Tomioka Yasufumi, Ueno Morio, Yamamoto Akihisa, Kitazawa Koji, Fukuoka Hideki, Tanaka Motomu, Sotozono Chie, Jurkunas Ula V, Kinoshita Shigeru
Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Department of Mechanical Systems Engineering, Graduate School of Systems Design, Tokyo Metropolitan University, Tokyo, Japan.
Ophthalmol Sci. 2025 May 2;5(5):100817. doi: 10.1016/j.xops.2025.100817. eCollection 2025 Sep-Oct.
To investigate regional variations in guttae distribution in Fuchs endothelial corneal dystrophy (FECD) and evaluate its relationship with anatomical ultraviolet (UV) protection by the eyelid.
A prospective observational study.
This study involved 19 eyes of 19 patients with FECD between April 2022 and June 2024 at Kyoto Prefectural University of Medicine.
Using slit-scanning wide-field contact specular microscopy, we analyzed guttae distribution in 5 corneal regions (central, superior, temporal, nasal, and inferior). Marginal reflex distance (MRD) was measured to assess the eyelid position. Proportion of guttae was quantified using image analysis.
Regional differences in guttae distribution and correlation with MRD measurements.
The superior region demonstrated a significantly lower proportion of guttae (29.4%) compared with central (69.0%), temporal (57.4%), and nasal areas (57.5%) (all < 0.05). The difference between superior and inferior areas (45.6%) was not significant ( = 0.08). Margin reflex distance measurements showed no significant correlation with superior guttae distribution ( = 0.40).
Our study reveals a distinct regional variation in FECD progression, with relative sparing of the superior cornea suggesting potential UV-protective mechanisms. Although not directly correlated with eyelid position, these findings indicate that environmental factors may influence disease progression. This insight suggests the potential benefit of UV protection as a preventive strategy, particularly in early-stage FECD patients.
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
研究富克斯内皮性角膜营养不良（FECD）中角膜小滴分布的区域差异，并评估其与眼睑对紫外线（UV）的解剖学防护之间的关系。
前瞻性观察性研究。
本研究纳入了2022年4月至2024年6月期间京都府立医科大学的19例FECD患者的19只眼睛。
使用裂隙扫描宽视野接触式角膜内皮显微镜，我们分析了5个角膜区域（中央、上方、颞侧、鼻侧和下方）的角膜小滴分布。测量边缘反射距离（MRD）以评估眼睑位置。使用图像分析对角膜小滴的比例进行量化。
角膜小滴分布的区域差异以及与MRD测量值的相关性。
与中央区域（69.0%）、颞侧区域（57.4%）和鼻侧区域（57.5%）相比，上方区域的角膜小滴比例显著较低（29.4%）（均P<0.05）。上方区域和下方区域（45.6%）之间的差异不显著（P = 0.08）。边缘反射距离测量结果显示与上方角膜小滴分布无显著相关性（P = 0.40）。
我们的研究揭示了FECD进展中存在明显的区域差异，上角膜相对较少受累提示可能存在紫外线防护机制。尽管与眼睑位置无直接相关性，但这些发现表明环境因素可能影响疾病进展。这一见解提示了紫外线防护作为一种预防策略的潜在益处，特别是对于早期FECD患者。
本文末尾的脚注和披露中可能会有专有或商业披露信息。
