The 7‐year cumulative incidence of cornea guttata and morphological changes in the corneal endothelium in the Reykjavik Eye Study

Abstract

ABSTRACT.Purpose: To examine the corneal endothelium and establish the 7-year cumulative incidence of cornea guttata (CG). Methods: Population-based prospective cohort study with 573 participants (third wave of the Reykjavik Eye Study (RES) in 2008). Four hundred and thirty-seven subjects had either right or left eyes available for analysis after excluding confounding eye conditions. The baseline for eyes at risk for developing CG is the second wave of the RES in 2001. Participants underwent specular microscopy and a standardized eye examination. Results: The cumulative 7-year incidence of CG in either eye was estimated as a 95% confidence interval for the expected value for both genders combined (15-23%), for males (8-18%) and for females (19-29%). In right eye only, the 7-year cumulative incidence for both genders combined was estimated to be 6-11%. For genders combined and for males only, the data indicated no correlation between 7-year cumulated incidence and age at baseline. In women, however, the change of 7-year incidence for CG in at least one eye appeared to be correlated to age at baseline. Reduction of endothelial cell density for corneas with CG at baseline was found [CI (0.95))132 ± 94]. Conclusion: The cumulative 7-year incidence of primary central CG for a middle-aged and older Caucasian population without history of potentially confounding eye disease has been established. Women tend to have higher incidence if onset occurs at middle age. If CG is present, the cell density and the cell size variation decrease within a 7-year period.

Prevalence of guttae in the graft following corneal transplantation

“…Despite the absence of preoperative specular microscopy images of these patients, based on the prevalence of guttae in the normal population,2 5 we assume that this finding was simply not detected before surgery.…”

“…The prevalence of central corneal guttae in patients older than 40 or 50 years varied in several studies from 3.8% to 70% 2 5. In particular, Borderie and co-workers found isolated guttae and grouped guttae in 25.6% and 4.8%, respectively, of 168 donor corneas for PK 5.…”

“…For this reason, donor corneas are screened to determine endothelial integrity and those with multiple or confluent guttae are discarded for penetrating (PK) or endothelial keratoplasty (EK) 2 4 5…”

Eye patching after cataract surgery is associated with an increased risk of short‐term corneal oedema

“…Special attention was given to the corneal examination and patients with guttata, corneal oedema or other pathological corneal findings as well as those with a known history of Fuchs endothelial dystrophy were excluded from the study. Zoega et al reported that mean corneal endothelial cell density in patients with no guttata present was 2495 ± 29 (cells per mm 2 ), suggesting that patients with no evidence of guttata on clinical examination have normal corneal endothelial cell counts. Considering the meticulous preoperative examination and the data from the above quoted study, we feel that preoperative ECD would not have altered our conclusions.…”

Scanning Acoustic Microscopy Comparison of Descemet's Membrane Normal Tissue and Tissue With Fuchs' Endothelial Dystrophy

“…F uchs' endothelial dystrophy (FECD) is a corneal disease accompanied by abnormality of the Descemet membrane indicated by polymegethism (irregularly shaped cells) and polymorphism (variable shape of cells) in addition to a considerable loss of the multifunctional, nondegenerative, corneal endothelial cells. [1][2][3] The progressive decrease of cell density is accompanied by an increase in the deposition of the extracellular matrix and thickening of Descemet membrane that accumulates in the form of granular guttae leading to corneal edema and decreased visual acuity. 3,4 FECD is associated with genetic mutations, [4][5][6][7] as well as environmental influences, 7 age and sex 8 among other possible factors.…”