Abstract
Purpose :
Fuchs endothelial corneal dystrophy (FECD) has multifactorial pathophysiology, with genetic and environmental factors. Systemic health contributions to FECD pathophysiology are incompletely characterized. This study aims to identify possible FECD associations with systemic comorbidities, lifestyle, and nutrition using a retrospective chart review and cross-sectional survey.
Methods :
50 FECD patients and 50 age/sex-matched control patients were enrolled. Inclusion criterion for the FECD group was FECD clinical diagnosis, and inclusion criteria for the control group were no FECD diagnosis and no guttae. Chart review examined demographics, FECD stage, medical history, and body mass index (BMI). Survey used a smoking & exercise questionnaire and a semiquantitative food frequency questionnaire (SFFQ). Statistical methods were Fisher exact text and Mann Whitney U test.
Results :
Rates of cardiovascular diseases had greater occurrence in FECD compared to controls: hyperlipidemia (74% vs. 50%, p=0.023), atrial fibrillation (26% vs 8%, p=0.031), hypertension (68% vs 50%, p=0.103), coronary artery disease (20% vs 8%, p=0.148), and aortic stenosis (10% vs 2%, p=0.204). Diabetes had similar occurrence (10% vs 10%, p=1.000). No difference was observed for having ever smoked (56% vs 38%, p=0.109), but FECD patients had higher current daily smoking behavior (8.64 vs 4.92 packs/day, p=0.046), smoking duration (13.10 vs 8.52 yrs, p=0.048), and total smoking exposure (11.24 vs 6.12 pack-years, p=0.017). There were no differences in BMI (26.54 vs 26.17, p=0.879) or exercise activity (4.66 vs 4.56 hrs/wk, p=0.840). SFFQ computed levels for 231 nutritional items; differences in nutritional items included: sodium (2036.12mg vs 436.22mg, p=0.021), insulinogenic load (711 vs 667.79, p=0.077), and total fat (67.00g vs 71.00g, p=0.036).
Conclusions :
Statistically significant differences between FECD and control patients were found for rates of cardiovascular diseases, smoking behavior, and sodium intake. Further investigation with a larger cohort may confirm these associations. Conclusions from the nutritional profile are limited by the single timepoint provided by a cross-sectional survey contrasting with the longitudinal nature of FECD pathogenesis. It might be prudent to counsel FECD patients about concomitant cardiovascular disease control, moderation of salt intake, and smoking cessation.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.