An Eye on the Diabetic Foot
Research type
Research Study
Full title
The Utility of Non-Invasive Ocular Imaging in Diabetic Foot Disease
IRAS ID
246882
Contact name
Uazman Alam
Contact email
Sponsor organisation
University of Liverpool
Duration of Study in the UK
1 years, 5 months, 30 days
Research summary
Advanced diabetic neuropathy, the nerve damage of diabetes, is a major cause of ill-health and death worldwide. Diabetic neuropathy leads to numbness and sometimes pain and weakness in the hands, arms, feet, and legs, and in some cases, foot ulceration and even amputation of a limb. Therefore, the accurate detection and characterisation of diabetic neuropathy including those at danger of foot ulceration is important to identify patients at risk, anticipate and monitor deterioration. A relatively new technique called corneal confocal microscopy (CCM) can be used to examine small nerve fibres in the cornea, the clear tissue at the front of the eye, at 700X magnification. CCM is a non-invasive, quick, cost-effective and reiterative method of imaging nerves in the human cornea. CCM has been shown to be capable of accurate diagnosis of neuropathy in people with diabetes. The aim of this work is to employ novel non-invasive techniques such as CCM and optical coherence tomography (OCT) and OCT Angiography (OCTA) in the eye as a measure of peripheral nerve dysfunction and vascular dysfunction and to determine systemic small nerve fibre loss at the time of diabetic foot ulceration. This would provide a rapid, reiterative method of ascertaining those at the highest risk of diabetic foot disease and translating this into real world clinical practice. Our aim is to determine differences in corneal nerve fibre pathology between those with neuropathy and neuropathic foot ulcers in type 1 diabetes and thus delineate putative prognostic cut offs. Our secondary objectives are to explore the relationship of OCT and OCTA measures which are non-invasive ocular tests to neuropathy and neuropathic diabetic foot ulcers.
REC name
North West - Preston Research Ethics Committee
REC reference
18/NW/0532
Date of REC Opinion
2 Oct 2018
REC opinion
Further Information Favourable Opinion