title: Wide-field assessment of the human corneal subbasal nerve plexus in diabetic neuropathy using a novel mapping technique.
abstract: To develop a rapid optimized technique of wide-field imaging of the human corneal subbasal nerve plexus. A dynamic fixation target was developed and, coupled with semiautomated tiling software, a rapid method of capturing and montaging multiple corneal confocal microscopy images was created. To illustrate the utility of this technique, wide-field maps of the subbasal nerve plexus were produced in 2 participants with diabetes, 1 with and 1 without neuropathy. The technique produced montages of the central 3 mm of the subbasal corneal nerve plexus. The maps seem to show a general reduction in the number of nerve fibers and branches in the diabetic participant with neuropathy compared with the individual without neuropathy.This novel technique will allow more routine and widespread use of subbasal nerve plexus mapping in clinical and research situations. The significant reduction in the time to image the corneal subbasal nerve plexus should expedite studies of larger groups of diabetic patients and those with other conditions affecting nerve fibers. The inferior whorl and the surrounding areas may show the greatest loss of nerve fibers in individuals with diabetic neuropathy, but this should be further investigated in a larger cohort.
authors.affiliation: Institute of Health and Biomedical Innovation, QueenslandUniversity of Technology, Queensland, Australia. katie.edwards@qut.edu.au
authors.forename: Katie
authors.initials: K
authors.lastname: Edwards
authors.forename: Nicola
authors.initials: N
authors.lastname: Pritchard
authors.forename: Kevin
authors.initials: K
authors.lastname: Gosschalk
authors.forename: Geoff P
authors.initials: GP
authors.lastname: Sampson
authors.forename: Anthony
authors.initials: A
authors.lastname: Russell
authors.forename: Rayaz A
authors.initials: RA
authors.lastname: Malik
authors.forename: Nathan
authors.initials: N
authors.lastname: Efron
mesh_terms: D003315:Cornea / Q000294:innervation*; D003316:Corneal Diseases / Q000175:diagnosis* / Q000209:etiology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003929:Diabetic Neuropathies / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D009415:Nerve Net / Q000473:pathology; D009434:Neural Pathways / Q000473:pathology; D009882:Ophthalmic Nerve / Q000473:pathology*