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Nicola Pritchard - Top 30 Publications

Corneal confocal microscopy for identification of diabetic sensorimotor polyneuropathy: a pooled multinational consortium study.

Small cohort studies raise the hypothesis that corneal nerve abnormalities (including corneal nerve fibre length [CNFL]) are valid non-invasive imaging endpoints for diabetic sensorimotor polyneuropathy (DSP). We aimed to establish concurrent validity and diagnostic thresholds in a large cohort of participants with and without DSP.

Corneal and Retinal Neuronal Degeneration in Early Stages of Diabetic Retinopathy.

To examine the neuronal structural integrity of cornea and retina as markers for neuronal degeneration in nonproliferative diabetic retinopathy (NPDR).

Ophthalmic and clinical factors that predict four-year development and worsening of diabetic retinopathy in type 1 diabetes.

To investigate the role of ophthalmic imaging markers - namely retinal thickness measures and corneal nerve morphology - in predicting four-year development and worsening of diabetic retinopathy (DR) in type 1 diabetes (T1DM).

Presence of Peripheral Neuropathy Is Associated With Progressive Thinning of Retinal Nerve Fiber Layer in Type 1 Diabetes.

Reduced retinal nerve fiber layer (RNFL) thickness has been demonstrated in patients with diabetic peripheral neuropathy (DPN) in cross-sectional studies. This prospective study defines longitudinal alterations to the RNFL thickness in individuals with type 1 diabetes without (DPN-ve) and with (DPN+ve) DPN and in relation to risk factors for nerve damage.

Optical coherence tomography predicts 4-year incident diabetic neuropathy.

To examine the capability of optical coherence tomography-derived retinal thickness measures in detecting 4-year incident diabetic peripheral neuropathy (DPN).

Corneal confocal microscopy best identifies the development and progression of neuropathy in patients with type 1 diabetes.

A sub-set of 38 individuals with type 1 diabetes that fulfilled a strict criterion of "normal" classification for all 7 measures of neuropathy at baseline, were identified and followed. Corneal nerve morphology, as captured with corneal confocal microscopy demonstrated the greatest, and most sustained degeneration over a 4 year period.

Focal loss volume of ganglion cell complex in diabetic neuropathy.

The aim was to investigate the relationship between diabetic peripheral neuropathy (DPN) and abnormalities in ganglion cell complex (GCC); specifically, focal loss volume (FLV) and global loss volume (GLV).

Abnormal Anterior Corneal Morphology in Diabetes Observed Using In Vivo Laser-scanning Confocal Microscopy.

To assess if diabetes alters corneal epithelial, anterior stromal and subbasal nerve plexus morphology and to determine the associations between these and other clinical variables.

A rapid decline in corneal small fibers and occurrence of foot ulceration and Charcot foot.

We present clinical, neuropathy and corneal nerve morphology data in a participant with type 2 diabetes who developed diabetic foot ulceration, partial amputation and Charcot during a longitudinal observational study. While conventional measures of neuropathy did not deteriorate significantly, corneal nerve parameters showed a rapid reduction prior to the development of foot complications.

Diagnostic capability of retinal thickness measures in diabetic peripheral neuropathy.

To examine the diagnostic capability of the full retinal and inner retinal thickness measures in differentiating individuals with diabetic peripheral neuropathy (DPN) from those without neuropathy and non-diabetic controls.

Characterization of Goblet Cells in a Pterygium Biopsy Using Laser Scanning Confocal Microscopy and Immunohistochemistry.

To confirm that structures presumed to be GCs observed using laser scanning confocal microscopy (LSCM) are actually GCs.

Longitudinal changes in Langerhans cell density of the cornea and conjunctiva in contact lens-induced dry eye.

The aim was to determine longitudinal changes in Langerhans cell density (LCD) in the human cornea and conjunctiva during asymptomatic and symptomatic contact lens wear.

Repeatability of Measuring Corneal Nerve Migration Rate in Individuals With and Without Diabetes.

To assess the repeatability of measuring the corneal nerve migration rate in individuals with and without neuropathy.

Time Course of Changes in Goblet Cell Density in Symptomatic and Asymptomatic Contact Lens Wearers.

To investigate longitudinal changes in goblet cell density (GCD) in contact lens (CL) wearers who do and do not develop symptoms of dry eye (DE).

Inflammatory Cell Upregulation of the Lid Wiper in Contact Lens Dry Eye.

To determine if Langerhans cells in the lid wiper are upregulated in contact lens-induced dry eye (CLIDE).

Development of a Novel Technique to Measure Corneal Nerve Migration Rate.

We have developed a novel technique to measure in vivo corneal nerve migration.

Retinal Tissue Thickness is Reduced in Diabetic Peripheral Neuropathy.

To investigate the relationship between diabetic peripheral neuropathy (DPN) and retinal tissue thickness.

Changes in corneal Langerhans cell density during the first few hours of contact lens wear.

To determine the impact of contact lens wear on Langerhans cell density (LCD) in the central cornea over an 8h period.

Retinal tissue thickness in type 1 and type 2 diabetes.

The objective was to investigate full retinal and inner retinal thickness in individuals with type 1 and type 2 diabetes.

Assessment of conjunctival goblet cell density using laser scanning confocal microscopy versus impression cytology.

To determine the association between conjunctival goblet cell density (GCD) assessed using in vivo laser scanning confocal microscopy and conjunctival impression cytology in a healthy population.

Risk Factors Associated With Corneal Nerve Alteration in Type 1 Diabetes in the Absence of Neuropathy: A Longitudinal In Vivo Corneal Confocal Microscopy Study.

The aim of this study was to determine alterations to the corneal subbasal nerve plexus (SNP) over 4 years using in vivo corneal confocal microscopy in participants with type 1 diabetes and to identify significant risk factors associated with these alterations.

Retinal thickness profile of individuals with diabetes.

To examine the retinal thickness profiles of individuals with and without diabetic retinopathy (DR).

Utility of Assessing Nerve Morphology in Central Cornea Versus Whorl Area for Diagnosing Diabetic Peripheral Neuropathy.

To compare small nerve fiber damage in the central cornea and whorl area in participants with diabetic peripheral neuropathy (DPN) and to examine the accuracy of evaluating these 2 anatomical sites for the diagnosis of DPN.

Biometry of eyes in type 1 diabetes.

This is a comprehensive study of a large range of biometric and optical parameters in people with type 1 diabetes. The parameters of 74 people with type 1 diabetes and an age matched control group were assessed. Most of the people with diabetes had low levels of neuropathy, retinopathy and nephropathy. Marginal or no significant differences were found between groups for corneal shape, corneal thickness, pupil size, and pupil decentrations. Relative to the control group, the diabetes group demonstrated smaller anterior chamber depths, more curved lenses, greater lens thickness and lower lens equivalent refractive index. While the optics of diabetic eyes make them appear as older eyes than those of people of the same age without diabetes, the differences did not increase significantly with age. Age-related changes in the optics of the eyes of people with diabetes need not be accelerated if the diabetes is well controlled.

Normative values for corneal nerve morphology assessed using corneal confocal microscopy: a multinational normative data set.

Corneal confocal microscopy is a novel diagnostic technique for the detection of nerve damage and repair in a range of peripheral neuropathies, in particular diabetic neuropathy. Normative reference values are required to enable clinical translation and wider use of this technique. We have therefore undertaken a multicenter collaboration to provide worldwide age-adjusted normative values of corneal nerve fiber parameters.

Corneal confocal microscopy predicts 4-year incident peripheral neuropathy in type 1 diabetes.

This study determined if deficits in corneal nerve fiber length (CNFL) assessed using corneal confocal microscopy (CCM) can predict future onset of diabetic peripheral neuropathy (DPN).

Natural history of corneal nerve morphology in mild neuropathy associated with type 1 diabetes: development of a potential measure of diabetic peripheral neuropathy.

To investigate longitudinal changes of subbasal nerve plexus (SNP) morphology and its relationship with conventional measures of neuropathy in individuals with diabetes.

Amplitude of accommodation in type 1 diabetes.

People with diabetes have accelerated age-related biometric ocular changes compared with people without diabetes. We determined the effect of type 1 diabetes on amplitude of accommodation.

Fully automated, semiautomated, and manual morphometric analysis of corneal subbasal nerve plexus in individuals with and without diabetes.

The aim of the study was to determine the association, agreement, and detection capability of manual, semiautomated, and fully automated methods of corneal nerve fiber length (CNFL) quantification of the human corneal subbasal nerve plexus (SNP).

Morphometric stability of the corneal subbasal nerve plexus in healthy individuals: a 3-year longitudinal study using corneal confocal microscopy.

We examined the age-dependent alterations and longitudinal course of subbasal nerve plexus (SNP) morphology in healthy individuals.