Corneal hydration control in fuchs’ endothelial corneal dystrophy

Katrin Wacker, Jay W. McLaren, Katrina M. Kane, Keith Baratz, Sanjay V. Patel

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

PURPOSE. To assess corneal hydration control across a range of severity of Fuchs’ endothelial corneal dystrophy (FECD) by measuring the percent recovery per hour (PRPH) of central corneal thickness after swelling the cornea and to determine its association with corneal morphologic parameters. METHODS. Twenty-three corneas of 23 phakic FECD patients and 8 corneas of 8 healthy control participants devoid of guttae were graded (modified Krachmer scale). Effective endothelial cell density (ECDe) was determined from the area of guttae and local cell density in confocal microscopy images. Steady-state corneal thickness (CTss) and standardized central corneal backscatter were derived from Scheimpflug images. Corneal swelling was induced by wearing a low-oxygen transmissible contact lens for 2 hours in the morning. De-swelling was measured over 5 hours after lens removal or until corneal thickness returned to CTss. Percent recovery per hour was 100 × (1 - e-k), where k was determined from CT(t) = (de-kt) + CTss, and where d was the initial change from CTss. RESULTS. After contact lens wear, corneas swelled by 9% (95% CI 9-10). Percent recovery per hour was 49%/h (95% CI 41-57) in controls and 37%/h in advanced FECD (95% CI 29-43, P = 0.028). Low PRPH was associated with disease severity, low ECDe, and increased anterior and posterior corneal backscatter. Anterior backscatter was associated with PRPH in a multivariable model (R2 = 0.44). CONCLUSIONS. Corneal hydration control is impaired in advanced FECD and is inversely related to anterior corneal backscatter. Anterior corneal backscatter might serve as an indicator of impaired endothelium in FECD.

Original languageEnglish (US)
Pages (from-to)5060-5065
Number of pages6
JournalInvestigative Ophthalmology and Visual Science
Volume57
Issue number11
DOIs
StatePublished - Sep 1 2016

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Fuchs' Endothelial Dystrophy
Cornea
Cell Count
Contact Lenses
Endothelial Cells
Confocal Microscopy
Lenses
Endothelium
Healthy Volunteers
Oxygen

Keywords

  • Corneal edema
  • Corneal endothelial cells
  • Fuchs’ dystrophy

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

Cite this

Corneal hydration control in fuchs’ endothelial corneal dystrophy. / Wacker, Katrin; McLaren, Jay W.; Kane, Katrina M.; Baratz, Keith; Patel, Sanjay V.

In: Investigative Ophthalmology and Visual Science, Vol. 57, No. 11, 01.09.2016, p. 5060-5065.

Research output: Contribution to journalArticle

Wacker, Katrin ; McLaren, Jay W. ; Kane, Katrina M. ; Baratz, Keith ; Patel, Sanjay V. / Corneal hydration control in fuchs’ endothelial corneal dystrophy. In: Investigative Ophthalmology and Visual Science. 2016 ; Vol. 57, No. 11. pp. 5060-5065.
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abstract = "PURPOSE. To assess corneal hydration control across a range of severity of Fuchs’ endothelial corneal dystrophy (FECD) by measuring the percent recovery per hour (PRPH) of central corneal thickness after swelling the cornea and to determine its association with corneal morphologic parameters. METHODS. Twenty-three corneas of 23 phakic FECD patients and 8 corneas of 8 healthy control participants devoid of guttae were graded (modified Krachmer scale). Effective endothelial cell density (ECDe) was determined from the area of guttae and local cell density in confocal microscopy images. Steady-state corneal thickness (CTss) and standardized central corneal backscatter were derived from Scheimpflug images. Corneal swelling was induced by wearing a low-oxygen transmissible contact lens for 2 hours in the morning. De-swelling was measured over 5 hours after lens removal or until corneal thickness returned to CTss. Percent recovery per hour was 100 × (1 - e-k), where k was determined from CT(t) = (de-kt) + CTss, and where d was the initial change from CTss. RESULTS. After contact lens wear, corneas swelled by 9{\%} (95{\%} CI 9-10). Percent recovery per hour was 49{\%}/h (95{\%} CI 41-57) in controls and 37{\%}/h in advanced FECD (95{\%} CI 29-43, P = 0.028). Low PRPH was associated with disease severity, low ECDe, and increased anterior and posterior corneal backscatter. Anterior backscatter was associated with PRPH in a multivariable model (R2 = 0.44). CONCLUSIONS. Corneal hydration control is impaired in advanced FECD and is inversely related to anterior corneal backscatter. Anterior corneal backscatter might serve as an indicator of impaired endothelium in FECD.",
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AU - Kane, Katrina M.

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N2 - PURPOSE. To assess corneal hydration control across a range of severity of Fuchs’ endothelial corneal dystrophy (FECD) by measuring the percent recovery per hour (PRPH) of central corneal thickness after swelling the cornea and to determine its association with corneal morphologic parameters. METHODS. Twenty-three corneas of 23 phakic FECD patients and 8 corneas of 8 healthy control participants devoid of guttae were graded (modified Krachmer scale). Effective endothelial cell density (ECDe) was determined from the area of guttae and local cell density in confocal microscopy images. Steady-state corneal thickness (CTss) and standardized central corneal backscatter were derived from Scheimpflug images. Corneal swelling was induced by wearing a low-oxygen transmissible contact lens for 2 hours in the morning. De-swelling was measured over 5 hours after lens removal or until corneal thickness returned to CTss. Percent recovery per hour was 100 × (1 - e-k), where k was determined from CT(t) = (de-kt) + CTss, and where d was the initial change from CTss. RESULTS. After contact lens wear, corneas swelled by 9% (95% CI 9-10). Percent recovery per hour was 49%/h (95% CI 41-57) in controls and 37%/h in advanced FECD (95% CI 29-43, P = 0.028). Low PRPH was associated with disease severity, low ECDe, and increased anterior and posterior corneal backscatter. Anterior backscatter was associated with PRPH in a multivariable model (R2 = 0.44). CONCLUSIONS. Corneal hydration control is impaired in advanced FECD and is inversely related to anterior corneal backscatter. Anterior corneal backscatter might serve as an indicator of impaired endothelium in FECD.

AB - PURPOSE. To assess corneal hydration control across a range of severity of Fuchs’ endothelial corneal dystrophy (FECD) by measuring the percent recovery per hour (PRPH) of central corneal thickness after swelling the cornea and to determine its association with corneal morphologic parameters. METHODS. Twenty-three corneas of 23 phakic FECD patients and 8 corneas of 8 healthy control participants devoid of guttae were graded (modified Krachmer scale). Effective endothelial cell density (ECDe) was determined from the area of guttae and local cell density in confocal microscopy images. Steady-state corneal thickness (CTss) and standardized central corneal backscatter were derived from Scheimpflug images. Corneal swelling was induced by wearing a low-oxygen transmissible contact lens for 2 hours in the morning. De-swelling was measured over 5 hours after lens removal or until corneal thickness returned to CTss. Percent recovery per hour was 100 × (1 - e-k), where k was determined from CT(t) = (de-kt) + CTss, and where d was the initial change from CTss. RESULTS. After contact lens wear, corneas swelled by 9% (95% CI 9-10). Percent recovery per hour was 49%/h (95% CI 41-57) in controls and 37%/h in advanced FECD (95% CI 29-43, P = 0.028). Low PRPH was associated with disease severity, low ECDe, and increased anterior and posterior corneal backscatter. Anterior backscatter was associated with PRPH in a multivariable model (R2 = 0.44). CONCLUSIONS. Corneal hydration control is impaired in advanced FECD and is inversely related to anterior corneal backscatter. Anterior corneal backscatter might serve as an indicator of impaired endothelium in FECD.

KW - Corneal edema

KW - Corneal endothelial cells

KW - Fuchs’ dystrophy

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