Differences in corneal endothelial abnormalities in the central and intermediate zones in Fuchs’ corneal dystrophy

Abstract

Purpose: Fuchs’ corneal dystrophy is a progressive corneal endothelial dystrophy that causes irreversible endothelial change and bullous keratopathy. To investigate the regional differences in the abnormality, we examined the corneal endothelium at multiple sites, including the periphery.

Methods: 17 eyes of 9 patients (6 women and 3 men; 30-80 years old) with Fuchs’ corneal dystrophy were studied at Osaka University Hospital. We used a newly developed non-contact specular microscope (NIDEK CEM-530) to examine the intermediate zone 27 degrees in the periphery from the corneal center in addition to the center and the peripheral 5 degrees from the center. We measured the size of the degenerative area with guttata and the cellular density in the residual intact area.

Results: The abnormal areas in the central zone (center and 5 degrees from the center) represented 65.4 ± 33.7% of the total area, and those in the 27 degrees of the peripheral zone represented 27.1 ± 34.2% of the total area. The results differed significantly (P < 0.001). The abnormal areas in the 27 degrees of the peripheral zone of 16 of 17 eyes were significantly (P< 0.05) larger than those in the center. In the 6 points 27 degrees of the peripheral zones, the abnormal areas inferiorly were significantly (P < 0.001) larger than superiorly, by the usage of z score analysis

Conclusions: In Fuchs’ corneal dystrophy, the corneal endothelial cells degenerate more rapidly in the central zone than the intermediate zone. This finding might offer new information to facilitate an understanding of the disease mechanisms.

Keywords: 481 cornea: endothelium