Diurnal Variation in Straylight in Patients With Fuchs Endothelial Corneal Dystrophy and Controls

Abstract

Purpose:The goal of this study was to investigate diurnal changes in intraocular straylight in relation to other corneal parameters and subjective complaints in patients with Fuchs endothelial dystrophy and healthy controls.Methods: This is a prospective study conducted in 2 tertiary care hospitals in Germany and the Netherlands. Patients with Fuchs endothelial dystrophy (n = 71) and healthy controls (n = 34) were included. Patients with Fuchs dystrophy were grouped by the presence of subjective complaints and measured over multiple time points during the day. Measurements included intraocular straylight using the C-Quant and corneal thickness and backscatter using a Scheimpflug camera. A separate group of healthy controls was measured intensively with repeated straylight measurements directly after waking. An exponential decay model was used to model the diurnal change.Results: Healthy controls showed an average straylight baseline of 1.17 log(s) with an increase in straylight after waking of 0.22 log(s). In the repeated measurements subgroup, the increase in morning straylight lasted for 22 minutes. Patients with Fuchs dystrophy showed a morning increase in straylight of 0.21 log(s) present up to 4 hours after waking before reaching an average baseline of 1.30 log(s). Straylight was positively correlated with anterior corneal backscatter, r = 0.21, P = 0.022, and corneal thickness, r = 0.46, P , 0.01. Conclusions:Healthy eyes experience a diurnal straylight increase similar to patients with Fuchs dystrophy in intensity. However, in Fuchs dystrophy, the resolution of increased straylight is prolonged over multiple hours compared with minutes in healthy eyes. This suggests pathological exacerbation of a physiological diurnal change. This mechanism can play a role in subjective complaints experienced by patients with Fuchs dystrophy.

Diurnal Variation of Visual Acuity and Refraction in Fuchs Endothelial Corneal Dystrophy

“…In previous studies, straylight was also higher after eye opening in Fuchs dystrophy compared with healthy corneas with a sloweddown resolution in eyes with poor hydration control. 3 The relative preservation of visual acuity compared with glare symptoms was also validated by experimental studies, whereby disability glare was affected by a small increase in stromal edema while visual acuity only started to decrease after substantial stromal swelling. 20,21 Nevertheless, the data obtained from this study serve as an approximation to what would be expected and experienced in everyday life because exact time points for lid closure at nighttime and eye opening in the morning in the intense measurement group were not controlled to include both eyes, if eligible, and sleep patterns in hospital might deviate from those at home.…”

“…Visual disability can be assessed using questionnaires such as the Visual Function and Corneal Health Status (V-FUCHS) instrument, 1,2 which covers Fuchs dystrophy-specific impairment in glare, contrast sensitivity, and diurnal variation of vision frequently reported by patients. 3,4 Besides symptom burden, objective measurements include optical assessments of visual acuity and disability glare, and signs of morphological disease progression, such as an increase in the Krachmer grading scale, an increase in edema, or a decrease in effective endothelial cell density.…”

A Google Trends Approach to Identify Distinct Diurnal and Day-of-Week Web-Based Search Patterns Related to Conjunctivitis and Other Common Eye Conditions: Infodemiology Study

“…This suggests infodemiological approaches can provide new understanding of specific days of the week, and hours of those days, on which particular ophthalmologic conditions are most affecting patients. Such approaches can add to the ongoing research studies to understand critical times or days for severity or treatment of symptoms and conditions outside of standard clinic hours for ocular conditions, as has also been studied for other disease [ 28 , 31 - 37 , 52 - 57 ]. We also observed that diurnal search patterns can differ by time of year for some terms, suggesting unique seasonal factors may affect the diurnal cycle of specific ocular conditions and raising the potential value of the approaches such as ours for enhancing the study of seasonal eye disease [ 29 ].…”

Graft Detachment after Descemet Membrane Endothelial Keratoplasty with and without Cataract Surgery

“…This study included participants of two completed and one ongoing prospective single-center cohort studies (German Clinical Trials Register, DRKS00016996; 17 DRKS00020945; 18,19 DRKS00020946, ongoing) and of one completed randomized-controlled trial (ClinicalTrials.gov, NCT04140422). 20 Ethics Committee approval was obtained for all studies and this analysis.…”