Macular drusen in Fuchs endothelial corneal dystrophy: a retrospective study using spectral-domain optical coherence tomography

Abstract

Purpose : Putative pathogenic parallels have been suggested between guttae in Fuchs endothelial corneal dystrophy (FECD) and drusen in dry age-related macular degeneration. Hallmarks of both pathologies may include cellular degeneration accompanied by deposition and accumulation of extracellular matrix of the basal membrane both preferentially located within the central ocular lightpath. The present preliminary study aimed to find first evidence regarding a potenially increased incidence of macular drusen in FECD eyes compared to normal controls using spectral-domain optical coherence tomography (SD-OCT).

Methods : Retrospective, nonrandomized, case series. Clinically diagnosed FECD patients undergoing posterior lamellar keratoplasty at the Department of Ophthalmology, University of Cologne, Cologne, Germany were included. Patients without corneal pathologies served as controls. An evaluation of SD-OCT images was performed by independent investigators. Existence of drusen served as main outcome measure. Due to the dependency in the data structure, as both eyes per patient were examined, the effect of FECD, age, gender and previous cataract surgery on drusen was modelled with Generalized Estimating Equations (GEE).

Results : A total of n=221 consecutive FECD patients and n=235 normal corneal control patients were included in this study. Retrospective analysis of FECD images demonstrated, that presence of FECD and age had significant impact on the incidence of drusen of the macula with odds ratios of 1.643 (p=0.020) and 1.091 (p<0.001), respectively. Gender and previous cataract surgery did not show any corresponding impact.

Conclusions : Our data provides preliminary evidence that there may be a potential association between FECD and an increased incidence of drusen of the macula. However, these comparably early results will need further validation by future prospective studies in larger cohorts.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.