Objective Assessment of the Corneal Endothelium in Fuchs' Endothelial Dystrophy

McLaren, Jay W.; Bachman, Lori A.; Kane, Katrina M.; Patel, Sanjay V.

doi:10.1167/iovs.13-13041

Cited by 53 publications

(57 citation statements)

References 26 publications

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“…Recent studies have reported a method for objectively grading 25,43 or predicting progression of Fuchs' endothelial corneal dystrophy. 44 The peripheral corneal thickness 25 and the central ratio of guttae 43 are especially useful for objective grading.…”

Section: Discussionmentioning

confidence: 99%

Quantitative Regional Differences in Corneal Endothelial Abnormalities in the Central and Peripheral Zones in Fuchs' Endothelial Corneal Dystrophy

Fujimoto

Maeda

Soma

et al. 2014

Invest. Ophthalmol. Vis. Sci.

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Section: Discussionmentioning

confidence: 99%

Quantitative Regional Differences in Corneal Endothelial Abnormalities in the Central and Peripheral Zones in Fuchs' Endothelial Corneal Dystrophy

Fujimoto

Maeda

Soma

et al. 2014

Invest. Ophthalmol. Vis. Sci.

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“…Although no significant differences were detected between wound types in regard to the size of CECs, CECs over peeled wounds were less circular than those over scratched wounds, with this difference accentuated by Y-27632 stimulation. Given the clinical observations of cellular pleomorphism and loss of cellular hexagonality associated with in vivo CEC migration and enlargement following acute endothelial cell loss, 24 this disparity in CEC circularity may simply be a reflection of the exaggerated promigratory response mounted by CECs secondary to the potent stimulating effects of Y-27632. Additionally, the forcible migration of CECs over an anatomically unfavorable substrate (bare posterior corneal stroma: peeled wound) under the influence of Y-27632 may possibly have induced greater cellular pleomorphism than that demonstrated by CECs migrating across smooth, CEC-denuded DM (scratched wound).…”

Section: Figurementioning

confidence: 99%

“…22 Disease progression is characterized by an increase in the size and density of guttae 23 and concomitant reductions in the population of healthy CECs. 24 In contrast, pseudophakic bullous keratopathy (PBK) is an acquired corneal endothelial disorder that may occur following intraocular cataract extraction surgery. 25 Various causative factors such as excessive phacoemulsification energy 26 and mechanical trauma 27 to the corneal endothelium during cataract extraction surgery have been implicated in causing stress-induced apoptosis of CECs.…”

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confidence: 99%

Predicative Factors for Corneal Endothelial Cell Migration

Soh

Peh

George

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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PURPOSE.To characterize the effects of Descemet's stripping, Rho-associated protein kinase inhibitor Y-27632, and donor age on endothelial migration in human corneas maintained in ex vivo culture.METHODS. Twenty-eight cadaveric human corneas underwent ex vivo culture in either standard or Y-27632-supplemented culture medium for 14 days. The posterior surface of each cornea was manipulated to create two types of wounds: scratched wound-corneal endothelial cells (CECs) were denuded from the Descemet's membrane (DM) to leave behind a bare but intact DM; and peeled wound-both the DM and overlying CECs were stripped to leave behind bare corneal stroma. Endothelial migration was assessed via Trypan blue staining. Morphologic traits of CECs were assessed via Alizarin red microscopy and scanning electron microscopy.RESULTS. The CECs migrated preferentially over scratched wounds compared with peeled wounds. Y-27632 supplementation accelerated endothelial migration over scratched wounds. Endothelial migration decreased with advanced donor age for both wound types, regardless of exposure to Y-27632. Y-27632 supplementation resulted in a less rapid decline in endothelial migration for donors older than 50 years of age for scratched surfaces. Greater cell density and hexagonality was observed over scratched wounds compared with peeled wounds, regardless of Y-27632 supplementation.CONCLUSIONS. The presence of an intact DM, Y-27632 supplementation, and young donor age are factors that promote endothelial migration in an ex vivo human cornea culture model. The negative effect of age on endothelial migration can be mitigated by the presence of an intact DM and Y-27632 supplementation.

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“…We examined the relationships between HOAs, backscatter, and corneal morphologic characteristics that are typically altered in FECD, such as corneal thickness and effective endothelial cell density (ECD e ). 14 We hypothesized that HOAs and backscatter are increased in the anterior and posterior cornea early in FECD, and are associated with ECD e and corneal thickness.…”

Section: Introductionmentioning

confidence: 99%

Corneal High-Order Aberrations and Backscatter in Fuchs' Endothelial Corneal Dystrophy

et al. 2015

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Purpose Suboptimal visual acuity after endothelial keratoplasty has been attributed to increased anterior corneal high-order aberrations (HOAs). In this study, we determined anterior and posterior corneal HOAs over a range of severity of Fuchs endothelial corneal dystrophy (FECD). Design Cross-sectional study. Participants 108 eyes (62 subjects) with a range of severity of FECD and 71 normal eyes (38 subjects). Methods All corneas were examined by using slit-lamp biomicroscopy to determine the severity of FECD versus normality. FECD corneas were categorized as mild, moderate, or advanced according to the area and confluence of guttae and the presence of clinically visible edema. Normal corneas were devoid of any guttae. Wavefront errors from the anterior and posterior corneal surfaces were derived from Scheimpflug images and expressed as Zernike polynomials through the 6th order over a 6-mm-diameter optical zone. Backscatter from the anterior 120 μm and posterior 60 μm of the cornea were also measured from Scheimpflug images and were standardized to a fixed scatter source. Variables were compared between FECD and control eyes by using generalized estimating equation models to adjust for age and correlation between fellow eyes. Main Outcome Measures HOAs, expressed as root-mean-square of wavefront errors, and backscatter of the anterior and posterior cornea. Results Total anterior corneal HOAs were increased in moderate (0.61 ± 0.27 μm, mean ± standard deviation; p =0.01) and advanced (0.66 ± 0.28 μm; p =0.01) FECD compared to controls (0.47 ± 0.16 μm). Total posterior corneal HOAs were increased in mild (0.22 ± 0.09 μm; p =0.017), moderate (0.22 ± 0.08 μm; p <0.001), and advanced (0.23 ± 0.09 μm; p <0.001) FECD compared to controls (0.16 ± 0.03 μm). Anterior and posterior corneal backscatter were higher for all severities of FECD compared to controls (p ≤0.02, anterior; p ≤0.001, posterior). Conclusions Anterior and posterior corneal HOAs and backscatter are higher than normal even in early stages of FECD. The early onset of HOAs in FECD might contribute to the persistence of HOAs and incomplete visual rehabilitation after endothelial keratoplasty.

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Objective Assessment of the Corneal Endothelium in Fuchs' Endothelial Dystrophy

Abstract: The effective ECD in confocal images provides an objective means of assessing the corneal endothelium in Fuchs' dystrophy and might be a useful tool in clinical studies.

Cited by 53 publications

References 26 publications

Quantitative Regional Differences in Corneal Endothelial Abnormalities in the Central and Peripheral Zones in Fuchs' Endothelial Corneal Dystrophy

Quantitative Regional Differences in Corneal Endothelial Abnormalities in the Central and Peripheral Zones in Fuchs' Endothelial Corneal Dystrophy

Predicative Factors for Corneal Endothelial Cell Migration

Corneal High-Order Aberrations and Backscatter in Fuchs' Endothelial Corneal Dystrophy

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