INTRAEPIDERMAL NERVE FIBER ANALYSIS USING IMMUNOFLUORESCENCE WITH AND WITHOUT CONFOCAL MICROSCOPY

IntroductionIntraepidermal nerve fiber (IENF) linear density is a reliable tool to detect small-fiber neuropathies. In immunofluorescence, the IENF count is performed typically by computer-assisted nerve tracing on confocal images. Alternatively, the count can be performed directly through the oculars of a standard epifluorescence microscope. We specifically compared measures obtained using the 2 methods. MethodsWe compared measures of IENF density in the same 50 skin samples using computer-assisted image analysis and direct count. ResultsThere was excellent agreement between the 2 methods. Linear regression showed a slope between paired measures virtually equal to 1 (=0.99). Bland-Altman analysis showed a mean difference (offset) between the measures of 0.460.91 fibers/mm. ConclusionsDirect observation with epifluorescence microscopy proved as reliable as the more time-consuming 3-dimensional computer-assisted analysis of confocal digital images for determining IENF density. Muscle Nerve 51: 501-504, 2015