PDF(Sci-hub)
Abstract：
OBJECTIVE: To examine and compare fully-automated and manually measured corneal nerve fiber parameters in type 2 diabetes mellitus (T2DM) patients with and without diabetic peripheral neuropathy (DPN).
METHODS: A total of 128 T2DM subjects and 24 healthy controls underwent neuropathy assessment and bilateral corneal confocal microscopy (CCM). Five representative nerve fiber images were selected for each participant and analyzed manually and with fully-automated software. Corneal nerve fiber length (CNFL), branch density (CNBD), and fiber density (CNFD) were examined.
RESULTS: Manual and full-automated methods for the whole cohort were significantly positive correlated for CNFL, CNBD and CNFD (r = 0.818, 0.845, 0.457, all P < 0.001). Analysis of agreement between the two measurements using Bland-Altman method showed a bias of 2.05 mm/mm2 (95% limits of agreement: -2.03 mm/mm2, 6.13 mm/mm2), 1.62 no./mm2 (95% limits of agreement: -17.92 no./mm2, 21.17 no./mm2), and 16.0 no./mm2 (95% limits of agreement: -0.14 no./mm2, 32.14 no./mm2) for CNFL, CNBD and CNFD respectively. A progressive decrease in manual and full-automated CNFL, CNBD and CNFD accompanied with the occurrence of DPN, The fully-automated method slightly underestimated corneal nerve fiber parameters.
CONCLUSIONS: This study demonstrated strong correlations between manual and fully-automated CNFL and CNBD, but not CNFD. Fully-automated corneal nerve fiber parameter quantification may be a fast, objective way to detect DPN.
METHODS: A total of 128 T2DM subjects and 24 healthy controls underwent neuropathy assessment and bilateral corneal confocal microscopy (CCM). Five representative nerve fiber images were selected for each participant and analyzed manually and with fully-automated software. Corneal nerve fiber length (CNFL), branch density (CNBD), and fiber density (CNFD) were examined.
RESULTS: Manual and full-automated methods for the whole cohort were significantly positive correlated for CNFL, CNBD and CNFD (r = 0.818, 0.845, 0.457, all P < 0.001). Analysis of agreement between the two measurements using Bland-Altman method showed a bias of 2.05 mm/mm2 (95% limits of agreement: -2.03 mm/mm2, 6.13 mm/mm2), 1.62 no./mm2 (95% limits of agreement: -17.92 no./mm2, 21.17 no./mm2), and 16.0 no./mm2 (95% limits of agreement: -0.14 no./mm2, 32.14 no./mm2) for CNFL, CNBD and CNFD respectively. A progressive decrease in manual and full-automated CNFL, CNBD and CNFD accompanied with the occurrence of DPN, The fully-automated method slightly underestimated corneal nerve fiber parameters.
CONCLUSIONS: This study demonstrated strong correlations between manual and fully-automated CNFL and CNBD, but not CNFD. Fully-automated corneal nerve fiber parameter quantification may be a fast, objective way to detect DPN.
摘要：
目的：观察和比较全自动和手动测量的2型糖尿病（T2DM）伴和不伴糖尿病周围神经病变（DPN）患者的角膜神经纤维参数。
方法：总共128名T2DM受试者和24名健康对照者接受了神经病变评估和双侧角膜共聚焦显微镜（CCM）。为每个参与者选择五个代表性神经纤维图像，并手动和使用全自动软件进行分析。角膜神经纤维长度(CNFL),分支密度（CNBD），和纤维密度（CNFD）进行了检查。
结果：整个队列的手动和全自动方法与CNFL呈显著正相关，CNBD和CNFD(r=0.818、0.845、0.457,均P<0.001)。使用Bland-Altman方法对两次测量之间的一致性进行分析，结果表明偏差为2.05mm/mm2（95％的一致性极限：-2.03mm/mm2，6.13mm/mm2），1.62no./mm2(95%一致性限制:-17.92号/mm2，21.17号。/mm2),和16.0号。/mm2(95%一致性限制:-0.14否/mm2，32.14号。/mm2)对于CNFL，分别为CNBD和CNFD。手动和全自动CNFL的逐步减少，CNBD和CNFD伴有DPN的发生，全自动方法略微低估了角膜神经纤维参数。
结论：这项研究表明，手动和全自动CNFL与CNBD之间存在很强的相关性，但不是CNFD。全自动角膜神经纤维参数量化可能是一种快速、检测DPN的客观方法。
方法：总共128名T2DM受试者和24名健康对照者接受了神经病变评估和双侧角膜共聚焦显微镜（CCM）。为每个参与者选择五个代表性神经纤维图像，并手动和使用全自动软件进行分析。角膜神经纤维长度(CNFL),分支密度（CNBD），和纤维密度（CNFD）进行了检查。
结果：整个队列的手动和全自动方法与CNFL呈显著正相关，CNBD和CNFD(r=0.818、0.845、0.457,均P<0.001)。使用Bland-Altman方法对两次测量之间的一致性进行分析，结果表明偏差为2.05mm/mm2（95％的一致性极限：-2.03mm/mm2，6.13mm/mm2），1.62no./mm2(95%一致性限制:-17.92号/mm2，21.17号。/mm2),和16.0号。/mm2(95%一致性限制:-0.14否/mm2，32.14号。/mm2)对于CNFL，分别为CNBD和CNFD。手动和全自动CNFL的逐步减少，CNBD和CNFD伴有DPN的发生，全自动方法略微低估了角膜神经纤维参数。
结论：这项研究表明，手动和全自动CNFL与CNBD之间存在很强的相关性，但不是CNFD。全自动角膜神经纤维参数量化可能是一种快速、检测DPN的客观方法。
