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Franziska Bucher, Werner Adler, Helmar Lehmann, Deniz Hos, Philipp Steven, Claus Cursiefen, Ludwig M. Heindl; Corneal Nerve Alterations in Different Stages of Fuchs’ Endothelial Corneal Dystrophy. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2447.
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To analyze potential alterations in corneal nerve morphology and function in different stages of Fuchs’ endothelial corneal dystrophy (FECD).
Thirty eyes with FECD underwent in vivo confocal microscopy to quantify the morphology of the central subbasal corneal nerve plexus (total nerve length, total nerve number, number of main nerve trunks, number of nerve branches) as well as esthesiometry of the central cornea to determine central corneal sensation as a measure of nerve function. Comparisons to biomicroscopical stage of FECD, visual acuity and central corneal thickness were performed using Spearman correlation.
Total nerve length (ρ=-0.806, p<0.001), total nerve number (ρ=-0.745, p<0.001), number of main nerve trunks (ρ=-0.602, p<0.001), and number of nerve branches (ρ=-0.706, p<0.001) decreased significantly with increasing FECD stages. Comparing to the visual acuity, significant positive correlations were found for total nerve length (ρ=0.455, p=0.012), total nerve number (ρ=0.504, p=0.005), number of main nerve trunks (ρ=0.433, p=0.017), and number of nerve branches (ρ=0.469, p=0.009). With central corneal thickness, there were significant inverse correlations for total nerve length (ρ=-0.596, p=0.001), total nerve number (ρ=-0.459, p=0.012), number of main nerve trunks (ρ=-0.448, p=0.015), and number of nerve branches (ρ=-0.441, p=0.017). Central corneal sensation was full in all FECD stage 1, stage 2 and stage 3 eyes, but mildly reduced in FECD stage 4 eyes.
Increasing severity of Fuchs’ endothelial corneal dystrophy (FECD) is concurrent with marked attenuation of the density as well as mild diminishment of the function of the subbasal corneal nerve plexus in advanced stages of the disease.
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