Abstract
Purpose :
Corneal dystrophy and degeneration are common in clinical practice. Correct diagnosis of dystrophies is important prior to planning the optimal treatment. The incidence and classification of the different corneal dystrophies vary depending on genetic background of the population and geographic location. The purpose of this study is to highlight the prevalence and incidence of corneal dystrophy/degeneration and the diagnostic histopathological features to differentiate the different types of corneal dystrophy.
Methods :
A single-centre, retrospective analysis of 865 corneal specimens received between 2006-2017 was performed at the MUHC-McGill University Ocular Pathology & Translational Research Laboratory. Of the 865 corneal specimens, 380 (43%) were inflammatory disease, 267 (30%) corneal dystrophies and degenerations, 141 (16%) failed graft corneas, 51 (6%) viral or microorganism infections, and 26 (3%) miscellaneous diagnoses. Specimens were sorted by diagnosis and grouped by age and sex.
Results :
Corneal dystrophies and degenerations represented 30% (n=267) of all corneal specimens with a slight predominance in men (n=152) when compared to women (n=115). Of these, 174 were degenerative corneal diseases, including keratoconus (37%, n=99), bullous keratopathy (22%, n=59), Salzmann nodule (3.7%, n=10), and band keratopathy (2.2%, n=6). Of the 93 corneal dystrophies, there were 48 cases (17%) of Fuch’s endothelial dystrophies, 27 cases (10.1%) of stromal dystrophies, 4 cases (1.5%) of epithelial dystrophies, and 14 cases (5.2%) of other dystrophies. Stromal dystrophies presented as lattice dystrophy in 13 patients (4.8%), granular in 4 patients (1.4%), macular in 2 patients (0.7%), and combined in 7 patients (2.6%).
Conclusions :
Corneal dystrophies and degenerations represent the second most common diagnosis for corneal transplants after corneal inflammatory disease. In this Canadian large series, Fuch’s endothelial dystrophy was the most frequent, followed by corneal stromal dystrophies. Lattice stromal dystrophy was the most common type, followed by combined-Avellino stromal dystrophy. Histopathological findings are essential to characterize corneal dystrophies and degenerations. Clinicopathological correlation of corneal dystrophies enables better management of these lesions.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.