Corneal Endothelial Cell Density in Early Childhood

Abstract

Purpose : Corneal endothelial cell density (ECD) can be measured using in-vivo specular microscopy. The aim of our study is to measure ECD in normal eyes of children under 5 years of age

Methods : Institutional research ethics board approval was obtained. Specular microscopy was performed using a validated protocol during examination under anesthesia in the lateral decubitus position during surgery for other reasons. Cooperative children were imaged in the conventional manner. Only healthy eyes of children without anterior segment trauma, surgery or disease were included in the study. Endothelial cell density was calculated using the center technique. In patients under 2 years, corneal diameter was also recorded. A quadratic linear fit model was used to describe the relationship between ECD and age. Pearson correlation served to assess the correlation between age and ECD and between changes in corneal diameter and ECD.

Results : One hundred and eighteen eyes of 118 patients under 5 years of age were included in the study. Mean patient age was 2.6 ± 1.4 years (range 0.1–5 years) and mean ECD was 3746 ± 370 cells/mm² (range 3145 – 5013 cells/mm²). Mean corneal diameter was available in 41 patients, 2 years and under was 11.85 ± 0.57 (range 10.50 – 12.75 mm). Up to 2 years of age, ECD was more inversely correlated with corneal diameter than with age (r= -0.61; p<0.0001, r= -0.38, p = 0.01, respectively). In contrast, after the age of 2, the ECD was more inversely correlated with age than with corneal diameter (r=-0.24, p=0.04, r=-0.24, p=0.2). The mean ECD decrease from birth to 5 years of age was 2.4% a year.

Conclusions : In the first 2 years of life there is a rapid decline in ECD, which is most likely related to corneal growth and not to cell loss.

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