Free Papers

Novel Quantitative AS-OCT Biomarkers for Fuchs Endothelial Corneal Dystrophy

Free Paper Details

First Author: M.Leitao PORTUGAL

Co Author(s):    M. Leitão   D. Cabral   M. Marques   C. Rodrigues   S. Alves   H. Nogueira     

Abstract Details

Purpose:

To compare Descemet Membrane/Endothelium Complex (DEC) thickness and reflectivity changes between Fuchs Endothelial Corneal Dystrophy (FECD) patients and healthy subjects after corneal imaging with high resolution Anterior Segment Optical Coherence Tomography (AS-OCT) and to compare its diagnostic and follow-up capabilities with Specular Microscopy.

Setting:

Prospective, single-center, comparative study at Instituto de Oftalmologia Dr. Gama Pinto, Lisbon, Portugal.

Methods:

26 eyes with FECD without clinical edema (slit-lamp evaluation; Central Corneal Thickness (CCT) less than 640µm; no visual symptoms) and 26 eyes from healthy subjects were recruited. Pachymetry, Specular Microscopy - Cell Density (CD), Coefficient of Variation (CV) and Hexagonality (Hex) – and cross-section central corneal images with AS-OCT were obtained for each group. Customized algorithms reduced image acquisition bias and determined: maximum Descemet/Endothelium Reflectivity (DERmax), Posterior Stroma Reflectivity (PSR), Reflectity Dispersion (RD); DERmax/PSR; and Descemet Membrane/Endothelium thickness (DET). Their discriminative ability between the two study groups and their correlation were assessed at a level of significance α = 0.05.

Results:

No statistically significant difference was noted in CCT between both groups. The mean CD was 2634.11±227 in controls and 1484.75±497.19 in FECD (p<0.001), while CV and Hex showed no statistically significant difference between both groups. The mean DET was 15.33±0.91 in controls and 23.77±5.55 in FECD (p<0.001); mean DERmax was 81.28±15.45 in controls and 115.09±19.62 in FECD (p<0.001); mean DER/PSR was 1.46±0.30 in controls and 1.89±0.37 in FECD (p=0.001); mean RD was 0.0399±0.0064 in controls and 0.0497±0.0010 in FECD (p=0.002). In the FECD group, there was an inverse correlation between CD and: DET (r=-0.590); DER/PSR (r=-0.550); and RD (r=-0.504).

Conclusions:

AS-OCT parameters were more discriminative than Specular Microscopy parameters for Fuchs patients without clinical edema from healthy subjects. There was an inverse correlation between CD and the AS-OCT parameters. Hence, the DET and DE reflectivity parameters are important novel biomarkers for both diagnosis and assessment of disease severity in FECD patients.

Financial Disclosure:

-