Radboud/Cologne Fuchs' endothelial corneal dystrophy scale (Radboud/Cologne FECD scale)

Session Details

Session Title: Cornea Miscellaneous

Session Date/Time: Monday 24/09/2018 | 16:30-18:00

Paper Time: 17:42

Venue: Room A3, Podium 3

First Author: : S.Nobacht THE NETHERLANDS

Co Author(s): :    B. Bachman   A. Domanian   D. Hos   M. Matthaei           

Abstract Details

Purpose:

Fuchs Endothelial Corneal Dystrophy (FECD) is a slowly progressive disease characterized by guttae of Descemet membrane, attrition of endothelial cells, and corneal edema. Existing Krachmer FECD scale dating from 1979 may be considered as difficult to interpret in the clinical practice. We developed in Nijmegen and Cologne a new grading scale for a modified classification for the severity of disease for optimized use in the clinical practice. This newly developed clinical grading scale for FECD was evaluated in the current study.

Setting:

Department of Ophthalmology, Radboud University Medical Center, Nijmegen, The The Netherlands, Department of Ophthalmology, Uniklinik Cologne, Germany

Methods:

In our scale the cornea is divided into 3 zones, Zone 1 is < 3mm of central cornea, Zone 2 < 5mm of the central cornea and Zone 3 > 5mm of the central cornea. Plus sign is indicated in the presence of epithelial or stromal edema. Each patient underwent a complete slitlamp examination with fully dilated pupil, endothelial cell count, Pentacam topography and a fundus photograph in retro-illumination. A Spearman's rank correlation coefficient was calculated in order to assess correlations. A Mann-Whitney U test and a One-way ANOVA with post-tests were used when applicable.

Results:

Data of 36 eyes was examined and there was a statistically significant difference in central corneal thickness and visual acuity with regard to the zones. Corneal thickness was greater and visual acuity lower in zone 3 compared to zone 2 (P < 0.05 ; One-way ANOVA). If plus sign was present, corneal thickness was even more increased. Irrespective of the zone, plus sign was associated with lower visual acuity (P < 0.05 ; Mann-Whitney U test). In 100% of patients observed by two differing investigators, zone classification was identical. In 78,95% of cases there was agreement regarding the plus sign.

Conclusions:

Radboud/Cologne clinical FECD scale could be considered as a new and potentially advantageous classification method to more objectively classify the severity of FECD with regard to corneal thickness and zone location.

Financial Disclosure:

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