ArticleScientific reports2020
An unbiased stereological method for corneal confocal microscopy in patients with diabetic polyneuropathy.
Article in Scientific reports, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Corneal confocal microscopy for the diagnosis of diabetic peripheral neuropathy: A systematic review and meta-analysis.Journal of diabetes investigation · 2022Pooled it
- Deep learning-based segmentation and density estimation of corneal nerves and dendritic cells from In Vivo confocal microscopy images.Scientific reports · 2026Article
- Methods for the evaluation of corneal nerve fibres in diabetes mellitus by in vivo confocal microscopy: a scoping review.BMJ open · 2025Article
- ConNeCT: weakly supervised corneal confocal microscopy image inpainting network based on a diffusion model.Biomedical optics express · 2025Article
- Quantifying the Corneal Nerve Whorl Pattern.Translational vision science & technology · 2024Article
- Assessing Corneal Confocal Microscopy and Other Small Fiber Measures in Diabetic Polyneuropathy.Neurology · 2023Article
- Diabetes Distal Peripheral Neuropathy: Subtypes and Diagnostic and Screening Technologies.Journal of diabetes science and technology · 2022Review
- Diabetic Corneal Neuropathy: Pathogenic Mechanisms and Therapeutic Strategies.Frontiers in pharmacology · 2022Review
- Painful and non-painful diabetic neuropathy, diagnostic challenges and implications for future management.Brain : a journal of neurology · 2021Review
- Intraepidermal Nerve Fiber Density as Measured by Skin Punch Biopsy as a Marker for Small Fiber Neuropathy: Application in Patients with Fibromyalgia.Diagnostics (Basel, Switzerland) · 2021Review
- Article
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Authors and funding
6 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Corneal confocal microscopy (CCM) derived corneal nerve measures are lower in diabetic sensorimotor polyneuropathy (DSPN). There are, however, methodological challenges in relation to adequate and unbiased sampling of images with objective corneal nerve quantification. Here we compare a new sampling method and adjusted area calculation with established methods of corneal nerve quantification in patients with and without DSPN and healthy controls. CCM images from 26 control subjects and 62 patients with type 1 diabetes with (n = 17) and without (n = 45) DSPN were analyzed. The images were randomly selected and corneal nerve fiber length (CNFL), corneal nerve fiber branch density (CNBD) and corneal nerve fiber density (CNFD) were determined in both a manual and automated manner. The new method generated 8-40% larger corneal nerve parameters compared to the standard procedure (p < 0.05). CNFL was significantly reduced using the new method for both manual and automated analysis; whilst CNFD and CNBD were significantly reduced using the automated method in both diabetic groups compared with controls. The new, objective method showed a reduction in corneal nerve parameters in diabetic patients with and without DSPN. We recommend using a randomized sampling method and area-dependent analysis to enable objective unbiased corneal nerve quantification.
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