Özer Orlando, Mestanoglu Mert, Howaldt Antonia, Clahsen Thomas, Schiller Petra, Siebelmann Sebastian, Reinking Niklas, Cursiefen Claus, Bachmann Björn, Matthaei Mario
Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany.
Eye Center Seufert, 51427 Bergisch Gladbach, Germany.
J Clin Med. 2022 May 17;11(10):2815. doi: 10.3390/jcm11102815.
Central subendothelial geographic deposits are formed as a fibrillar layer (FL) in advanced Fuchs endothelial corneal dystrophy (FECD). Previous studies demonstrated a significant decrease in corneal endothelial cell (CEC) density and an increase in focal corneal backscatter in the FL area. The present study investigated the association of the FL with edema formation and its localization. Patients ( = 96) presenting for Descemet membrane endothelial keratoplasty (DMEK) for advanced FECD were included. Slit-lamp biomicroscopy with FECD grading was followed by Scheimpflug imaging with en face backscatter analysis and pachymetric analysis. FL dimensions were measured, and correlation with pachymetric values was performed. An FL was detected in 74% of all eyes ( = 71). Pachymetric values in FL-positive versus FL-negative eyes were for corneal thickness at the apex (ACT) 614 ± 52 µm and 575 ± 46 µm ( = 0.001), for peripheral corneal thickness at 1 mm (PCT) 616 ± 50 µm and 580 ± 44 µm ( = 0.002), for PCT 625 ± 48 µm and 599 ± 41 µm ( = 0.017), for PCT 651 ± 46 µm and 635 ± 40 µm ( = 0.128) and for PCT 695 ± 52 µm and 686 ± 43 µm ( = 0.435), respectively. Correlation analysis indicated a weak correlation for the FL maximum vertical caliper diameter with ACT and PCT values but no further relevant correlations. In FL-positive eyes, increased focal corneal backscatter and increased corneal thickness showed primarily central and inferotemporal localization. In conclusion, Scheimpflug imaging shows an association of the FL with increased corneal thickness in advanced FECD and shows localization of the FL and increased corneal thickness in the central and inferotemporal region. This may provide important information for progression assessment and therapeutic decision making in FECD patients in the future.
在晚期富克斯内皮性角膜营养不良（FECD）中，中央内皮细胞下的地图状沉积物形成为纤维层（FL）。先前的研究表明，在FL区域角膜内皮细胞（CEC）密度显著降低，角膜局部后向散射增加。本研究调查了FL与水肿形成及其定位之间的关联。纳入了96例因晚期FECD接受Descemet膜内皮角膜移植术（DMEK）的患者。在进行FECD分级的裂隙灯生物显微镜检查后，进行带有前表面后向散射分析和测厚分析的Scheimpflug成像。测量FL尺寸，并进行与测厚值的相关性分析。在所有眼中，74%（n = 71）检测到FL。FL阳性眼与FL阴性眼的测厚值分别为：顶点角膜厚度（ACT）614±52μm和575±46μm（P = 0.001），1mm处周边角膜厚度（PCT）616±50μm和580±44μm（P = 0.002），2mm处PCT 625±48μm和599±41μm（P = 0.017），3mm处PCT 651±46μm和635±40μm（P = 0.128），4mm处PCT 695±52μm和686±43μm（P = 0.435）。相关性分析表明，FL最大垂直卡尺直径与ACT和PCT值呈弱相关，但无进一步的显著相关性。在FL阳性眼中，角膜局部后向散射增加和角膜厚度增加主要表现为中央和颞下定位。总之，Scheimpflug成像显示在晚期FECD中FL与角膜厚度增加有关，并显示了FL以及中央和颞下区域角膜厚度增加的定位。这可能为未来FECD患者的病情进展评估和治疗决策提供重要信息。
