The Utility of Corneal Nerve Fractal Dimension Analysis in Peripheral Neuropathies of Different Etiology

Ioannis N Petropoulos, Abdulrahman Al-Mohammedi, Xin Chen, Maryam Ferdousi, Georgios Ponirakis, Harriet Kemp, Reena Chopra, Scott Hau, Marc Schargus, Jan Vollert, Dietrich Sturm, Tina Bharani, Christopher Kleinschnitz, Mark Stettner, Tunde Peto, Christoph Maier, Andrew S. C. Rice, Rayaz A. Malik

Research output: Contribution to journalArticlepeer-review

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Abstract

Purpose: Quantification of corneal confocal microscopy (CCM) images has shown a significant reduction in corneal nerve fiber length (CNFL) in a range of peripheral neuropathies. We assessed whether corneal nerve fractal dimension (CNFrD) analysis, a novel metric to quantify the topological complexity of corneal subbasal nerves, can differentiate peripheral neuropathies of different etiology.

Methods: Ninety patients with peripheral neuropathy, including 29 with diabetic peripheral neuropathy (DPN), 34 with chronic inflammatory demyelinating polyneuropathy (CIDP), 13 with chemotherapy-induced peripheral neuropathy (CIPN), 14 with human immunodeficiency virus-associated sensory neuropathy (HIV-SN), and 20 healthy controls (HCs), underwent CCM for estimation of corneal nerve fiber density (CNFD), CNFL, corneal nerve branch density (CNBD), CNFrD, and CNFrD adjusted for CNFL (ACNFrD).

Results: In patients with DPN, CIDP, CIPN, or HIV-SN compared to HCs, CNFD (P = 0.004–0.0001) and CNFL (P = 0.05–0.0001) were significantly lower, with a further significant reduction among subgroups. CNFrD was significantly lower in patients with CIDP compared to HCs and patients with HIV-SN (P = 0.02–0.0009) and in patients with DPN compared to HCs and patients with HIV-SN, CIPN, or CIDP (P = 0.001–0.0001). ACNFrD was lower in patients with CIPN, CIDP, or DPN compared to HCs (P = 0.03–0.0001) and in patients with DPN compared to those with HIV-SN, CIPN, or CIDP (P = 0.01–0.005).

Conclusions: CNFrD can detect a distinct pattern of corneal nerve loss in patients with DPN or CIDP compared to those with CIPN or HIV-SN and controls.
Original languageEnglish
JournalTranslational Vision Science & Technology
Early online date28 Aug 2020
DOIs
Publication statusEarly online date - 28 Aug 2020

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