Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan.
Cornea. 2024 Feb 1;43(2):207-213. doi: 10.1097/ICO.0000000000003356. Epub 2023 Jul 27.
This study aimed to evaluate Descemet membrane reflectivity using anterior segment optical coherence tomography (AS-OCT) in eyes with Fuchs endothelial corneal dystrophy (FECD).
We retrospectively assessed 144 eyes of 88 consecutive participants (41 FECD, 15 pseudophakic bullous keratopathies [BKs], and 32 healthy controls, 63.5 ± 16.5 years). FECD was graded 0 to 3 based on the guttae areas using specular microscopy. The sum of AS-OCT reflectivity of the 3-dimensional volume from 10 μm thickness from the endothelial surface of the cornea and residual stromal area was calculated as D sum (endo) and D sum (stroma) in the central area of 3- and 6-mm diameters, respectively. The D ES ratio was defined as the ratio of D sum (endo) to D sum (stroma). The percentage of the guttae area in the specular images was calculated using MATLAB. D sum (endo) and D ES ratio were compared among FECD, BK, and healthy controls.
D sum (endo) in FECD grade 3 was significantly higher than that in healthy control eyes, FECD patients with mild and moderate guttae, and BK (all P ≤ 0.040). The D ES ratio in FECD patients with mild to severe guttae (grade 1-3) was significantly higher than that in healthy control eyes and BK (all P ≤ 0.035). The percentage of the guttae area was significantly correlated with D sum (endo) (R = 0.488, P < 0.001 for 3 mm, R = 0.512, P < 0.001 for 6 mm) and D ES ratio (R = 0.450, P < 0.001 for 3 mm, R = 0.588, P < 0.001 for 6 mm).
Descemet membrane reflectivity in AS-OCT can be objective biomarkers for assessing guttae and FECD severity from early to end-stage FECD.
本研究旨在使用眼前节光学相干断层扫描（AS-OCT）评估伴有 Fuchs 内皮角膜营养不良（FECD）的眼睛的后弹力层反射率。
我们回顾性评估了 88 例连续患者（41 例 FECD、15 例假性大疱性角膜病变[BK]和 32 例健康对照者，年龄 63.5±16.5 岁）的 144 只眼。使用共聚焦显微镜根据胶滴面积将 FECD 分级为 0 至 3 级。角膜内皮表面 10μm 厚度的 3 维体积的 AS-OCT 反射率之和以及中央 3mm 和 6mm 直径区域的剩余基质面积的总和分别计算为 D sum（endo）和 D sum（stroma）。D ES 比定义为 D sum（endo）与 D sum（stroma）的比值。使用 MATLAB 计算共聚焦图像中胶滴区域的百分比。比较 FECD、BK 和健康对照组之间的 D sum（endo）和 D ES 比值。
FECD 3 级的 D sum（endo）明显高于健康对照组、FECD 轻度和中度胶滴患者和 BK（均 P≤0.040）。FECD 轻至重度胶滴患者（1-3 级）的 D ES 比值明显高于健康对照组和 BK（均 P≤0.035）。胶滴面积与 D sum（endo）显著相关（R=0.488，P<0.001，3mm；R=0.512，P<0.001，6mm）和 D ES 比值（R=0.450，P<0.001，3mm；R=0.588，P<0.001，6mm）。
AS-OCT 中的后弹力层反射率可以作为评估胶滴和 FECD 严重程度的客观生物标志物，从早期到晚期 FECD。
