Prevalence of Primary Cornea guttata and Morphology of Corneal Endothelium in Aging Japanese and Singaporean Subjects

Kitagawa, Kitagawa; Kojima, Masami; Sasaki, Huroshi; Shui, Ying-Bo; Chew, Sek-Jin; Cheng, Hong; Ono, Masaji; Morikawa, Yuko; Sasaki, Kohsuke

doi:10.1159/000063656

Cited by 71 publications

(48 citation statements)

References 11 publications

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“…6 In our study, there was no sex-related difference in the incidence of cornea pseudoguttata. On the contrary, the ratio of female patients with cornea pseudoguttata (55%) was lower than that of the study population (64.4%).…”

Section: Discussioncontrasting

confidence: 46%

Clinical evaluation of cornea pseudoguttata

Nakashima¹,

Yoshitomi²,

Oshika

2006

British Journal of Ophthalmology

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Aim: To report on cornea pseudoguttata which occurred in 44 eyes from 40 patients. Methods: In 3521 consecutive patients seen at a local eye clinic, eyes were examined with a slit-lamp biomicroscope in specular illumination. When guttate appearance was found, specular microscopy was performed. Results: Cornea pseudoguttata was found in 44 eyes of 40 patients (1.1%). All patients had some form of anterior-segment ocular diseases, including keratitis (corneal infiltration) with contact lens wear (n = 16), epidemic keratoconjunctivitis (n = 8), corneal epithelial defect (n = 6), superficial punctate keratitis (n = 4), corneal foreign body (n = 3), keratitis of unknown causes (n = 3), corneal ulcer (n = 2), herpetic keratitis (n = 1), and iritis (n = 1). Six eyes were lost to follow-up, but in the remaining 38 eyes, cornea pseudoguttata completely resolved as the primary anterior-segment diseases subsided. Specular microscopy, measured after resolution of cornea pseudoguttata, showed that corneal endothelial cell density was not different between the affected and contralateral healthy eyes. Conclusion: Cornea pseudoguttata is commonly found in cases with corneal infiltration and inflammation. These results indicate that cornea pseudoguttata is reversible in its nature and resolves completely without any damage to the corneal endothelial cells. C ornea pseudoguttata represents transient corneal endothelial changes that are caused by anterior-segment diseases such as iritis and keratitis.1-3 Unlike primary cornea guttata, which is usually associated with corneal endothelial dystrophy and consists of focal thickening of Descemet's membrane, cornea pseudoguttata is characterised by reversible corneal endothelial cell oedema. 1In 1981, Krachmer et al 1 reported three cases of cornea pseudoguttata that were seen during a short-term episode of iritis and corneal inflammation. Zantos and Holden 2 described the rapid appearance and gradual disappearance of guttate endothelial changes in a patient who experienced an acute red-eye symptom associated with continuous wear of contact lenses.2 Several other reports described clinical findings of cornea pseudoguttata.4 5 To the best of our knowledge, however, there have been no other reports of cornea pseudoguttata in the literature, and thus its clinical characteristics are not known in detail, including long-term clinical consequences, incidence and influences on corneal endothelial cell morphology. In this article, we report on 44 eyes with cornea pseudoguttata that were found in 3521 consecutive cases at the Nakashima Eye Center, Fukuoka, Japan. SUBJECTS AND METHODSOf the 3521 consecutive patients (mean age 47.8 (standard deviation (SD)) 20.3 years) who were seen at the Nakashima Eye Clinic between March and October 2003, 1252 (35.6%) were men and 2269 (64.4%) were women. All patients were examined using the slit-lamp biomicroscope in specular illumination. Eyes with corneal opacity, which hindered observation of the corneal back surface, were excluded from the study. When da...

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Section: Discussioncontrasting

confidence: 46%

Clinical evaluation of cornea pseudoguttata

Nakashima¹,

Yoshitomi²,

Oshika

2006

British Journal of Ophthalmology

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“…Previous studies suggest a prevalence in the United States of approximately 4 to 7%, 22, 23 in Europe of 4.5 to 9%, 15 and in Asia of 3.8 to 8.5%. 16, 17, 24 Although the variation among studies in methods and thresholds utilized to define affectation, such as specular microscopy or slit-lamp examination, limits direct comparison, the data suggest an increased prevalence on the island. This finding is supported by the high frequency of the TCF4 variant allele noted in this isolated population.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Severity of Fuchs Corneal Dystrophy in Tangier Island

Eghrari¹,

McGlumphy²,

Iliff³

et al. 2012

American Journal of Ophthalmology

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Purpose To investigate the clinical and genetic features of late-onset FCD on Tangier, an island in the Chesapeake Bay with an isolated population of approximately 500 individuals. Design Observational, cross-sectional study Methods A total of 156 individuals born to inhabitants of Tangier Island volunteered to undergo ophthalmic evaluation. Medical history was ascertained prior to examination. All participants underwent anterior segment examination with slit-lamp biomicroscopy. Retroillumination photographs were acquired from affected individuals and the disease severity was compared with individuals from large families ascertained previously. Genomic DNA samples were investigated for the presence of the recently identified risk allele rs613872, an intronic variant of TCF4. Results Of the 148 examined individuals who were at least 30 years of age, 32 showed the classical symptoms of late-onset FCD (21.6%), providing a minimum prevalence of 11% among individuals over the age of 50 years. Severity was significantly lower compared to 51 cases from unlinked families, among individuals either 50 to 70 or above 70 years of age (p = 0.05 and 0.01, respectively). Retroillumination photography analyses were suggestive of mild severity when compared with the disease phenotype associated with FCD1 and FCD2-linked families. The rs613872 variant was associated with a higher affectation rate (p=0.01), while the wild-type allele was correlated with a higher proportion of subclinical disease (p=0.01). Conclusions In this study population in Tangier, late-onset FCD manifests clinically with a mild phenotype and increased prevalence. The rs613872 variant correlates with increased affectation and a clinical disease phenotype.

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“…FECD demonstrates a female preponderance with a 3.5:1 bias in patients that underwent penetrating keratoplasty for FECD at Duke University Eye Centre, USA (Afshari et al, 2006). Prevalences of 11% females vs 7% males in Icelanders, 8.5% vs 4.4% in Chinese Singaporeans, and 5.5% vs 1.5% in Japanese were also found (Kitagawa et al, 2002;Zoega et al, 2006). An association with hypermetropia is common (Pitts and Jay, 1990).…”

Section: Introductionmentioning

confidence: 92%

“…The Reykjavik Eye Study revealed a 9.2% prevalence in residents over 55 years old in Reykjavik, Iceland (Zoega et al, 2006); a study found a prevalence of 6.7% in an over-50 year old Chinese Singaporean population and 3.7% in an over-50 year old Japanese population (Kitagawa et al, 2002). It typically presents in the sixth decade but early onset cases have also been reported (Borboli and Colby, 2002).…”

Section: Introductionmentioning

confidence: 99%