{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T15:59:52Z","timestamp":1790351992538,"version":"4.1.0"},"reference-count":59,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T00:00:00Z","timestamp":1730073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>The eye, and the cornea in particular, is a common site of chemotherapy induced toxicity, and ocular side effects of both traditional and novel agents have been reported. Corneal confocal microscopy (CCM) is an in vivo technique that allows for the study of all the corneal layers in an easy, non-invasive and reproducible way via the direct visualization of corneal cell morphologies as well as of sub-basal nerve plexus. Thus, it represents a useful way to identify and monitor chemotherapy induced corneal alterations. This work aims to review the use of CCM in identifying corneal toxicity secondary to chemotherapy treatment, as regards both corneal nerves alterations in the setting of chemotherapy induced peripheral neuropathy (CIPN) and other corneal structure changes, particularly involving the corneal epithelium.<\/jats:p>","DOI":"10.3390\/diagnostics14212399","type":"journal-article","created":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T07:04:04Z","timestamp":1730099044000},"page":"2399","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Chemotherapy Induced Corneal Changes Assessed by Corneal Confocal Microscopy: A Review"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8579-3211","authenticated-orcid":false,"given":"Eleonora","family":"Cosmo","sequence":"first","affiliation":[{"name":"Department of Neuroscience\u2014Ophthalmology, University of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4712-6631","authenticated-orcid":false,"given":"Giulia","family":"Midena","sequence":"additional","affiliation":[{"name":"IRCCS\u2014Fondazione Bietti, 00198 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0216-727X","authenticated-orcid":false,"given":"Raffaele","family":"Parrozzani","sequence":"additional","affiliation":[{"name":"Department of Neuroscience\u2014Ophthalmology, University of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Midena","sequence":"additional","affiliation":[{"name":"Department of Neuroscience\u2014Ophthalmology, University of Padova, 35128 Padova, Italy"},{"name":"IRCCS\u2014Fondazione Bietti, 00198 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"47","DOI":"10.3892\/mco.2023.2643","article-title":"Development, Efficacy and Side Effects of Antibody\u2013Drug Conjugates for Cancer Therapy (Review)","volume":"18","author":"Sun","year":"2023","journal-title":"Mol. Clin. Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"407","DOI":"10.3892\/ijo.2018.4661","article-title":"From Chemotherapy to Biological Therapy: A Review of Novel Concepts to Reduce the Side Effects of Systemic Cancer Treatment","volume":"54","author":"Schirrmacher","year":"2019","journal-title":"Int. J. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1771","DOI":"10.1007\/s00417-019-04337-8","article-title":"Known and Novel Ocular Toxicities of Biologics, Targeted Agents, and Traditional Chemotherapeutics","volume":"257","author":"Kunkler","year":"2019","journal-title":"Graefe\u2019s Arch. Clin. Exp. Ophthalmol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1016\/j.jcrs.2010.12.037","article-title":"Anatomy and Physiology of the Cornea","volume":"37","author":"DelMonte","year":"2011","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1097\/00003226-200105000-00008","article-title":"Morphology of Corneal Nerves Using Confocal Microscopy","volume":"20","author":"Efron","year":"2001","journal-title":"Cornea"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Cosmo, E., Midena, G., Frizziero, L., Bruno, M., Cecere, M., and Midena, E. (2022). Corneal Confocal Microscopy as a Quantitative Imaging Biomarker of Diabetic Peripheral Neuropathy: A Review. J. Clin. Med., 11.","DOI":"10.3390\/jcm11175130"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"S1011","DOI":"10.3928\/1081-597X-20071102-06","article-title":"Long-Term Effects on Corneal Keratocytes of Mitomycin C during Photorefractive Keratectomy: A Randomized Contralateral Eye Confocal Microscopy Study","volume":"23","author":"Midena","year":"2007","journal-title":"J. Refract. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1136\/bjo.2010.183244","article-title":"Topical 1% 5-Fluorouracil in Ocular Surface Squamous Neoplasia: A Long-Term Safety Study","volume":"95","author":"Parrozzani","year":"2011","journal-title":"Br. J. Ophthalmol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/j.ophtha.2011.09.018","article-title":"Corneal Confocal Microscopy in Patients with Vernal Keratoconjunctivitis","volume":"119","author":"Leonardi","year":"2012","journal-title":"Ophthalmology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1390","DOI":"10.1167\/iovs.14-15004","article-title":"Small Fiber Peripheral Neuropathy in Wilson Disease: An in Vivo Documentation by Corneal Confocal Microscopy","volume":"56","author":"Sturniolo","year":"2015","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Midena, E., Cosmo, E., Cattelan, A.M., Briani, C., Leoni, D., Capizzi, A., Tabacchi, V., Parrozzani, R., Midena, G., and Frizziero, L. (2022). Small Fibre Peripheral Alterations Following COVID-19 Detected by Corneal Confocal Microscopy. J. Pers. Med., 12.","DOI":"10.3390\/jpm12040563"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1038\/nrclinonc.2015.152","article-title":"Cancer-Treatment-Induced Neurotoxicity--Focus on Newer Treatments","volume":"13","author":"Stone","year":"2016","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"419","DOI":"10.3322\/caac.21204","article-title":"Chemotherapy-Induced Peripheral Neurotoxicity: A Critical Analysis","volume":"63","author":"Park","year":"2013","journal-title":"CA Cancer J. Clin."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.jtos.2021.06.007","article-title":"Corneal Nerve Changes Following Treatment with Neurotoxic Anticancer Drugs","volume":"21","author":"Chiang","year":"2021","journal-title":"Ocul. Surf."},{"key":"ref_15","first-page":"1361","article-title":"Neurophysiological, Nerve Imaging and Other Techniques to Assess Chemotherapy-Induced Peripheral Neurotoxicity in the Clinical and Research Settings","volume":"90","author":"Argyriou","year":"2019","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1136\/jnnp-2017-317215","article-title":"Incidence and Disease Burden of Chemotherapy-Induced Peripheral Neuropathy in a Population-Based Cohort","volume":"89","author":"Shah","year":"2018","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Zajaczkowsk\u0105, R., Kocot-K\u0119pska, M., Leppert, W., Wrzosek, A., Mika, J., and Wordliczek, J. (2019). Mechanisms of Chemotherapy-Induced Peripheral Neuropathy. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20061451"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1016\/j.neurol.2020.11.001","article-title":"Clinical and Biochemical Markers in CIPN: A Reappraisal","volume":"177","author":"Bonomo","year":"2021","journal-title":"Rev. Neurol. (Paris)"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1111\/jns5.12036","article-title":"Corneal Confocal Microscopy in Patients with Oxaliplatin-Induced Peripheral Neuropathy","volume":"18","author":"Campagnolo","year":"2013","journal-title":"J. Peripher. Nerv. Syst."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Ferdousi, M., Azmi, S., Petropoulos, I.N., Fadavi, H., Ponirakis, G., Marshall, A., Tavakoli, M., Malik, I., Mansoor, W., and Malik, R.A. (2015). Corneal Confocal Microscopy Detects Small Fibre Neuropathy in Patients with Upper Gastrointestinal Cancer and Nerve Regeneration in Chemotherapy Induced Peripheral Neuropathy. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0139394"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1111\/jns.12413","article-title":"Oxaliplatin- and Docetaxel-Induced Polyneuropathy: Clinical and Neurophysiological Characteristics","volume":"25","author":"Bennedsgaard","year":"2020","journal-title":"J. Peripher. Nerv. Syst."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1167\/tvst.10.1.24","article-title":"A Cross-Sectional Study of Sub-Basal Corneal Nerve Reduction Following Neurotoxic Chemotherapy","volume":"10","author":"Chiang","year":"2021","journal-title":"Transl. Vis. Sci. Technol."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Chiang, J.C.B., Goldstein, D., Trinh, T., Au, K., Park, S.B., Krishnan, A.V., and Markoulli, M. (2021). A Cross-Sectional Study of Ocular Surface Discomfort and Corneal Nerve Dysfunction after Paclitaxel Treatment for Cancer. Sci. Rep., 11.","DOI":"10.1038\/s41598-021-81398-y"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Tyler, E.F., McGhee, C.N.J., Lawrence, B., Braatvedt, G.D., Mankowski, J.L., Oakley, J.D., Sethi, S., and Misra, S.L. (2022). Corneal Nerve Changes Observed by In Vivo Confocal Microscopy in Patients Receiving Oxaliplatin for Colorectal Cancer: The COCO Study. J. Clin. Med., 11.","DOI":"10.3390\/jcm11164770"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Riva, N., Bonelli, F., Lasagni Vitar, R.M., Barbariga, M., Fonteyne, P., Lopez, I.D., Domi, T., Scarpa, F., Ruggeri, A., and Reni, M. (2022). Corneal and Epidermal Nerve Quantification in Chemotherapy Induced Peripheral Neuropathy. Front. Med., 9.","DOI":"10.3389\/fmed.2022.832344"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1001\/archneurol.2010.17","article-title":"Chemotherapy-Associated Peripheral Sensory Neuropathy Assessed Using in Vivo Corneal Confocal Microscopy","volume":"67","author":"Ferrari","year":"2010","journal-title":"Arch. Neurol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"3440","DOI":"10.3109\/10428194.2015.1023723","article-title":"Corneal Sub-Basal Neural Damage Pattern in Multiple Myeloma Patients Treated with Bortezomib: An in Vivo Confocal Study","volume":"56","author":"Cocito","year":"2015","journal-title":"Leuk. Lymphoma"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Parrozzani, R., Lombardi, G., Midena, E., Londei, D., Padovan, M., Marchione, G., Caccese, M., Midena, G., Zagonel, V., and Frizziero, L. (2020). Ocular Side Effects of EGFR-Inhibitor ABT-414 in Recurrent Glioblastoma: A Long-Term Safety Study. Front. Oncol., 10.","DOI":"10.3389\/fonc.2020.593461"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1002\/mus.21874","article-title":"Early, Progressive, and Sustained Dysfunction of Sensory Axons Underlies Paclitaxel-Induced Neuropathy","volume":"43","author":"Park","year":"2011","journal-title":"Muscle Nerve"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1111\/jns.12097","article-title":"Long-Term Course of Oxaliplatin-Induced Polyneuropathy: A Prospective 2-Year Follow-up Study","volume":"19","author":"Briani","year":"2014","journal-title":"J. Peripher. Nerv. Syst."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/j.ejphar.2014.07.025","article-title":"Cisplatin in Cancer Therapy: Molecular Mechanisms of Action","volume":"740","author":"Dasari","year":"2014","journal-title":"Eur. J. Pharmacol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1038\/nrc1317","article-title":"Microtubules as a Target for Anticancer Drugs","volume":"4","author":"Jordan","year":"2004","journal-title":"Nat. Rev. Cancer"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Chiang, J.C.B., Goldstein, D., Tavakoli, A., Trinh, T., Klisser, J., Lewis, C.R., Friedlander, M., Naduvilath, T.J., Au, K., and Park, S.B. (2021). Corneal Dendritic Cells and the Subbasal Nerve Plexus Following Neurotoxic Treatment with Oxaliplatin or Paclitaxel. Sci. Rep., 11.","DOI":"10.1038\/s41598-021-02439-0"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"109253","DOI":"10.1016\/j.exer.2022.109253","article-title":"Tear Film Substance P in Patients Treated with Neurotoxic Chemotherapy","volume":"224","author":"Chiang","year":"2022","journal-title":"Exp. Eye Res."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Sterenczak, K.A., Stache, N., Bohn, S., Allgeier, S., K\u00f6hler, B., Bartschat, A., George, C., Guthoff, R.F., Stachs, O., and Stachs, A. (2021). Burst of Corneal Dendritic Cells during Trastuzumab and Paclitaxel Treatment. Diagnostics, 11.","DOI":"10.3390\/diagnostics11050838"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Bohn, S., Stache, N., Sperlich, K., Allgeier, S., K\u00f6hler, B., Bartschat, A., Do, H.V., George, C., Guthoff, R.F., and Stachs, A. (2022). In Vivo Monitoring of Corneal Dendritic Cells in the Subbasal Nerve Plexus during Trastuzumab and Paclitaxel Breast Cancer Therapy-A One-Year Follow-Up. Diagnostics, 12.","DOI":"10.3390\/diagnostics12051180"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1097\/00001813-200409000-00005","article-title":"Peripheral Neuropathy Associated with Capecitabine","volume":"15","author":"Saif","year":"2004","journal-title":"Anticancer Drugs"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1016\/j.jfo.2018.07.005","article-title":"Ocular Surface Adverse Events of Systemic Epidermal Growth Factor Receptor Inhibitors (EGFRi): A Prospective Trial","volume":"41","author":"Reguart","year":"2018","journal-title":"J. Fr. Ophtalmol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1758835920907543","DOI":"10.1177\/1758835920907543","article-title":"Corneal Side Effects Induced by EGFR-Inhibitor Antibody\u2013Drug Conjugate ABT-414 in Patients with Recurrent Glioblastoma: A Prospective Clinical and Confocal Microscopy Study","volume":"12","author":"Parrozzani","year":"2020","journal-title":"Ther. Adv. Med. Oncol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"27","DOI":"10.3109\/08820538.2011.631510","article-title":"Tamoxifen Keratopathy as Seen with In-Vivo Confocal Microscopy","volume":"27","author":"Tarafdar","year":"2012","journal-title":"Semin. Ophthalmol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e427","DOI":"10.1016\/j.clbc.2018.03.005","article-title":"Corneal Changes in Trastuzumab Emtansine Treatment","volume":"18","author":"Kreps","year":"2018","journal-title":"Clin. Breast Cancer"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1007\/s10549-019-05179-y","article-title":"Corneal Features in Trastuzumab Emtansine Treatment: Not a Rare Occurrence","volume":"175","author":"Deklerck","year":"2019","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1097\/ICO.0000000000001560","article-title":"Confocal Microscopy Observation of Cornea Verticillata After Vandetanib Therapy for Medullary Thyroid Carcinoma","volume":"37","year":"2018","journal-title":"Cornea"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1007\/s40123-020-00280-8","article-title":"Corneal Epithelial Findings in Patients with Multiple Myeloma Treated with Antibody\u2013Drug Conjugate Belantamab Mafodotin in the Pivotal, Randomized, DREAMM-2 Study","volume":"9","author":"Farooq","year":"2020","journal-title":"Ophthalmol. Ther."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1186\/s13045-021-01172-5","article-title":"Corneal in Vivo Confocal Microscopy to Detect Belantamab Mafodotin-Induced Ocular Toxicity Early and Adjust the Dose Accordingly: A Case Report","volume":"14","author":"Marquant","year":"2021","journal-title":"J. Hematol. Oncol."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Mencucci, R., Cennamo, M., Alonzo, L., Senni, C., Vagge, A., Desideri, L.F., Scorcia, V., and Giannaccare, G. (2022). Corneal Findings Associated to Belantamab-Mafodotin (Belamaf) Use in a Series of Patients Examined Longitudinally by Means of Advanced Corneal Imaging. J. Clin. Med., 11.","DOI":"10.3390\/jcm11102884"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1881","DOI":"10.21873\/invivo.12451","article-title":"Treatment of Capecitabine Corneal Side Effects with Autologous Blood-Derived Serum Eye Drops","volume":"35","author":"Gattazzo","year":"2021","journal-title":"In Vivo"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"114","DOI":"10.4274\/tjo.galenos.2020.99248","article-title":"Cytarabine-Induced Corneal Toxicity: Clinical Features and Relief of Symptoms with Loteprednol Etabonate 0.5% in Two Patients","volume":"51","year":"2021","journal-title":"Turk. J. Ophthalmol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1177\/112067219500500406","article-title":"Screening for Tamoxifen Ocular Toxicity: A Prospective Study","volume":"5","author":"Therssen","year":"1995","journal-title":"Eur. J. Ophthalmol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1089\/jop.2015.0064","article-title":"Ocular Adverse Events Associated with Antibody-Drug Conjugates in Human Clinical Trials","volume":"31","author":"Eaton","year":"2015","journal-title":"J. Ocul. Pharmacol. Ther."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1097\/00003226-200101000-00016","article-title":"Expression of the Receptor Tyrosine Kinases, Epidermal Growth Factor Receptor, ErbB2, and ErbB3, in Human Ocular Surface Epithelia","volume":"20","author":"Liu","year":"2001","journal-title":"Cornea"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1006\/exer.2000.0979","article-title":"The Epidermal Growth Factor Receptor (EGFR): Role in Corneal Wound Healing and Homeostasis","volume":"72","author":"Nakamura","year":"2001","journal-title":"Exp. Eye Res."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/S1470-2045(19)30788-0","article-title":"Belantamab Mafodotin for Relapsed or Refractory Multiple Myeloma (DREAMM-2): A Two-Arm, Randomised, Open-Label, Phase 2 Study","volume":"21","author":"Lonial","year":"2020","journal-title":"Lancet Oncol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1016\/j.survophthal.2012.12.003","article-title":"Quantitative Analysis of Invivo Confocal Microscopy Images: A Review","volume":"58","author":"Patel","year":"2013","journal-title":"Surv. Ophthalmol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1109\/TBME.2016.2573642","article-title":"An Automatic Tool for Quantification of Nerve Fibres in Corneal Confocal Microscopy Images","volume":"64","author":"Chen","year":"2017","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1007\/s00125-019-05023-4","article-title":"An Artificial Intelligence-Based Deep Learning Algorithm for the Diagnosis of Diabetic Neuropathy Using Corneal Confocal Microscopy: A Development and Validation Study","volume":"63","author":"Williams","year":"2020","journal-title":"Diabetologia"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Mehrgardt, P., Zandavi, S.M., Poon, S.K., Kim, J., Markoulli, M., and Khushi, M. (2020). U-Net Segmented Adjacent Angle Detection (USAAD) for Automatic Analysis of Corneal Nerve Structures. Data, 5.","DOI":"10.3390\/data5020037"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1167\/tvst.9.2.32","article-title":"A Deep Learning Model for Automated Sub-Basal Corneal Nerve Segmentation and Evaluation Using In Vivo Confocal Microscopy","volume":"9","author":"Wei","year":"2020","journal-title":"Transl. Vis. Sci. Technol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1097\/ICO.0000000000002181","article-title":"Multiple-Image Deep Learning Analysis for Neuropathy Detection in Corneal Nerve Images","volume":"39","author":"Scarpa","year":"2020","journal-title":"Cornea"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/21\/2399\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:22:15Z","timestamp":1760113335000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/21\/2399"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,28]]},"references-count":59,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2024,11]]}},"alternative-id":["diagnostics14212399"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics14212399","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,28]]}}}