September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Diagnostic performance of the Endothelial/Descemet’s membrane thickness versus endothelial cell density in the diagnosis of corneal graft rejection.
Author Affiliations & Notes
  • Georgios Kontadakis
    Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States
    1st Department of Ophthalmology, Ophthalmiatreio Eye Hospital of Athens, ATHENS, Greece
  • Christopher Smith
    Saint Louis University Eye Institute, Saint Louis University, Saint Louis, Missouri, United States
  • Daniel Kaitis
    Saint Louis University Eye Institute, Saint Louis University, Saint Louis, Missouri, United States
  • Rocio Bentivegna
    Saint Louis University Eye Institute, Saint Louis University, Saint Louis, Missouri, United States
  • Jordan Winegar
    Saint Louis University Eye Institute, Saint Louis University, Saint Louis, Missouri, United States
  • Sonia H Yoo
    Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States
  • Victor L Perez
    Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States
  • Mohamed Abou Shousha
    Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States
  • Footnotes
    Commercial Relationships   Georgios Kontadakis, None; Christopher Smith, None; Daniel Kaitis, None; Rocio Bentivegna, None; Jordan Winegar, None; Sonia Yoo, None; Victor Perez, None; Mohamed Abou Shousha, University of Miami (P)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 1933. doi:
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      Georgios Kontadakis, Christopher Smith, Daniel Kaitis, Rocio Bentivegna, Jordan Winegar, Sonia H Yoo, Victor L Perez, Mohamed Abou Shousha; Diagnostic performance of the Endothelial/Descemet’s membrane thickness versus endothelial cell density in the diagnosis of corneal graft rejection.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1933.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To assess the diagnostic performance of the Endothelial/Descemet’s membrane thickness (En/DMT) as measured by the high resolution optical coherence tomography (HD-OCT) in the diagnosis of corneal graft rejection and compare it to that of endothelial cell density (ECD) and central corneal thickness (CCT).

Methods : This prospective study includes 42 corneal grafts. Assessment included detailed history, clinical examination, automated assessment of the corneal endothelial layer with corneal confocal microscopy, and corneal imaging with HD-OCT. Blinded observers calculated manually CCT and EnDMT on HD-OCT images. Eyes were divided into two groups, rejected and clear grafts. CCT, EnDMT and ECD were compared between groups. Diagnostic performance of EnDMT for the diagnosis of graft rejection was evaluated using receiver operating characteristic (ROC) curves.

Results : CCT and EnDMT showed statistically significant differences among groups. Clear grafts’ mean CCT was 525 μm (±74) and mean EnDMT was 15μm (SD 3). Whereas, in the rejected grafts group, mean CCT was 809μm (±251) and mean EnDMT was 48 μm (SD 49, p<0.05 for corresponding comparisons, Mann-Whitney U test). On the other hand, no significant difference in ECD was found between the two groups. EnDMT showed better diagnostic accuracy than CCT (EnDMT area under the curve, AUC was 0.93, p<0.001 and for CCT AUC was 0.81, p<0.001).

Conclusions : Endothelial/Descemet’s membrane thickness demonstrated excellent accuracy in the diagnosis of corneal graft rejection, which is significantly better than that of central corneal thickness and endothelial cell density.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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