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Sangita P Patel, Patricia A. Gianfagna, Teigan E. Ruster, Amy E Millen; Prevalence of Fuchs’ endothelial corneal dystrophy by age and sex. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3774.
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Fuchs’ endothelial corneal dystrophy (FECD), the most common indication for corneal transplantation in the United States, occurs twice as frequently in women than men. The basis for this sex disparity and age at which it arises are unknown. Because FECD is most prevalent in older adults, we hypothesize that postmenopausal hormonal changes may contribute to the greater prevalence of FECD in women compared to men. We performed a clinical study to examine the prevalence of FECD by age group in men and women separately. We hypothesized that the prevalence of FECD would be differentially higher in women than in men after the age of 50.
Following IRB approval, we retrospectively reviewed 6 months of patient records, and prospectively enrolled and examined consecutive patients for an additional 2 months from the cornea clinic of a single ophthalmologist (SPP) at the Ross Eye Institute in Buffalo, NY. Participants had to be >18 years old and could not have bilateral corneal scarring or other condition (e.g., corneal transplant) preventing exam of the native corneal endothelium. All patients had evaluation of their corneal endothelium for guttae with high magnification slit lamp biomicroscopy by a single examiner (SPP). We recorded the presence of any severity of guttae or corneal transplant for documented FECD as presence of FECD for that individual. We estimated the prevalence of FECD by age group and sex.
Of the 397 patient records reviewed and patients examined, 295 (178 women and 117 men) met our inclusion criteria. FECD prevalence was 39.3% in women and 30.8% in men. In men, prevalence increased for each increasing age group, from 6% in 18-29 year olds to 69% in 80-99 year olds. The greatest increase (3.6-fold) occurred between the age groups 50-59 and 60-69. While the prevalence of FECD increased by age in men, prevalence for women peaked in the 50-59 and 70-79 year age groups and was lower in other age groups. The greatest increase (4.2-fold) occurred between the age groups 30-49 and 50-59.
The greatest sex disparity in FECD prevalence occurred in the 50-59 year old age group. The 50-59 year old age group, when FECD prevalence peaks for women, represents the peri- and postmenopausal transition. These findings support a hypothesized role for menopausal hormonal changes in FECD pathophysiology.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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