Precision, agreement and utility of a contemporary non‐contact corneal aesthesiometer

Swanevelder, Sarah K; Misra, Stuti; Tyler, Ellen F.; McGhee, Charles N J

doi:10.1111/cxo.13036

Cited by 8 publications

(8 citation statements)

References 33 publications

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“…Corneal sensation threshold was measured with a non-contact corneal esthesiometer. 11 The esthesiometer utilizes a controlled pulse of air to stimulate corneal nerves using a 0.5-mm-diameter aperture for a variable and user-selectable puff intensity stimulus. The sensation is measured using a yes/no response, double staircase procedure at the center of the cornea.…”

Section: Methodsmentioning

confidence: 99%

Corneal Confocal Microscopy in Type 1 Diabetes Mellitus: A Six-Year Longitudinal Study

Slater¹,

Misra²,

Braatvedt

et al. 2022

Trans. Vis. Sci. Tech.

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Purpose The current study describes corneal nerve morphology using in vivo confocal microscopy (IVCM) in patients with type 1 diabetes (T1D) who were followed up for 6 years, and it examines the relationship between corneal parameters and metabolic control of glucose and peripheral neuropathy. Methods Sixty-two participants (37 with T1D and 25 control participants) were assessed in 2011 and 2017. Participants with bilateral cataract surgery or controls who developed diabetes were excluded. All underwent HbA1c, IVCM, and central corneal sensitivity measurements at both time points in the eye previously examined. A modified total neuropathy score was obtained. Results Participants were age and sex matched. The mean duration of diabetes was 32.1 ± 12.0 years at the follow-up visit. The sub-basal nerve density in participants with T1D was lower than that of the controls and did not change (mean ± SD, 11.07 ± 4.0 to 11.41 ± 4.1 mm/mm 2 ; P = 0.71), but it showed a marginal change in controls (19.5 ± 3.7 to 21.63 ± 4.03 mm/mm 2 ; P = 0.06). The corneal sensitivity in T1D did not change (1.3 ± 1.5 to 1.4 ± 1.0 mbar; P = 0.8), and it declined in the controls (0.2 ± 0.3 to 0.6 ± 0.3 mbar; P < 0.001). There were no significant changes in HbA 1c (60.5 ± 12.5 to 61.6 ± 13.7 mmol/mol) or in modified total neuropathy scores (2.4 ± 3.2 to 3.4 ± 3.8; P = 0.2). Conclusions The corneal nerve damage and poorer corneal sensitivity reported in the patients with T1D did not change and displayed improvement with good glycemic control. Translational Relevance The corneal nerve changes may be of more value in those with a shorter duration of diabetes for the timely prediction of at-risk individuals likely to develop peripheral neuropathy, particularly in type 1 diabetes.

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Section: Methodsmentioning

confidence: 99%

Corneal Confocal Microscopy in Type 1 Diabetes Mellitus: A Six-Year Longitudinal Study

Slater¹,

Misra²,

Braatvedt

et al. 2022

Trans. Vis. Sci. Tech.

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“…The external and anterior ocular structures were examined using a Topcon slit lamp biomicroscope (Topcon Medical Systems, Oakland, NJ, USA). CST was evaluated with the Non-Contact Corneal Aesthesiometer [ 19 ]. Assessment of colour vision deficiency was performed with Ishihara test plates.…”

Section: Methodsmentioning

confidence: 99%

Corneal Nerve Changes Observed by In Vivo Confocal Microscopy in Patients Receiving Oxaliplatin for Colorectal Cancer: The COCO Study

Tyler

McGhee

Lawrence

et al. 2022

JCM

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An objective method of early identification of people at risk of chemotherapy-induced peripheral neuropathy is needed to minimize long-term toxicity and maximize dose intensity. The aims of the study were to observe corneal nerve microstructure and corneal sensitivity changes and peripheral neuropathy in patients receiving oxaliplatin, and to determine its association with corneal parameters at different stages of treatment and assess utility as non-invasive markers to detect and monitor peripheral neuropathy. Twenty-three patients scheduled to receive oxaliplatin chemotherapy with intravenous 5-FU for gastro-intestinal cancer were recruited and followed up with for 12 months. Ocular examinations including corneal and retinal evaluations, alongside peripheral neuropathy assessment, were performed. The corneal nerve density did not show significant change after chemotherapy when measured with a widely used semi-automated program or an automated analysis technique. Macula and optic nerve function did not change during or after oxaliplatin chemotherapy. However, the corneal nerve density modestly correlated with clinical peripheral neuropathy after 20 weeks of chemotherapy (r = 0.61, p = 0.01) when peripheral neuropathy is typical most profound, and corneal nerve sensitivity correlated with neuropathy at 12 (r = 0.55, p = 0.01) and 20 weeks (r = 0.64, p = 0.006). In conclusion, corneal changes detected on confocal microscopy show moderate association with peripheral neuropathy, indicating their potential to identify the development of oxaliplatin-induced peripheral neuropathy. However, further studies are required to confirm these findings.

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“…The cornea is the most densely innervated tissue of the human body, 400 times more densely innervated than the skin [ 1 ]. Adequate corneal innervation is vital to many aspects of normal ocular surface function, including maintenance of the tear film, perception of foreign bodies, recognition of noxious stimuli, and neurotrophic influences on the corneal epithelium [ 2 , 3 , 4 ].…”

Section: The Cornea and Neurotrophic Keratopathymentioning

confidence: 99%

Corneal Nerve Assessment by Aesthesiometry: History, Advancements, and Future Directions

Crabtree,

Tannir,

Tran

et al. 2024

Vision

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The measurement of corneal sensation allows clinicians to assess the status of corneal innervation and serves as a crucial indicator of corneal disease and eye health. Many devices are available to assess corneal sensation, including the Cochet–Bonnet aesthesiometer, the Belmonte Aesthesiometer, the Swiss Liquid Jet Aesthesiometer, and the newly introduced Corneal Esthesiometer Brill. Increasing the clinical use of in vivo confocal microscopy and optical coherence tomography will allow for greater insight into the diagnosis, classification, and monitoring of ocular surface diseases such as neurotrophic keratopathy; however, formal esthesiometric measurement remains necessary to assess the functional status of corneal nerves. These aesthesiometers vary widely in their mode of corneal stimulus generation and their relative accessibility, precision, and ease of clinical use. The development of future devices to optimize these characteristics, as well as further comparative studies between device types should enable more accurate and precise diagnosis and treatment of corneal innervation deficits. The purpose of this narrative review is to describe the advancements in the use of aesthesiometers since their introduction to clinical practice, compare currently available devices for assessing corneal innervation and their relative limitations, and discuss how the assessment of corneal innervation is crucial to understanding and treating pathologies of the ocular surface.

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Precision, agreement and utility of a contemporary non‐contact corneal aesthesiometer

Cited by 8 publications

References 33 publications

Corneal Confocal Microscopy in Type 1 Diabetes Mellitus: A Six-Year Longitudinal Study

Corneal Confocal Microscopy in Type 1 Diabetes Mellitus: A Six-Year Longitudinal Study

Corneal Nerve Changes Observed by In Vivo Confocal Microscopy in Patients Receiving Oxaliplatin for Colorectal Cancer: The COCO Study

Corneal Nerve Assessment by Aesthesiometry: History, Advancements, and Future Directions

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