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Spatial analysis improves the detection of early corneal nerve fiber loss in patients with recently diagnosed type 2 diabetes

Ziegler, Dan; Winter, Karsten; Strom, Alexander; Zhivov, Andrey; Allgeier, Stephan ORCID iD icon 1; Papanas, Nikolaos; Ziegler, Iris; Brüggemann, Jutta; Ringel, Bernd; Peschel, Sabine; Köhler, Bernd 1; Stachs, Oliver; Guthoff, Rudolf F.; Roden, Michael
1 Institut für Angewandte Informatik (IAI), Karlsruher Institut für Technologie (KIT)


Corneal confocal microscopy (CCM) has revealed reduced corneal nerve fiber (CNF) length and density (CNFL, CNFD) in patients with diabetes, but the spatial pattern of CNF loss has not been studied. We aimed to determine whether spatial analysis of the distribution of corneal nerve branching points (CNBPs) may contribute to improving the detection of early CNF loss. We hypothesized that early CNF decline follows a clustered rather than random distribution pattern of CNBPs. CCM, nerve conduction studies (NCS), and quantitative sensory testing (QST) were performed in a cross-sectional study including 86 patients recently diagnosed with type 2 diabetes and 47 control subjects. In addition to CNFL, CNFD, and branch density (CNBD), CNBPs were analyzed using spatial point pattern analysis (SPPA) including 10 indices and functional statistics. Compared to controls, patients with diabetes showed lower CNBP density and higher nearest neighbor distances, and all SPPA parameters indicated increased clustering of CNBPs (all P<0.05). SPPA parameters were abnormally increased >97.5th percentile of controls in up to 23.5% of patients. When combining an individual SPPA parameter with CNFL, ≥1 of 2 indices were >99th or <1st percentile of controls in 28.6% of patients compared to 2.1% of controls, while for the conventional CNFL/CNFD/CNBD combination the corresponding rates were 16.3% vs 2.1%. ... mehr

Verlagsausgabe §
DOI: 10.5445/IR/1000068811
Veröffentlicht am 16.03.2018
DOI: 10.1371/journal.pone.0173832
Zitationen: 13
Web of Science
Zitationen: 11
Zitationen: 14
Cover der Publikation
Zugehörige Institution(en) am KIT Institut für Angewandte Informatik (IAI)
Publikationstyp Zeitschriftenaufsatz
Publikationsjahr 2017
Sprache Englisch
Identifikator ISSN: 1932-6203
KITopen-ID: 1000068811
HGF-Programm 43.23.02 (POF III, LK 01) X-Ray Optics
Erschienen in PLoS one
Verlag Public Library of Science (PLoS)
Band 12
Heft 3
Seiten e0173832
Nachgewiesen in Scopus
Web of Science
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