Corneal Endothelial Cell Density and Associated Factors in a Cross Sectional, Population-Based Study in Japan: The Chikusei Eye Study

Abstract

Purpose : Previous studies reported that corneal endothelial cell density (ECD) loss occurs after ocular surgery, trauma, inflammation, and the aging process, yet systemic factors related to ECD loss are not known well. The purpose of this study is to examine ECD and associated factors of normal Japanese in a population-based setting.

Methods : Residents of Chikusei, Japan, aged 40 years and older, who came to the medical checkup held by Chikusei local government in 2013, were asked to undergo a comprehensive questionnaire and ocular examination, including noncontact specular microscopy (NONCONROBO FA-3809D, KONAN, Hyogo, Japan). The linear regression analyses of ECD (independent variables were age, height, weight, systolic blood pressure, HbA1c, spherical equivalent, mean keratometric power, axial length, anterior chamber depth, intraocular pressure, and central corneal thickness) was done with Stata/SE 14.1.

Results : Of 1972 subjects with available data, 286 cases were excluded from analysis due to prior ocular surgery. Among 1686 eligible cases, 675 were men and 1011 were women, without any significant inter-sex difference of the mean ECD(P= 0.55, unpaired t test). There was no significant difference in mean ECD between the left and right eyes (P= 0.15, paired t test), with a moderate correlation bilaterally (R = 0.58, P<0.05, Pearson). The mean ECD in the right eyes of all the cases was 2706±253 cells/mm² (95% CI, 2695-2718), and decreased significantly with age (r = -0.146, P<0.05, Pearson). The results of linear regression analyses showed that increased age and higher intraocular pressure were significantly negatively correlated with ECD, with a slope of -2.27/mm²/year (P<0.05) and -12.7/mm²/mmHg (P<0.05). Central corneal thickness was significantly positively correlated with ECD, with a slope of +1.02/mm²/μm (P<0.05).

Conclusions : Mean ECD in ophthalmic normal Japanese in Chikusei aged 40 years or older was 2706 cells/mm². Older age, higher intraocular pressure, and lower central corneal thickness were identified as factors correlating with lower ECD, though no systemic factors were specified within our study.

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