Vision transformers for automated detection of diabetic peripheral neuropathy in corneal confocal microscopy images

Early detection and management of diabetic peripheral neuropathy (DPN) are critical to reducing associated morbidity and mortality. Corneal Confocal Microscopy (CCM) facilitates the imaging of corneal nerves to detect early and progressive nerve damage in DPN. However, its wider adoption has been li...

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Main Authors: Chaima Ben Rabah, Ioannis N. Petropoulos, Rayaz A. Malik, Ahmed Serag
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-02-01
Series:Frontiers in Imaging
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Online Access:https://www.frontiersin.org/articles/10.3389/fimag.2025.1542128/full
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author Chaima Ben Rabah
Ioannis N. Petropoulos
Rayaz A. Malik
Ahmed Serag
author_facet Chaima Ben Rabah
Ioannis N. Petropoulos
Rayaz A. Malik
Ahmed Serag
author_sort Chaima Ben Rabah
collection DOAJ
description Early detection and management of diabetic peripheral neuropathy (DPN) are critical to reducing associated morbidity and mortality. Corneal Confocal Microscopy (CCM) facilitates the imaging of corneal nerves to detect early and progressive nerve damage in DPN. However, its wider adoption has been limited by the subjectivity and time-intensive nature of manual nerve fiber quantification. This study investigates the diagnostic utility of state-of-the-art Vision Transformer (ViT) models for the binary classification of CCM images to distinguish between healthy controls and individuals with DPN. The ViT model's performance was also compared to ResNet50, a convolutional neural network (CNN) previously applied for DPN detection using CCM images. Using a dataset of approximately 700 CCM images, the ViT model achieved an AUC of 0.99, a sensitivity of 98%, a specificity of 92%, and an F1-score of 95%, outperforming previously reported methods. These findings highlight the potential of the ViT model as a reliable tool for CCM-based DPN diagnosis, eliminating the need for time-consuming manual image segmentation. Moreover, the results reinforce CCM's value as a non-invasive and precise imaging modality for detecting nerve damage, particularly in neuropathy-related conditions such as DPN.
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publisher Frontiers Media S.A.
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spelling doaj-art-93341ed1a82443fdbbd82484a6337f432025-02-03T06:33:24ZengFrontiers Media S.A.Frontiers in Imaging2813-33152025-02-01410.3389/fimag.2025.15421281542128Vision transformers for automated detection of diabetic peripheral neuropathy in corneal confocal microscopy imagesChaima Ben Rabah0Ioannis N. Petropoulos1Rayaz A. Malik2Ahmed Serag3AI Innovation Lab, Weill Cornell Medicine-Qatar, Doha, QatarDepartment of Medicine, Weill Cornell Medicine-Qatar, Doha, QatarDepartment of Medicine, Weill Cornell Medicine-Qatar, Doha, QatarAI Innovation Lab, Weill Cornell Medicine-Qatar, Doha, QatarEarly detection and management of diabetic peripheral neuropathy (DPN) are critical to reducing associated morbidity and mortality. Corneal Confocal Microscopy (CCM) facilitates the imaging of corneal nerves to detect early and progressive nerve damage in DPN. However, its wider adoption has been limited by the subjectivity and time-intensive nature of manual nerve fiber quantification. This study investigates the diagnostic utility of state-of-the-art Vision Transformer (ViT) models for the binary classification of CCM images to distinguish between healthy controls and individuals with DPN. The ViT model's performance was also compared to ResNet50, a convolutional neural network (CNN) previously applied for DPN detection using CCM images. Using a dataset of approximately 700 CCM images, the ViT model achieved an AUC of 0.99, a sensitivity of 98%, a specificity of 92%, and an F1-score of 95%, outperforming previously reported methods. These findings highlight the potential of the ViT model as a reliable tool for CCM-based DPN diagnosis, eliminating the need for time-consuming manual image segmentation. Moreover, the results reinforce CCM's value as a non-invasive and precise imaging modality for detecting nerve damage, particularly in neuropathy-related conditions such as DPN.https://www.frontiersin.org/articles/10.3389/fimag.2025.1542128/fullartificial intelligencediabetic neuropathycorneal confocal microscopyimage classificationdisease diagnosis
spellingShingle Chaima Ben Rabah
Ioannis N. Petropoulos
Rayaz A. Malik
Ahmed Serag
Vision transformers for automated detection of diabetic peripheral neuropathy in corneal confocal microscopy images
Frontiers in Imaging
artificial intelligence
diabetic neuropathy
corneal confocal microscopy
image classification
disease diagnosis
title Vision transformers for automated detection of diabetic peripheral neuropathy in corneal confocal microscopy images
title_full Vision transformers for automated detection of diabetic peripheral neuropathy in corneal confocal microscopy images
title_fullStr Vision transformers for automated detection of diabetic peripheral neuropathy in corneal confocal microscopy images
title_full_unstemmed Vision transformers for automated detection of diabetic peripheral neuropathy in corneal confocal microscopy images
title_short Vision transformers for automated detection of diabetic peripheral neuropathy in corneal confocal microscopy images
title_sort vision transformers for automated detection of diabetic peripheral neuropathy in corneal confocal microscopy images
topic artificial intelligence
diabetic neuropathy
corneal confocal microscopy
image classification
disease diagnosis
url https://www.frontiersin.org/articles/10.3389/fimag.2025.1542128/full
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AT ioannisnpetropoulos visiontransformersforautomateddetectionofdiabeticperipheralneuropathyincornealconfocalmicroscopyimages
AT rayazamalik visiontransformersforautomateddetectionofdiabeticperipheralneuropathyincornealconfocalmicroscopyimages
AT ahmedserag visiontransformersforautomateddetectionofdiabeticperipheralneuropathyincornealconfocalmicroscopyimages