Skip to main content
SpringerLink
Log in

In-vivo-Bildgebung des kornealen Nervenplexus

Vom Einzelbild zur großflächigen Darstellung

In vivo imaging of the corneal nerve plexus

From single image to large scale map

  • Leitthema
  • Published:
Der Ophthalmologe Aims and scope Submit manuscript

Zusammenfassung

Der subbasale Nervenplexus (SNP) der Kornea bietet die Möglichkeit, periphere Nervenstrukturen nichtinvasiv in vivo mithilfe der Konfokalmikroskopie (CCM) zu untersuchen. Morphologische Veränderungen des SNP können so unmittelbar detektiert und quantitativ charakterisiert werden. Aufgrund der inhomogenen Verteilung der Nervenfasern reicht eine einzelne CCM-Aufnahme für eine valide Diagnose nicht aus. Gesucht werden daher Verfahren zur großflächigen Erfassung des SNP. Dieser Beitrag gibt einen Überblick über publizierte Ansätze zur Lösung dieses Problems. Aktuelle Entwicklungsarbeiten am Karlsruher Institut für Technologie und der Universitätsaugenklinik in Rostock lassen zukünftig eine vereinfachte Handhabung der Technologie und eine weitere Verbesserung der Bildqualität erwarten.

Abstract

The sub-basal nerve plexus (SNP) of the cornea provides the possibility of in vivo and non-invasive examination of peripheral nerve structures by corneal confocal microscopy (CCM). Thus morphological alterations of the SNP can be directly detected and quantified. A single CCM image is insufficient for a well-founded diagnosis because of the inhomogeneous distribution of the nerve fibers; therefore, there is a demand for techniques for large area imaging of the SNP. This article provides an overview of published approaches to the problem. Current developmental work at the Karlsruhe Institute of Technology and the University of Rostock Eye Clinic is expected to lead to a simplified handling of the technology and a further improvement in the image quality.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5
Abb. 6

Literatur

  1. Ahmed A, Bril V, Orszag A, Paulson J, Yeung E, Ngo M, Orlov S, Perkins BA (2012) Detection of diabetic sensorimotor polyneuropathy by corneal confocal microscopy in type 1 diabetes: a concurrent validity study. Diabetes Care 35(4):821–828. doi:10.2337/dc11-1396

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Allgeier S, Eberle F, Köhler B, Maier S, Stachs O, Guthoff RF, Bretthauer G (2010) Ein neues Mosaikbildverfahren zur großflächigen Darstellung des subbasalen Nervenplexus der Kornea in vivo. Biomed Tech (Berl) 55(Suppl 1). doi:10.1515/bmt.2010.710

    Google Scholar 

  3. Allgeier S, Köhler B, Eberle F, Maier S, Stachs O, Zhivov A, Bretthauer G (2011) Elastische Registrierung von in-vivo-CLSM-Aufnahmen der Kornea. In: Handels H, Ehrhardt J, Deserno TM, Meinzer H‑P, Tolxdorff T (Hrsg) Bildverarbeitung für die Medizin 2011. Algorithmen – Systeme – Anwendungen. Springer, Berlin Heidelberg, S 149–153

    Chapter  Google Scholar 

  4. Allgeier S, Zhivov A, Eberle F, Köhler B, Maier S, Bretthauer G, Guthoff RF, Stachs O (2011) Image reconstruction of the subbasal nerve plexus with in vivo confocal microscopy. Invest Ophthalmol Vis Sci 52(9):5022–5028. doi:10.1167/iovs.10-6065

    Article  PubMed  Google Scholar 

  5. Allgeier S, Maier S, Mikut R, Peschel S, Reichert K‑M, Stachs O, Köhler B (2014) Mosaicking the subbasal nerve plexus by guided eye movements. Invest Ophthalmol Vis Sci 55(9):6082–6089. doi:10.1167/iovs.14-14698

    Article  PubMed  Google Scholar 

  6. Allgeier S, Winter K, Bretthauer G, Guthoff RF, Peschel S, Reichert K‑M, Stachs O, Kohler B (2016) A novel approach to analyze the progression of measured corneal sub-basal nerve fiber length in continuously expanding mosaic images. Curr Eye Res. doi:10.1080/02713683.2016.1221977

    Google Scholar 

  7. Baltrusch S (2017) Der konfokal mikroskopisch sichtbare korneale Nervenplexus als Biomarker für systemische Erkrankungen. Ophthalmologe. doi:10.1007/s00347-017-0480-4

  8. Bartschat A, Toso L, Stegmaier J, Kuijper A, Mikut R, Köhler B, Allgeier S (2016) Automatic corneal tissue classification using bag-of-visual-words approaches. In: Puente León F, Heizmann M (Hrsg) Forum Bildverarbeitung 2016. KIT Scientific Publishing, Karlsruhe, S 245–256

    Google Scholar 

  9. De Cillà S, Ranno S, Carini E, Fogagnolo P, Ceresara G, Orzalesi N, Rossetti LM (2009) Corneal subbasal nerves changes in patients with diabetic retinopathy: an in vivo confocal study. Invest Ophthalmol Vis Sci 50(11):5155–5158. doi:10.1167/iovs.09-3384

    Article  PubMed  Google Scholar 

  10. De Clerck EEB, Schouten JSAG, Berendschot TTJM, Kessels AGH, Nuijts RMMA, Beckers HJM, Schram MT, Stehouwer CDA, Webers CAB (2015) New ophthalmologic imaging techniques for detection and monitoring of neurodegenerative changes in diabetes: a systematic review. Lancet Diabetes Endocrinol 3(8):653–663. doi:10.1016/S2213-8587(15)00136-9

    Article  PubMed  Google Scholar 

  11. Edwards K, Pritchard N, Gosschalk K, Sampson GP, Russell AW, Malik RA, Efron N (2012) Wide-field assessment of the human corneal subbasal nerve plexus in diabetic neuropathy using a novel mapping technique. Cornea 31(9):1078–1082

    Article  PubMed  Google Scholar 

  12. Grupcheva CN, Wong T, Riley AF, McGhee CNJ (2002) Assessing the sub-basal nerve plexus of the living healthy human cornea by in vivo confocal microscopy. Clin Experiment Ophthalmol 30(3):187–190

    Article  PubMed  Google Scholar 

  13. Guthoff RF, Baudouin C, Stave J (2006) Atlas of confocal laser scanning in-vivo microscopy in ophthalmology. Principles and applications in diagnostic and therapeutic ophthalmology. Springer, Berlin Heidelberg

    Google Scholar 

  14. Hertz P, Bril V, Orszag A, Ahmed A, Ng E, Nwe P, Ngo M, Perkins BA (2011) Reproducibility of in vivo corneal confocal microscopy as a novel screening test for early diabetic sensorimotor polyneuropathy. Diabet Med 28(10):1253–1260. doi:10.1111/j.1464-5491.2011.03299.x

    Article  CAS  PubMed  Google Scholar 

  15. Köhler B, Allgeier S, Eberle F, Maier S, Peschel S, Reichert K‑M, Stachs O (2014) Grossflächige Abbildung kornealer Nervenfasern durch geführte Augenbewegungen. Klin Monbl Augenheilkd 231(12):1170–1173. doi:10.1055/s-0034-1383331

    Article  PubMed  Google Scholar 

  16. Köhler B, Bretthauer G, Guthoff R, Reichert K‑M, Sieber I, Stachs O, Toso L, Allgeier S (2016) EyeGuidance – a computer controlled system to guide eye movements. Curr Dir Biomed Eng 2:433–436. doi:10.1515/cdbme-2016-0096

    Google Scholar 

  17. Malik R, Kallinikos P, Abbott C, van Schie C, Morgan P, Efron N, Boulton A (2003) Corneal confocal microscopy: a non-invasive surrogate of nerve fibre damage and repair in diabetic patients. Diabetologia 46(5):683–688. doi:10.1007/s00125-003-1086-8

    Article  CAS  PubMed  Google Scholar 

  18. Misra S, Craig JP, McGhee CNJ, Patel DV (2012) Interocular comparison by in vivo confocal microscopy of the 2‑dimensional architecture of the normal human corneal subbasal nerve plexus. Cornea 31(12):1376–1380. doi:10.1097/ICO.0b013e31823f0b60

    Article  PubMed  Google Scholar 

  19. Patel DV, McGhee CNJ (2005) Mapping of the normal human corneal sub-Basal nerve plexus by in vivo laser scanning confocal microscopy. Invest Ophthalmol Vis Sci 46(12):4485–4488. doi:10.1167/iovs.05-0794

    Article  PubMed  Google Scholar 

  20. Patel DV, McGhee CNJ (2006) Mapping the corneal sub-basal nerve plexus in keratoconus by in vivo laser scanning confocal microscopy. Invest Ophthalmol Vis Sci 47(4):1348–1351. doi:10.1167/iovs.05-1217

    Article  PubMed  Google Scholar 

  21. Patel DV, McGhee CNJ (2008) In vivo laser scanning confocal microscopy confirms that the human corneal sub-basal nerve plexus is a highly dynamic structure. Invest Ophthalmol Vis Sci 49(8):3409–3412. doi:10.1167/iovs.08-1951

    Article  PubMed  Google Scholar 

  22. Rosenberg ME, Tervo TMT, Immonen IJ, Müller LJ, Grönhagen-Riska C, Vesaluoma MH (2000) Corneal structure and sensitivity in type 1 diabetes mellitus. Invest Ophthalmol Vis Sci 41(10):2915–2921

    CAS  PubMed  Google Scholar 

  23. Tavakoli M, Quattrini C, Abbott CA, Kallinikos PA, Marshall A, Finnigan J, Morgan P, Efron N, Boulton AJM, Malik RA (2010) Corneal confocal microscopy: a novel noninvasive test to diagnose and stratify the severity of human diabetic neuropathy. Diabetes Care 33(8):1792–1797. doi:10.2337/dc10-0253

    Article  PubMed  PubMed Central  Google Scholar 

  24. Tavakoli M, Kallinikos PA, Iqbal A, Herbert A, Fadavi H, Efron N, Boulton AJM, Malik RA (2011) Corneal confocal microscopy detects improvement in corneal nerve morphology with an improvement in risk factors for diabetic neuropathy. Diabet Med 28(10):1261–1267. doi:10.1111/j.1464-5491.2011.03372.x

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Tavakoli M, Mitu-Pretorian M, Petropoulos IN, Fadavi H, Asghar O, Alam U, Ponirakis G, Jeziorska M, Marshall A, Efron N, Boulton AJM, Augustine T, Malik RA (2013) Corneal confocal microscopy detects early nerve regeneration in diabetic neuropathy after simultaneous pancreas and kidney transplantation. Diabetes 62(1):254–260. doi:10.2337/db12-0574

    Article  CAS  PubMed  Google Scholar 

  26. Toso L, Allgeier S, Eberle F, Maier S, Reichert K‑M, Köhler B (2015) Iterative algorithms for the generation of large scale mosaic images. In: Handels H, Deserno TM, Meinzer H‑P, Tolxdorff T (Hrsg) Bildverarbeitung für die Medizin 2015. Algorithmen – Systeme – Anwendungen. Proceedings des Workshops vom 15. bis 17. März 2015 in Lübeck. Springer Vieweg, Berlin, S 203–208

    Google Scholar 

  27. Turuwhenua JT, Patel DV, McGhee CNJ (2012) Fully automated montaging of laser scanning in vivo confocal microscopy images of the human corneal subbasal nerve plexus. Invest Ophthalmol Vis Sci 53(4):2235–2242. doi:10.1167/iovs.11-8454

    Article  PubMed  Google Scholar 

  28. Vagenas D, Pritchard N, Edwards K, Shahidi AM, Sampson GP, Russell AW, Malik RA, Efron N (2012) Optimal image sample size for corneal nerve morphometry. Optom Vis Sci 89(5):812–817. doi:10.1097/OPX.0b013e31824ee8c9

    Article  PubMed  Google Scholar 

  29. Winter K, Scheibe P, Guthoff RF, Allgeier S, Stachs O (2017) Morphometrische Charakterisierung des subbasalen Nervenplexus. Ophthalmologe. doi:10.1007/s00347-017-0465-3

  30. Winter K, Scheibe P, Köhler B, Allgeier S, Guthoff RF, Stachs O (2015) Local variability of parameters for characterization of the corneal Subbasal nerve plexus. Curr Eye Res. doi:10.3109/02713683.2015.1010686

    PubMed  Google Scholar 

  31. Yokogawa H, Kobayashi A, Sugiyama K (2008) Mapping of normal corneal K‑structures by in vivo laser confocal microscopy. Cornea 27(8):879–883. doi:10.1097/ICO.0b013e318170aed0

    Article  PubMed  Google Scholar 

  32. Zhivov A, Blum M, Guthoff RF, Stachs O (2010) Real-time mapping of the subepithelial nerve plexus by in vivo confocal laser scanning microscopy. Br J Ophthalmol 94(9):1133–1135. doi:10.1136/bjo.2009.175489

    Article  PubMed  Google Scholar 

  33. Ziegler D, Papanas N, Zhivov A, Allgeier S, Winter K, Ziegler I, Brüggemann J, Strom A, Peschel S, Köhler B, Stachs O, Guthoff RF, Roden M, German Diabetes Study (GDS) Group (2014) Early detection of nerve fiber loss by corneal confocal microscopy and skin biopsy in recently diagnosed type 2 diabetes. Diabetes 63(7):2454–2463. doi:10.2337/db13-1819

    Article  PubMed  Google Scholar 

Download references

Förderung

Die vorgestellten Arbeiten sind in Teilen gefördert von der Heidelberg Engineering GmbH, der Helmholtz Gemeinschaft und der Deutschen Forschungsgemeinschaft (Förderkennzeichen: KO 5003/1-1, MI 1315/5-1 und STA 543/6-1).

Author information

Authors and Affiliations

  1. Institut für Angewandte Informatik, Karlsruher Institut für Technologie, Kaiserstraße 12, 76131, Karlsruhe, Deutschland

    B. Köhler, S. Allgeier, A. Bartschat, K.-M. Reichert & R. Mikut

  2. Universitätsaugenklinik, Universitätsmedizin Rostock, Rostock, Deutschland

    R. F. Guthoff, S. Bohn & O. Stachs

  3. Institut für Anatomie, Medizinische Fakultät, Universität Leipzig, Leipzig, Deutschland

    K. Winter

Authors
  1. B. Köhler
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Allgeier
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Bartschat
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R. F. Guthoff
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. S. Bohn
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. K.-M. Reichert
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. O. Stachs
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. K. Winter
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. R. Mikut
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to B. Köhler.

Ethics declarations

Interessenkonflikt

B. Köhler, S. Allgeier, A. Bartschat, R.F. Guthoff, S. Bohn, K.-M. Reichert, O. Stachs, K. Winter und R. Mikut geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Köhler, B., Allgeier, S., Bartschat, A. et al. In-vivo-Bildgebung des kornealen Nervenplexus. Ophthalmologe 114, 601–607 (2017). https://doi.org/10.1007/s00347-017-0464-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00347-017-0464-4

Schlüsselwörter

Keywords

Search

Navigation