[Morphologic characteristics of cornea in Fuchs endothelial dystrophy observed by confocal microscopy]

Abstract

Objective: To analyze the image of corneas with Fuchs endothelial dystrophy using confocal microscopy in vivo.

Methods: Central corneas of 38 eyes (19 patients aged 33 approximately 76 years) were examined using scanning slit confocal microscopy in vivo after being diagnosed with Fuchs endothelial dystrophy. They were divided into two groups namely symptomatic (19 eyes) and asymptomatic (19 eyes). The control group comprised of 30 normal eyes. The images were analyzed visually for morphology of corneas and the densities of cells, as well as the diameter of the guttae and the corneal nerves were counted by NAVIS software.

Results: (1) In the symptomatic groups, confocal microscopy revealed guttae in 19 eyes. The diameter of the guttae ranged from 20 to 60 micro m. The density of endothelial cells was statistically significant compared with the control group (t = 18.74, P < 0.01). Descemet's membrane was thickened in 9 eyes. Dark bands 6.0 approximately 10.8 micro m in diameter were detected in 14 eyes. All eyes showed a diffuse increased light reflection in the stroma.17 eyes exhibited an abnormal Bowman's layer: multiple focal bright reflection. 10 eyes revealed normal corneal nerves. The differences between posterior and anterior keratocyte densities in the control and study groups were not statistically significantly different (t = 0.854, 1.173; P = 0.38, 0.24 respectively). (2) In the asymptomatic groups, less number of guttae could be seen in the endothelial layer. The diameter of the guttae was 15 approximately 40 micro m. The densities of endothelial cells were not significantly different compared with control group (t = 1.998, P = 0.053). Other layers of the cornea exhibited no other abnormal phenomenon. The densities of endothelial cells between symptomatic and asymptomatic groups were statistically significantly different (t = 8.352, P < 0.01).

Conclusions: Morphologic characteristics of cornea are observed by confocal microscopy in Chinese patients with Fuchs endothelial dystrophy. Preliminary results demonstrate that there is no significant difference between Chinese and western patients. Confocal microscopy allows to diagnose Fuchs dystrophy and visualize endothelial cells within the swollen cornea. And it is especially useful for patients whose endothelial cells can not be seen with non-contact specular microscopy.