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Research Article
Rayaz A. Malik
Weill Cornell Medicine-Qatar
Corresponding Author
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Background: In patients with ischemic stroke, pial collaterals play a key role in limiting neurological disability by maintaining blood flow to ischemic penumbra. We hypothesized that patient with poor pial collateral status will have greater corneal nerve and endothelial cell abnormalities.
Method: 35 patients with acute ischemic stroke secondary to middle cerebral artery occlusion with poor (n=12) and moderate/good (n=23) pial collaterals and 35 healthy controls underwent corneal confocal microscopy and quantification of corneal nerve and endothelial cell morphology.
Results: In patients with MCA stroke, corneal nerve fibre length (CNFL) (P=0.000), density (CNFD) (P=0.025) and branch density (CNBD) (P=0.002) were lower compared to controls. Age, BMI, cholesterol, triglycerides, HDL, LDL, systolic blood pressure, NIHSS and endothelial cell parameters did not differ but mRS was higher (p=0.023) and CNFL (p=0.026) and CNBD (p=0.044) were lower in patients with poor compared to moderate-good collaterals. CNFL and CNBD distinguished subjects with poor from good pial collaterals with an AUC of 72% (95% CI: 53-92%) and 71% (95% CI: 53-90%), respectively.
Conclusion: Corneal nerve loss is greater in patients with poor compared to good pial collaterals and may act as a surrogate marker for pial collateral status in patients with ischemic stroke.
Keywords
Corneal Nerve Fibre, Corneal Confocal Microscopy, Corneal Endothelial Cell Pial Collateral, Stroke
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No competing interests reported.
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CURRENT STATUS: Under Review
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Posted 27 May, 2021
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Editorial decision: Major revision
On 23 Jul, 2021
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Received 22 Jul, 2021
Reviewers agreed
On 19 Jul, 2021
Reviews received
Received 19 Jul, 2021
Reviewers agreed
On 12 Jul, 2021
Reviewers invited
Invitations sent on 18 Jun, 2021
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A new preprint design is coming!
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This preprint is under consideration at Scientific Reports. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Rayaz A. Malik
Weill Cornell Medicine-Qatar
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 27 May, 2021
No community comments so far
Editorial decision: Major revision
On 23 Jul, 2021
Reviews received
Received 22 Jul, 2021
Reviewers agreed
On 19 Jul, 2021
Reviews received
Received 19 Jul, 2021
Reviewers agreed
On 12 Jul, 2021
Reviewers invited
Invitations sent on 18 Jun, 2021
Editor assigned
On 18 Jun, 2021
Editor invited
On 27 May, 2021
Submission checks complete
On 25 May, 2021
First submitted
On 24 May, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: In patients with ischemic stroke, pial collaterals play a key role in limiting neurological disability by maintaining blood flow to ischemic penumbra. We hypothesized that patient with poor pial collateral status will have greater corneal nerve and endothelial cell abnormalities.
Method: 35 patients with acute ischemic stroke secondary to middle cerebral artery occlusion with poor (n=12) and moderate/good (n=23) pial collaterals and 35 healthy controls underwent corneal confocal microscopy and quantification of corneal nerve and endothelial cell morphology.
Results: In patients with MCA stroke, corneal nerve fibre length (CNFL) (P=0.000), density (CNFD) (P=0.025) and branch density (CNBD) (P=0.002) were lower compared to controls. Age, BMI, cholesterol, triglycerides, HDL, LDL, systolic blood pressure, NIHSS and endothelial cell parameters did not differ but mRS was higher (p=0.023) and CNFL (p=0.026) and CNBD (p=0.044) were lower in patients with poor compared to moderate-good collaterals. CNFL and CNBD distinguished subjects with poor from good pial collaterals with an AUC of 72% (95% CI: 53-92%) and 71% (95% CI: 53-90%), respectively.
Conclusion: Corneal nerve loss is greater in patients with poor compared to good pial collaterals and may act as a surrogate marker for pial collateral status in patients with ischemic stroke.
Figure 1
Figure 2
Figure 3
Figure 4
No competing interests reported.
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