CLASSIFICATION OF DIFFERENT MORPHOMETRIC PROFILES OF HUMAN CORNEAL ENDOTHELIUM

Abstract

Purpose : Morphometric analysis is a useful way to describe the endothelial status based on the profile of specific data generated by the corneal specular microscope (CSMe): Endothelial Cell Density (ECD), Cellular Area (A), polymeghetism represented by coefficient of variation (CV) and Pleomorphism represented by the percentage of hexagonal cells (%H). Morphometric endothelial analysis can diagnose 8 types of endothelial profile (Figure 2). The purpose of this study is to describe and quantify the possible types of morphometric endothelial diagnosis.

Methods :
Cross-sectional study of database of patients submitted to CSMe at Clínica de Olhos Prof. Dr. Fernando Abib (Curitiba, Brazil) and Santa Casa de Sao Paulo (Sao Paulo- Brazil) from August 2006 to November 2009. All patients with any cornea dystrophy or scars were excluded from this study. 1048 eyes of 537 patients chosen randomly were submitted to CSMe (CSO^®, Florence, Italy) and generated data were analyzed: ECD, A, CV and H%. Absolute number of counted cells was analyzed using reliability index software (Cells Analyzer^® software _{USA Pattent} Technicall, Brazil). For this study, relative error or Sample Error (SE) was considered as 5%. For analysis of the Morphometric Endothelial Diagnosis, the measurements were plotted usingStatistical-Analytical Rulers of the Cells Analyzer^®_{USA Pattent} (Technicall, Brazil) previously cited (Abib et al, ARVO 2015) (Figure 1). For the present study, all data for each eye was classified in 8 different morphometric diagnoses according to Figure 2. It is considered as Subnormal corneal endothelium (SnCE) all corneas with ECD lower than expected for age; otherwise, they are contemplated as Normal corneal endothelium (NCE).

Results :
This study showed eight different morphometric types according to the data generated by the CSMe. Type 1 (NCE) was 42.46%, followed by Type 2 with 16.41% (NCE + polymeghetism) and Type 5 (SnCE) with 15.27% (Figure 2).

Conclusions : Polymeghetism can be more frequent in NCE. SnCE with no polymeghetism and no pleomorphism was observed in 15.27%. Other types of endothelial profiles are not commonly found (T3, T4, T6, T7 and T8).

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Figure 1–The Statistical-Analytical Ruler: the blue and white areas opposed to the red one represent NCE; white area between blue and red represents SnCE

 

Table 1 - Distribution by frequency of NCE and SnCE diagnosis