In vivo confocal microscopic observation in patients with Fuchs’ endothelial corneal dystrophy based on severity grading using anterior segment optical coherence tomography.

Abstract

Purpose : To observe cellular changes in patients with Fuchs’ endothelial corneal dystrophy (FECD) based on severity grading using anterior segment optical coherence tomography (AS-OCT).

Methods : 32 eyes of 20 patients with FECD were enrolled. Each eye was graded as 0 to 3 based on severity grading using AS-OCT: 0, no change; 1, mild edema; 2, moderate edema with posterior elevation; 3, severe edema with posterior irregular elevation. Cell density of corneal epithelial basal cell, keratocyte in anterior and posterior stroma, endothelial cell was analyzed using in vivo confocal microscope (HRT III Rostock Cornea Module).

Results : 9 eyes were graded as 0, 10 eyes as grade1, 8 eyes as grade 2, 5 eyes as grade 3. The cell density of anterior keratocyte was 555±322cells/mm² in grade0, 359±224 cells/mm² in grade1, 179±219cells/mm² in grade2, and 42±57cells/mm2 in grade3, and the difference was significant. (p=0.0026) The cell density of endothelial cell was 1628±515 cells/mm2 in grade0, 335±377 cells/mm² in grade 1, 226±265 cells/mm2 in grade 2, and 411±283 cells/mm2 in grade 3, and the difference was significant. (p = 0.0001) There was no significant difference between grades in cell density of basal cell and posterior keratocyte. (p = 0.68 and 0.11 respectively).

Conclusions : The cell density of anterior keratocyte and endothelial cell decreases with disease progression in patients with FECD detected by AS-OCT.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.