Optom trial to scan cornea for diabetic nerve damage

A six-month trial led by the University of Manchester will see community optometrists monitor patients with diabetic eye disease for signs of nerve damage

30 Apr 2015 by Ryan O'Hare

Researchers at the University of Manchester are embarking on a six-month project to screen patients for diabetic nerve damage by scanning the nerves of the cornea. If successful, the technique could form part of the diagnostic arsenal of community optometrists.

The £200,000 project, which is part-funded by Heidelberg Engineering, will be carried out at four optometry practices in Greater Manchester and aims to assess the feasibility of a community approach, alongside diabetic retinopathy screening.

Diabetic neuropathy is a common long-term complication of diabetes which affects the nerves. It mainly affects the legs and feet and can lead to ulceration and even amputation of a patient’s foot. The damage to nerve fibres is normally assessed through skin and nerve biopsies.

The four practices in the study will be in the areas of Harpurhey, Hulme, Urmston and Altrincham, in order to capture the diversity of the Greater Manchester region. Each practice will monitor 100 patients with diabetic eye disease using confocal microscopy to monitor the corneal nerves for signs of diabetic neuropathy, avoiding the need for invasive biopsies.

The project’s lead researcher, Dr Mitra Tavakoli, said: “Early identification of neuropathy enables earlier treatment to control progression of this serious and life-limiting condition. Corneal confocal microscopy (CCM) is an established diagnostic tool used in a variety of other clinical applications. This relatively novel eye test is non-invasive and quick to administer, making it an ideal method to study the cornea as a sensitive alternative marker to detect diabetic neuropathy early.”

Dr Tavakoli added: “In the future, we expect High Street opticians to be performing this screening for both retinopathy and neuropathy and to share this data with General Practitioners. Currently only the Heidelberg Engineering technology is sensitive enough to monitor these minute changes,” she added.”

The study is also funded by the Collaboration for Leadership in Applied Research and Care (CLAHRC) General Manchester, National Institute for Health Research. Clinicians involved in the study will use Heidelberg’s HRT3 retina tomography with Rostock Corneal Module to assess patients.

Image credit: National Eye Institute, National Institutes of Health

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