Correlation between guttata density and Descemet’s membrane thickness in eyes with Fuchs’ endothelial corneal dystrophy

Abstract

Purpose : To characterize Fuchs’ endothelial corneal dystrophy (FECD) using specular microscopy (SM) and spectral domain optical coherence tomography (SD-OCT).

Methods : The central cornea of 21 eyes with FECD and 15 eyes of age-matched normal controls were examined with the Konan NSP-9900 specular microscope(Konan Medical, Inc., Hyogo, Japan) and Heidelberg Spectralis SD-OCT (Heidelberg Engineering Gmbh, Heidelberg, Germany). Three images of the central cornea were taken with each instrument. The density of endothelial guttata based on specular images was graded on a 0-4 scale (Figure. 1) by two trained graders from the Doheny Image Reading Center. The thickness of the Descemet’s membrane and endothelial complex was manually calculated via analysis of the SD-OCT images using ImageJ (National Institutes of Health, Bethesda, Maryland, USA). Correlation between the guttata density and the thickness of Descemet’s membrane & endothelium was analyzed by SPSS 13.0.

Results : The thickness of Descemet’s membrane and endothelial complex in controls and the eyes with FECD was 19.3±2.3 µm and 34.8±11.6 µm, respectively (P<0.001). There was a positive correlation between guttata density and the thickness of Descemet’s membrane and endothelium in eyes with FECD (r=0.606, P=0.004).

Conclusions : The thickness of Descemet’s membrane and endothelium is increased in eyes with FECD, with the higher density of guttata correlating with increasing thickness. Specular microscopy combined with SD-OCT could represent a good approach to assess severity of FECD.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

Figure 1. DIRC Guttata Grading Scale for Specular Microspcopy.