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CCMetrics is an image analysis software which allows manual quantification of nerve fibre metrics from single or multiple CCM images.

Product specification: Corneal Nerve Fibre Image analysis

Product description: CCMetrics allows quantification of subbasal nerve fibre metrics in images obtained using the Heidelberg HRT III corneal confocal microscope. It quantifies the Corneal Nerve Fibre Length (CNFL), Nerve Fibre Density (CNFD), Nerve Branch Density (CNBD), Nerve Fibre Tortuosity (CNFT) from single CCM images with a field of view of 400x400 um2.

This software has applications in the quantification of corneal nerve abnormalities for a variety of peripheral neuropathies such as diabetic neuropathy, chemotherapy induced peripheral neuropathy, sarcoid neuropathy, CMT1A, Fabry disease etc.

​​Product requirements: 32 & 64 bit computer processor

Cut-off point​s: 

Manual (automated) quantification of CNFD and CNFL with CCMetrics provides high sensitivity/specificity for diagnosis of peripheral neuropathy and is associated with a high odds ratio (OR) (Petropoulos et al. 2014). A manual CNFD result of 18.7 no./mm2 (14.7) is associated with sens/spec of 0.79/0.78 (0.76/0.72) and OR of 16.5 (11.0). A manual CNFL result of 15.8 mm/mm2 (14.6) is associated with sens/spec of 0.77/0.76 (0.77/0.74) and OR of 9.8 (12.9).



If you publish results using CCMetrics, we expect acknowledgement and appropriate citation of the following papers, which describe the design and validation of the software.

Software design:

Dabbah , MA, Graham, J, Petropoulos, I, Tavakoli, M, Malik, RA (2011). Automatic Analysis of Diabetic Peripheral Neuropathy using Multi-scale Quantitative Morphology of Nerve Fibres in Corneal Confocal Microscopy Imaging, Journal of Medical Image Analysis 15(5), 738-747.

Dabbah, MA, Graham, J, Petropoulos, I, Tavakoli, M, Malik, RA (2010). Dual-model automatic detection of nerve-fibres in corneal confocal microscopy images, Med Image Comput Comput Assist Interv 13, 300-307.

Validation of the corneal nerve parameters:​

Petropoulos IN, Alam U, Fadavi H, Marshall A, Asghar O, Dabbah MA, et al. Rapid automated diagnosis of diabetic peripheral neuropathy with in vivo corneal confocal microscopy. Investigative ophthalmology & visual science 2014; 55:2071-2078.

Petropoulos IN, Manzoor T, Morgan P, Fadavi H, Asghar O, Alam U, et al. Repeatability of in vivo corneal confocal microscopy to quantify corneal nerve morphology. Cornea 2013; 32:e83-89.

Chen X, Graham J, Dabbah MA, Petropoulos IN, Ponirakis G, Asghar O, et al. Small nerve fiber quantification in the diagnosis of diabetic sensorimotor polyneuropathy: comparing corneal confocal microscopy with intraepidermal nerve fiber density. Diabetes Care 2015; 38:1138-1144.

Tavakoli M, Ferdousi M, Petropoulos IN, Morris J, Pritchard N, Zhivov A, et al. Normative values for corneal nerve morphology assessed using corneal confocal microscopy: a multinational normative data set. Diabetes Care 2015; 38:838-843.


Product Training:  2 day training courses are available in both Manchester, England and Doha, Qatar. These practical hands-on courses have been established to train researchers in CCM image acquisition and image analysis.

  • Dr. ​Maryam Ferdousi at the University of Manchester, UK
  • Dr. Ioannis Petropoulos at Weill Cornell Medicine in Qatar

To book a course please contact Georgios Ponirakis at ccmanalytics@qatar-med.cornell.edu.​​


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Corneal Nerve Fibre Quantification

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MAN_002-3494548-v2-UMIP Annual Research Licence C2G final 1.00

Annual Research Licence

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Term: 12 months
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MAN_002-3494503-v2-UMIP Annual Commercial Licence FOC c2g FINAL 1.00

This is a free of charge, annual licence for the use of the software by commercial organisations only.

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