Sandvik Siv A, Morisbakk Tove Lise, Lundanes Eilin, Lid Jorunn, Lagali Neil, Sundling Vibeke
Department of Optometry, Radiology and Lighting Design, University of South-Eastern Norway, Kongsberg, Norway
Department of Optometry, Radiology and Lighting Design, University of South-Eastern Norway, Kongsberg, Norway.
BMJ Open. 2025 Sep 4;15(9):e098294. doi: 10.1136/bmjopen-2024-098294.
To map, summarise and analyse the methodologies of corneal nerve fibre imaging in studies using in vivo confocal microscopy (IVCM) in diabetes and assess the potential for standardising methods and reporting.
A scoping review was conducted using five databases, MEDLINE, Embase, Cochrane, Web of Science and Scopus, with search terms related to IVCM, diabetes and corneal nerves. Two researchers independently screened the studies for eligibility. Relevant data were extracted and systematically analysed.
Out of 1533 screened articles, 195 met the inclusion criteria. Spanning from 2000 to 2024, the studies showed high variability in image acquisition, image processing, image analysis and reporting detail. Most studies used laser scanning confocal microscopy, examining the central cornea in both eyes in patients with type 2 diabetes, manually selecting 3-6 images from each eye, and using ACCMetrics and CCMetrics for quantifying corneal nerve fibre length in mm/mm. Many studies lacked sufficient methodological details for reproducibility.
IVCM studies of corneal nerve fibres in diabetes show substantial methodological heterogeneity and inconsistent reporting, limiting reproducibility. We propose a guideline to support standardisation and improve the reliability of future research.
在糖尿病患者体内共聚焦显微镜（IVCM）研究中，绘制、总结并分析角膜神经纤维成像方法，评估方法标准化及报告的可能性。
使用五个数据库（MEDLINE、Embase、Cochrane、Web of Science和Scopus）进行范围综述，搜索词与IVCM、糖尿病和角膜神经相关。两名研究人员独立筛选研究的合格性。提取相关数据并进行系统分析。
在1533篇筛选文章中，195篇符合纳入标准。研究时间跨度从2000年至2024年，在图像采集、图像处理、图像分析和报告细节方面显示出高度变异性。大多数研究使用激光扫描共聚焦显微镜，检查2型糖尿病患者双眼的中央角膜，每只眼睛手动选择3至6张图像，并使用ACCMetrics和CCMetrics以毫米/毫米为单位量化角膜神经纤维长度。许多研究缺乏足够的方法学细节以实现可重复性。
糖尿病患者角膜神经纤维的IVCM研究显示出显著的方法学异质性和报告不一致性，限制了可重复性。我们提出一项指南以支持标准化并提高未来研究的可靠性。
