorl organization.
  • To establish a quantitative framework for analyzing corneal nerve patterns in patient cohorts.

Main Methods:

  • Analyzed SBNP whorl patterns as a vector field, calculating seven distinct whorl metrics.
  • Validated the whorl metrics using synthetic images, ex vivo mouse corneas, and in vivo confocal microscopy (IVCM) images.
  • Employed linear discriminant analysis and the Peacock test for statistical comparisons between diabetic and control subjects.

Main Results:

  • The developed algorithm successfully quantified different whorl patterns in the patient population.
  • Corneal whorl patterns were found to be bilateral in patients (P < 0.001).
  • No statistically significant differences were observed in whorl patterns between diabetic and control subjects, or between patients with or without neuropathy symptoms.

Conclusions:

  • The study presents a generalizable computational framework for statistically comparing corneal nerve patterns.
  • The findings indicate that corneal whorl patterns, as quantified by the developed metrics, may not serve as a reliable noninvasive biomarker for diabetic neuropathy.
  • Further research is needed to identify robust quantitative IVCM endpoints for ocular diseases.