Corneal Backscatters as an Objective Index for Assessing Fuchs’ Endothelial Corneal Dystrophy: A Pilot Study

Abstract

Purpose To provide an objective, quantitative approach for monitoring Fuchs' endothelial corneal dystrophy (FECD), with Scheimpflug imaging. Design This is a retrospective case-control pilot study. Methods The study group consisted of 53 eyes in 27 patients diagnosed with FECD, with normal subjects paired as control. Main outcome measures were corneal thickness, morphological patterns on densitograms, and indices of corneal density including the average area density (mean AD) and the average ratio of Descemet's membrane density versus area density (DM/AD) in Pentacam Scheimpflug images. Results There were no significant differences in age and corneal thickness between FECD and normal groups. Morphologically, hanging-hammock patterns were noted on the densitograms of FECD patients, which were different from the high-back chair patterns in normal subjects. Quantitatively, mean AD and DM/AD were both elevated in FECD patients as compared with normal subjects (P = 0.01 and 0.025, resp.). In addition, FECD patients with corneal edema had significantly higher mean AD (P = 0.018) than those without corneal edema. Conclusions This pilot study shows that Pentacam system provides an objective, quantitative way to approach FECD corneas. It can assist ophthalmologists in detecting the early change and in monitoring disease progression of FECD. Further studies are needed to consolidate the findings.

Corneal endothelium features in Fuchs’ Endothelial Corneal Dystrophy: A preliminary 3D anterior segment optical coherence tomography study

“…We strongly believe that the presence of abnormal accumulation of macromolecules with irregularities in corneal water content and collagen fiber diameter may influence the light scattering of OCT signal trough the cornea, thus leading to the pattern 2 or 3. A similar mechanism has already been described by Chu et al in 2017 [22]. Indeed, the authors analyzed the backscattered light from the corneal tissue by a Pentacam Scheimpflug densitometry, stating that both abnormalities in corneal thickness and composition may contribute to change its optical properties in FECD patients.…”

Anterior Corneal High-order Aberrations in Fuchs’ Endothelial Corneal Dystrophy Classified by Scheimpflug Tomography

“…Although various factors affecting visual acuity, such as high-order aberrations, subjective forward light scattering, and corneal backscatter, have been investigated in eyes with Fuchs' endothelial corneal dystrophy, which factor is the most effective in vision expectancy after surgery remains a controversial issue. [9][10][11]30 In eyes with subclinical corneal edema, there was a positive correlation between the 6-mm trefoil measurement and best-corrected visual acuity. In our study, more patients in the Fuchs' endothelial corneal dystrophy-edema group with intermediate values (between a large set of data points and a few "outliers") are required to assess the correlation of other aberrations with best-corrected visual acuity.…”

Changes in the Optical Corneal Densitometry, Visual Acuity, and Refractive Error after the Annular Intracorneal Inlay Implantation

“…Clinical evaluation of the back-scattered light or, in other words, optical corneal densitometry plays an important role in the evaluation of the corneal status and progression of some ocular diseases, such as keratoconus. 17 18 19 20 As mentioned earlier, optical corneal densitometry is the outcome of the order of collagen fibers, extracellular matrix, and keratocyte harmony; 19 21 therefore, it can be expected that the placement of an intracorneal ring would alter the balance of the above-mentioned factors and eventually change the optical corneal densitometry. In a study on 18 rabbits, Salamatrad et al ., observed that the keratocyte cell density was not different between the control and inlay-treated groups that had an AICI ring placed into their corneas.…”