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A. M. Alfawaz, G. N. Holland, F. Yu, J. A. Giaconi, R. D. Levinson, A. J. Aldave; Corneal Endothelial Cell Changes in Patients With Uveitis. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4866.
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© ARVO (1962-2015); The Authors (2016-present)
To describe corneal endothelial changes in eyes with anterior segment inflammation and to identify host and disease factors that affect these changes.
In a prospective, cross-sectional study, parameters associated with corneal endothelium (including central cell density, percent hexagonality) were evaluated for both eyes of patients with anterior or panuveitis using a Konan SP-8800 noncontact specular microscope (Konan Medical USA, Torrance, CA). Central corneal thickness was determined by ultrasound pachymetry (Tomey SP 3000; Tomey USA, Phoenix, AZ). Data regarding demographics, laterality of uveitis, disease course, and nature of inflammatory signs were recorded. Results were compared to a well-characterized historical population of normal, age-matched controls. Differences were evaluated using T-tests and Wilcoxon signed rank tests.
Both eyes of 42 patients were evaluated (14 unilateral, 28 bilateral uveitis; 70 involved eyes). Central cell density was lowest among eyes that had undergone cataract surgery or placement of glaucoma drainage devices. Among all eyes that had not undergone surgery (n=50), mean central cell density was lower in eyes with uveitis than in control eyes for each age group (p≤0.01 for three of the five 10-year age intervals tested). Among patients with unilateral uveitis who had not undergone surgery in either eye (n=9), median central cell density was lower in eyes with uveitis (2262 cells/mm2 [range 1543-3289 cells/mm2]) than in contralateral eyes (2762 cells/mm2 [1887-3546 cells/mm2], p=0.004). Percent hexagonality was lower in eyes with uveitis (52% [33-62%]) than in contralateral eyes (58% [56-82%], p=0.03). Despite these findings, there was no significant difference in central corneal thickness between eyes (p=0.36), and no eye with uveitis had clinically apparent central corneal edema.
Anterior segment inflammation affects corneal endothelial cell number and morphologic features, although changes do not seem to be sufficiently severe to affect endothelial function. Longitudinal studies are warranted to determine whether long-standing anterior uveitis increases risk of endothelial dysfunction, especially in the setting of intraocular surgery.
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