Purpose: To investigate central endothelial cell density (ECD), morphology, and central corneal thickness (CCT) in patients newly diagnosed with severe obstructive sleep apnea–hypopnea syndrome (OSAHS) and to determine the correlation between these parameters and OSAHS severity. Methods: This prospective, comparative case series was conducted in a university ophthalmology clinic. In total, 51 patients recently diagnosed with severe OSAHS (apnea–hypopnea index above 30) and a paired, age and sex-matched control group of 44 healthy individuals were enrolled. After detailed ophthalmologic examination, specular microscopy measurement was performed for all participants. Central ECD, average cell area, coefficient of variation (CV) of cell area, hexagonal cell appearance ratio (% Hex), and CCT were compared between the groups. The Pearson correlation test was also used to assess the influence of the polysomnographic findings, that is, the proportion of each stage of sleep, apnea–hypopnea index, SpO2, mean and maximum duration of apneas, oxygen desaturation index, and arousal index on corneal endothelial morphometric parameters and CCT. Results: A total of 190 eyes were examined: 102 eyes of patients with severe OSAHS and 88 eyes of the control group. The mean ECD, CV, % Hex, and CCT values in the OSAHS group were 2439.25 ± 344.36 cells/mm2, 41.41 ± 11.62, 45.22 ± 7.06%, and 533.88 ± 40.53 μm, respectively. ECD and CCT did not significantly differ between the groups (P = 0.46, P = 0.55, respectively). CV value was significantly higher (P = 0.009), whereas the %Hex was significantly lower (P = 0.01) in the OSAHS group. We observed a significant negative correlation between CCT and REM sleep percentage (P = 0.005). Conclusions: Greater pleomorphism and polymegathism of corneal endothelium was found in patients with severe OSAHS when compared with healthy subjects. Low percentage of REM sleep, usually found in patients with OSAHS, may cause an increase in corneal thickness.

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Purpose: The aim of this study was to evaluate the morphological properties of corneal endothelial cells and central corneal thickness (CCT) in patients with neurofibromatosis type 1 (NF1) and to compare them with age-matched healthy controls. Methods: Nineteen NF1 patients and 38 healthy individuals were recruited. All participants underwent complete ophthalmological examination as well as noncontact specular microscopy to measure endothelial cell density (ECD), average cell area (AVG), coefficient of variation of cell area (CV), the percentage of hexagonal cells, and CCT. Eyes with previous ocular trauma, inflammation or surgery, and preexisting corneal and ocular surface diseases were excluded. Results: NF1 patients had higher ECD compared to healthy controls of the same age (2764.2 ± 270.4 versus 2570.4 ± 449.2 cells/mm, respectively), although at a borderline level ( P = 0.051). Patients with NF1 presented significantly lower CV and AVG when compared to controls (32.9 ± 4.6 versus 37.8 ± 9.5%, P = 0.011 and 364.9 ± 34.4 versus 406.0 ± 107.4 µm, P = 0.038, respectively). The NF1 group had significantly higher hexagonality in comparison with controls (55.7 ± 6.5 versus 50.5 ± 9.9%, P = 0.025). CCT was similar between the two groups ( P = 0.955). Conclusion: Our results show that corneal endothelium has more favorable morphological characteristics in NF1 patients compared to healthy individuals of the same age.