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Hiroko Nakagawa, Tsutomu Inatomi, Shigeru Kinoshita; Evaluation of the central and peripheral corneal endothelial cells in patients with Fuchs’ Endothelial Corneal Dystrophy. Invest. Ophthalmol. Vis. Sci. 2014;55(13):994.
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© ARVO (1962-2015); The Authors (2016-present)
To analyze the clinical characteristics and the central and peripheral corneal endothelial cells of Japanese patients suffering from Fuchs’ Endothelial Corneal Dystrophy (FECD).
This study involved 96 eyes of 48 Japanese FECD patients. Patient age, sex, history of keratoplasty, severity of the disease, corneal endothelial cell density (ECD), and corneal thickness were analyzed. Severity was graded on the Krachmer Grading Scale (graded 1-5). Noncontact specular microscopy (SP-3000; TOMEY Corp., Nagoya, Japan) was used to evaluate corneal endothelium at the central region, and wide-field contact specular microscopy (prototype model; Konan Medical, Inc., Nishinomiya, Japan) was used to evaluate the peripheral corneal regions.
Of the total 48 patients, 17 (35%) were male and 31 (65%) were female (mean age: 69 years). Of those, 30 eyes of 25 patients had undergone keratoplasty (penetrating keratoplasty: 5 eyes, Descemets’ Stripping Automated Endothelial Keratoplasty: 25 eyes). Severity grading results revealed 3 (3%) Grade-1 eyes (>12 central guttae in either eye), 3 (3%) Grade-2 eyes (confluent central guttae 1-2mm), 9 (9%) Grade-3 eyes (confluent central guttae 2-5mm), 37 (39%) Grade-4 eyes (confluent central guttae > 5mm), and 44 (46%) Grade-5 eyes (Grade 4+edema). The mean ECD in the central region was 1385±655 cells/mm2 (15 eyes) (excluding the 30 keratoplasty eyes and 51 eyes in which ECD was unmeasurable). The mean ECD in the peripheral region (horizontal peripheral area at approximately 8mm) was 1540±713 cells/mm2 (29 eyes). The mean corneal thickness was 595±59μm. A negative correlation was found between peripheral ECD and corneal thickness (p=0.02).
The findings of this study show that analysis of the distribution of guttae in the central and peripheral corneal ECD is important for evaluating the severity and for elucidating the pathology of FECD.
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