![](/images/graphics-bg.png)
Corneal Subbasal Nerve Plexus Changes in Severe Diabetic Charcot Foot Deformity: A Pilot Study in Search for a DNOAP Biomarker
Joint Authors
Mittlmeier, Thomas
Prakasam, Ruby Kala
Peschel, Sabine
Allgeier, Stephan
Köhler, Bernd
Winter, Karsten
Eschler, Anica
Stachs, Oliver
Guthoff, Rudolf F.
Source
Issue
Vol. 2018, Issue 2018 (31 Dec. 2018), pp.1-7, 7 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2018-11-04
Country of Publication
Egypt
No. of Pages
7
Main Subjects
Abstract EN
Introduction.
Diabetic neuroosteoarthropathy (DNOAP) early symptoms are unspecific, mimicking general infectious symptoms and rendering a diagnosis challenging.
Consequently, unfavourable outcomes occur frequently, with recurrent foot ulceration, infectious complications, and eventually amputation.
Corneal confocal microscopy (CCM) of the subbasal nerve plexus (SNP) is used to detect early peripheral neuropathy in diabetic patients without diabetic retinopathy.
This pilot study was designed to determine if specific SNP changes manifest in severe DNOAP in comparison to a healthy control group.
Methods.
This pilot study utilized a matched-pair analysis to investigate SNP changes by in vivo CCM for 26 patients (mean patient age 63.7 years, range 27 to 78) with severe DNOAP defined by condition after the need for reconstructive foot surgery (n=13) and a healthy control group (n=13).
Corneal nerve fibre length (CNFL), nerve fibre density (CNFD), nerve branch density (CNBD), average weighted corneal nerve fibre thickness (CNFTh), nerve connecting points (CNCP), and average weighted corneal nerve fibre tortuosity (CNFTo) were assessed as well as the general clinical status, diabetic status, and ophthalmologic basic criteria.
Results.
In vivo CCM revealed significantly reduced SNP parameters in the DNOAP group for CNFL (p=0.010), CNFD (p=0.037), CNBD (p=0.049), and CNCP (p=0.012) when compared to the healthy control group.
Six patients (46%) of the DNOAP group suffered from diabetic retinopathy and none of the control group.
Conclusions.
This pilot study revealed a rarefication of SNP in all measured parameters in patients with severe DNOAP.
We see a potential value of CCM providing a SNP-based biomarker for early stages of DNOAP prior to the development of any foot deformities that needs to be evaluated in further studies.
This trial is registered with German Clinical Trials Register (DKRS) DRKS00007537.
American Psychological Association (APA)
Eschler, Anica& Prakasam, Ruby Kala& Peschel, Sabine& Allgeier, Stephan& Köhler, Bernd& Winter, Karsten…[et al.]. 2018. Corneal Subbasal Nerve Plexus Changes in Severe Diabetic Charcot Foot Deformity: A Pilot Study in Search for a DNOAP Biomarker. Journal of Diabetes Research،Vol. 2018, no. 2018, pp.1-7.
https://search.emarefa.net/detail/BIM-1183727
Modern Language Association (MLA)
Eschler, Anica…[et al.]. Corneal Subbasal Nerve Plexus Changes in Severe Diabetic Charcot Foot Deformity: A Pilot Study in Search for a DNOAP Biomarker. Journal of Diabetes Research No. 2018 (2018), pp.1-7.
https://search.emarefa.net/detail/BIM-1183727
American Medical Association (AMA)
Eschler, Anica& Prakasam, Ruby Kala& Peschel, Sabine& Allgeier, Stephan& Köhler, Bernd& Winter, Karsten…[et al.]. Corneal Subbasal Nerve Plexus Changes in Severe Diabetic Charcot Foot Deformity: A Pilot Study in Search for a DNOAP Biomarker. Journal of Diabetes Research. 2018. Vol. 2018, no. 2018, pp.1-7.
https://search.emarefa.net/detail/BIM-1183727
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1183727