Imaging Fuchs Endothelial Corneal Dystrophy in Clinical Practice and Clinical Trials

Patel, Sanjay

doi:10.1097/ico.0000000000002738

Cited by 16 publications

(7 citation statements)

References 14 publications

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“… 52 Scheimpflug tomography can generate useful pachymetry and posterior elevation maps, providing functional assessments of the health of the corneal endothelium in FECD. 53 However, because these Scheimpflug imaging parameters related to the thickness of the cornea are disturbed only in late FECD after significant loss of the endothelium and the onset of edema, they may not be ideal as end points to test the efficacy of molecular therapies intended to slow progression in patients with mild or moderate disease.…”

Section: Discussionmentioning

confidence: 99%

Loss of Corneal Nerves and Corneal Haze in Patients with Fuchs’ Endothelial Corneal Dystrophy with the Transcription Factor 4 Gene Trinucleotide Repeat Expansion

Gillings¹,

Mastro²,

Zhang³

et al. 2023

Ophthalmology Science

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Section: Discussionmentioning

confidence: 99%

Loss of Corneal Nerves and Corneal Haze in Patients with Fuchs’ Endothelial Corneal Dystrophy with the Transcription Factor 4 Gene Trinucleotide Repeat Expansion

Gillings¹,

Mastro²,

Zhang³

et al. 2023

Ophthalmology Science

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“…On the other hand, when classifying eyes based on the presence of subclinical edema independently from the Krachmer grading, 10,19 eyes without preoperative edema reached comparable BCVA outcomes as the control group while eyes with preoperative subclinical edema had worse BCVA outcomes than the control group. For eyes without preoperative edema, the anterior corneal backscatter was comparable to the control group in the 2-to 6-mm zone and only a borderline difference in the 0to 2-mm zone (Table 4).…”

Section: Discussionmentioning

confidence: 93%

Impact of Fuchs Endothelial Corneal Dystrophy Severity on Scheimpflug-Derived Parameters After Descemet Membrane Endothelial Keratoplasty

Santana

Vasiliauskaitė

Dijk

et al. 2022

Cornea

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The aim of this study was to evaluate how Scheimpflugderived parameters of eyes with Fuchs endothelial corneal dystrophy (FECD) are influenced by Descemet membrane endothelial keratoplasty (DMEK) depending on FECD severity and the presence of subclinical edema. Methods:A retrospective cohort study including 115 eyes (115 patients) that underwent DMEK for FECD and a control group of 27 eyes with nonpathological corneas was conducted. Preoperative and 6 months postoperative Scheimpflug imaging was used to analyze pachymetry, presence of tomographic features (loss of isopachs/ displacement of the thinnest point/focal posterior depression), and corneal backscatter. FECD severity was based on the modified Krachmer scale and the absence/presence of subclinical edema.Results: Scheimpflug-derived pachymetry, tomographic, and corneal backscatter parameters were correlated with FECD severity, and all changed from preoperatively to postoperatively (all P , 0.05). Postoperative central corneal thickness, anterior and posterior corneal backscatter, and presence of focal posterior depression remained different from the control group (all P , 0.05). Of eyes without preoperative clinical edema (n = 75), 18.7% showed 0 or 1 tomographic feature (no edema group) and 82.4% had 2 or 3 features (subclinical edema group). Compared with the control group, postoperative bestcorrected visual acuity for the "no edema" group did not differ (0.03 6 0.12 vs. 20.02 6 0.08 logarithm of the minimum angle of resolution, P = 0.150) but was worse for the subclinical edema group (0.06 6 0.08 vs. 20.02 6 0.08 logarithm of the minimum angle of resolution, P = 0.001). Conclusions:For eyes without preoperative edema, more parameters reversed back to 'normal' levels than for eyes with (sub)clinical edema. Although most analyzed parameters correlated with FECD severity, corneal tomography might be best suited for objective grading of disease severity to aid in surgical decision-making.

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“…Sun et al in 2019 proposed a revised classification of subclinical edema in FECD based on topographic images and the presence of (1) loss of regular isopachs, (2) displacement of the thinnest point, and (3) focal posterior surface depression, all independent of CCT. [5][6][7][8] Figure 3, A and B and Table 1 present the comparative topography of the left eye after PRK in 2007 and during the acute presentation of FECD in 2018, respectively. Over the span of 8 years between 2010 when corneal guttae was first noted and the acute presentation in 2018, mild changes were observed in astigmatism and manifest refraction of the patient along with topographic signs suggestive of subclinical edema associated with FECD and a progressively thickening CCT in the left eye.…”

Section: Discussionmentioning

confidence: 99%

Fuchs endothelial corneal dystrophy masking an underlying postrefractive surgery ectasia

Gnanaraj,

Taravella,

Davidson

2023

JCRS Online Case Rep

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Introduction: This article describes a case presenting Fuchs endothelial corneal dystrophy (FECD) masking an underlying postrefractive surgery ectasia. Patient and Clinical Findings: A 69-year-old woman presented in January 2022 with blurriness, halos, and glare in the left eye. Ocular history included a photorefractive keratectomy performed twice in her left eye in 2007 for hyperopic astigmatism. A diagnosis of asymptomatic Fuchs dystrophy was noted in 2010. She had acute decompensation of the cornea in the left eye because of FECD, and the first Descemet-stripping automated endothelial keratoplasty (DSAEK) with cataract surgery was performed in 2018. Diagnosis, Intervention, and Clinical Findings: The patient had a failed DSAEK graft in the left eye. A repeat DSAEK was performed in 2022, and 6 months postoperatively, the patient started showing signs of ectasia in the left eye. The authors believe the ectasia was preexisting but masked by the failed DSAEK graft and FECD and started showing after corneal deturgescence postoperatively. Conclusions: The presence of FECD and corneal ectasia can complicate diagnosis because of overlapping clinical and topographic features. This case highlights the importance of preoperative topography with epithelial/stromal thickness mapping in patients with a history of multiple refractive corneal procedures to consider the possibility of ectasia and prevent unforeseen outcomes and complications. Further research is necessary to determine standardized imaging techniques, particularly in cases of concurrent diseases.

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Imaging Fuchs Endothelial Corneal Dystrophy in Clinical Practice and Clinical Trials

Cited by 16 publications

References 14 publications

Loss of Corneal Nerves and Corneal Haze in Patients with Fuchs’ Endothelial Corneal Dystrophy with the Transcription Factor 4 Gene Trinucleotide Repeat Expansion

Loss of Corneal Nerves and Corneal Haze in Patients with Fuchs’ Endothelial Corneal Dystrophy with the Transcription Factor 4 Gene Trinucleotide Repeat Expansion

Impact of Fuchs Endothelial Corneal Dystrophy Severity on Scheimpflug-Derived Parameters After Descemet Membrane Endothelial Keratoplasty

Fuchs endothelial corneal dystrophy masking an underlying postrefractive surgery ectasia

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