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Mohamed Abou Shousha, Matthew Council, Sean Edelstein, Ravi S Shah, Xiaotang Yin, Eric Schmidt, Patrick M Stuart, Sonia H Yoo, Victor L Perez; Descemet’s Membrane Thickness (DMT): A Novel Sign for the Diagnosis of Corneal Graft Rejection. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4863.
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© ARVO (1962-2015); The Authors (2016-present)
Evaluate the use of Descemet’s Membrane Thickness (DMT) in the diagnosis of corneal graft rejection.
We evaluated 63 eyes, which included: 27 functional grafts, 10 immunologically rejected grafts, 6 failed grafts secondary to non-immunological causes and 20 normal control eyes. These eyes were imaged using spectral domain optical coherence tomography and DMT was compared among groups and correlated to status of their corneas.
Immunologically rejected grafts showed significantly thicker DMT than normal control eyes and functional grafts (52 vs. 17 and 17 μm; P<0.001). While comparison of total corneal thickness between immunologically rejected grafts and non-immunologically failed grafts did not reveal a significant difference (886 vs. 758 μm, P=0.9), comparison of DMT between these groups demonstrated a greater than two-fold difference (52 vs. 24 μm, P=0.01). In non-immunologically failed grafts, both DMT and host corneal thickness were 1.5 fold those of functional grafts. Whereas, in immunologically rejected grafts, DMT thickening was 3.25 fold thicker when corneal thickness was only 1.7 fold thicker than those of functional grafts.
DMT is a novel sign for the diagnosis of corneal graft immunological rejection. It is of particular interest that in rejected grafts, the increase in DMT is caused by the immunological insult not just the swelling of the cornea. Evaluating the use of DMT to diagnose subclinical rejection is warranted.
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