A5010444069- Ocular Surface and Contact Lens
- Pain Mechanisms and Treatments
- Glaucoma and retinal disorders
- Corneal surgery and disorders
- Bee Products Chemical Analysis
- Retinal Diseases and Treatments
- Botulinum Toxin and Related Neurological Disorders
- Musculoskeletal pain and rehabilitation
- Lipoproteins and Cardiovascular Health
- Lipid metabolism and disorders
- Hormonal and reproductive studies
- Advanced Glycation End Products research
- Heart Rate Variability and Autonomic Control
- Sexual function and dysfunction studies
- Cardiovascular Disease and Adiposity
- Neurological and metabolic disorders
- Pharmacology and Obesity Treatment
- Diabetes Management and Research
- Ophthalmology and Visual Impairment Studies
- Acne and Rosacea Treatments and Effects
- Advanced Optical Imaging Technologies
- Atherosclerosis and Cardiovascular Diseases
- Body Contouring and Surgery
- Cardiovascular Health and Disease Prevention
- Antiplatelet Therapy and Cardiovascular Diseases
University of Manchester
2018-2025
NIHR Wellcome Trust Southampton Clinical Research Facility
2017-2023
Manchester University NHS Foundation Trust
2019-2022
National Institute for Health Research
2018
Purpose To assess the effect of applying a protocol for image selection and number images required adequate quantification corneal nerve pathology using in vivo confocal microscopy (IVCCM). Methods IVCCM was performed 35 participants by single examiner. For each participant, 4 observers used standardized to select 6 central inter-observer variability. Furthermore, were selected observer on two occasions intra-observer variability sample size assessed comparing with 12 images. Corneal fiber...
Abstract We assessed whether a measure of more distal corneal nerve fibre loss at the inferior whorl(IW) region is better than proximal measures central damage in relation to diagnosis diabetic peripheral neuropathy(DPN), painful DPN and quality life(QoL). Participants underwent detailed assessment neuropathy, QoL using SF36 questionnaire, pain visual analogue score(VAS), confocal microscopy(CCM). Corneal density (CNFD), branch (CNBD) length (CNFL) cornea whorl (IWL) average(ANFL)...
OBJECTIVE To assess the diagnostic utility of corneal confocal microscopy (CCM) for diabetic peripheral neuropathy (DPN) and risk factors nerve loss. RESEARCH DESIGN AND METHODS A total 490 participants, including 72 healthy control subjects, 149 with type 1 diabetes, 269 2 underwent detailed assessment CCM in relation to factors. RESULTS Corneal fiber density (CNFD) (P < 0.0001 P 0.0001), branch (CNBD) length (CNFL) = 0.02) were significantly lower patients diabetes compared...
There are limited data on the impact of bariatric surgery microvascular complications type 2 diabetes (T2D), particularly diabetic neuropathy. We assessed (especially neuropathy) in obese patients with T2D before and 12 months after surgery.This was a prospective observational cohort study. Measurements neuropathy symptom profile (NSP), disability score (NDS), vibration (VPT), cold (CPT) warm (WPT) perception thresholds, nerve conduction studies (NCS) corneal confocal microscopy (CCM) to...
Abstract Neuropathic pain is believed to arise from damage nociceptive C fibres in diabetic neuropathy (DN). We have utilised corneal confocal microscopy (CCM) quantify the severity of small nerve fibre relation neuropathic and quality life (QoL) patients with without painful DN. 30 controls (n = 78) painless 62) DN underwent assessment large function, CCM, symptoms (small symptom inventory questionnaire, scale) QoL (SF-36, pre-R-ODS hospital anxiety depression scale). Patients compared DN,...
We hypothesized that longitudinal changes in corneal nerve morphology would differ between the central cornea and inferior whorl relation to other measures of diabetic neuropathy.Thirty patients with diabetes (age: 54.08 ± 15.86, duration: 23.95 14.2, HbA1c: 7.51 1.37) 19 age-matched healthy controls 49.47 13.25) underwent assessment neuropathy disability score (NDS), vibration perception threshold (VPT), cold (CPT) warm (WPT) thresholds, peroneal motor conduction velocity (PMNCV), fiber...
Increased corneal and epidermal Langerhans cells (LCs) have been reported in patients with diabetic neuropathy. The aim of this study was to quantify the density LCs relation nerve morphology presence neuropathy determine if differed type 1 diabetes mellitus (T1DM), 2 (T2DM), latent autoimmune adults (LADA).
Abstract Accurately quantifying the progression of diabetic peripheral neuropathy is key to identify individuals who will progress foot ulceration and power clinical intervention trials. We have undertaken detailed phenotyping assess longitudinal utility different measures in patients with diabetes. Nineteen diabetes (age 52.5 ± 14.7 years, duration 26.0 13.8 years) 19 healthy controls underwent assessment symptoms signs neuropathy, quantitative sensory testing, autonomic nerve function,...
The purpose of this study was to assess the relationship between corneal keratocyte density (KD) and nerve damage in patients with without diabetic peripheral neuropathy.Eighty-six type 1 2 diabetes 21 age-matched control subjects underwent assessment neuropathy disability score, quantitative sensory testing, electrophysiology, confocal microscopy were divided into those (DN-) (n = 22) (DN+) 64) neuropathy. Corneal sub-basal parameters KD anterior, mid, posterior stroma quantified.Anterior,...
ABSTRACT Background Corneal confocal microscopy (CCM) is a noninvasive, reproducible ophthalmic technique to quantify corneal small nerve fiber degeneration. CCM demonstrates damage in Parkinson's disease (PD), but its role as longitudinal biomarker of PD progression has not been explored. Objective The aim this study was assess morphology using relation PD. Methods Sixty‐four participants with were assessed at baseline and 12‐month follow‐up. Participants underwent automated quantification...
Introduction Diabetic neuropathy can be diagnosed and assessed using a number of techniques including corneal confocal microscopy (CCM). Research design methods We have undertaken quantitative sensory testing, nerve conduction studies CCM in 143 patients with type 1 2 diabetes without (n=51), mild (n=47) moderate to severe (n=45) age-matched controls (n=30). Results Vibration perception threshold (p<0.0001), warm (WPT) (p<0.001), sural velocity (SNCV) fiber density (CNFD) branch (CNBD)...
Purpose: Obesity is associated with peripheral neuropathy, which bariatric surgery may ameliorate. The aim of this study was to assess whether corneal confocal microscopy can show a change in nerve morphology and keratocyte density subjects severe obesity after surgery. Methods: Twenty obese patients diabetes (n = 13) without 7) underwent assessment hemoglobin A1c (HbA1c), lipids, IL-6, highly sensitive C-reactive protein (hsCRP), before 12 months Corneal fiber (CNFD), branch (CNBD), length...
Abstract The dominant sensory phenotype in patients with diabetic polyneuropathy and neuropathic pain is a loss of function. This raises questions as to which mechanisms underlie generation the face potentially reduced afferent input. One potential mechanism spinal disinhibition, whereby inhibition leads increased ascending nociceptive drive due amplification of, or failure suppress, incoming signals from periphery. We aimed explore whether putative biomarker impaired rate-dependent...
Abstract Background and purpose Previously it has been shown that patients with painful diabetic neuropathy (PDN) have greater corneal nerve loss compared to painless neuropathy. This study investigated if the severity of was related PDN. Methods Participants ( n = 118) healthy controls 38) underwent clinical neurological evaluation, quantitative sensory testing, conduction testing confocal microscopy were categorized into those no 43), mild 34) moderate‐to‐severe 41) neuropathic pain....
Limited studies have identified risk factors linked to the progression of diabetic peripheral neuropathy (DPN) in type 2 diabetes. This study examined association with change measures over years. Participants diabetes (n = 78) and controls 26) underwent assessment clinical metabolic parameters using corneal confocal microscopy (CCM), vibration perception threshold (VPT), DN4 questionnaire at baseline year follow-up. had a lower nerve fiber density (CNFD), branch (CNBD), length (CNFL) (P ≤...
We studied the utility of corneal confocal microscopy (CCM) in detecting a reduction nerve parameters large cohort patients with Parkinson's disease (PD) compared to controls using fully automated potentially scalable method analysis. also assessed if CCM are related severity and sub-type PD. 98 participants PD 26 healthy underwent quantification, MDS-UPDRS III, Hoehn Yahr scale, Montreal Cognitive Assessment, Disease Questionnaire-39 subtype assessment. Corneal fibre density (mean...
Damage to small nociceptive fibres may contribute painful diabetic neuropathy. We aimed compare large and nerve fibre measurements together with skin biopsy corneal confocal microscopy in patients type 1 diabetes or painless neuropathy.We have assessed the McGill pain questionnaire, neuropathy disability score, vibration perception threshold, warm cold sensation thresholds, electrophysiology, participants (n = 41) 50) control subjects 50).The duration of diabetes, body mass index, glycated...
Purpose: Patients with diabetes have a propensity to develop dry eye symptoms (DES), reduced tear secretion and corneal sensitivity. The underlying pathologic basis of DES was explored in patients Type 1 diabetes. Methods: Forty-two mellitus (T1DM) (age: 49.21 ± 2.53 years, duration diabetes: 29.98 2.64 years) 25 control subjects 48.70 2.84 underwent assessment using validated questionnaire, stability production were assessed breakup time (TBUT) Schirmer's test, respectively. Corneal...
OBJECTIVE Impaired rate-dependent depression of the Hoffman reflex (HRDD) is a marker spinal inhibitory dysfunction and has previously been associated with painful neuropathy in proof-of-concept study patients type 1 diabetes. We have now undertaken an assessment HRDD or 2 RESEARCH DESIGN AND METHODS A total 148 participants, including 34 healthy control subjects, 42 diabetic neuropathy, 62 without pain, underwent detailed peripheral nerve conduction studies, corneal confocal microscopy,...
Context Multiple factors contribute to sexual dysfunction in men with obesity. Sex hormone levels are commonly abnormal obesity and this abnormality is often the focus of management clinical practice. The role small fibre neuropathy obesity-related not well established. Objective We aimed investigate relationship between function, sex nerve morphology severe Materials methods A prospective study 29 was undertaken. Sexual function assessed using European Male Ageing Study Function...