Peripheral Endothelial Cell Count Is a Predictor of Disease Severity in Advanced Fuchs Endothelial Corneal Dystrophy.
Peripheral Endothelial Cell Count Is a Predictor of Disease Severity in Advanced Fuchs Endothelial Corneal Dystrophy.
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DOI：
10.1097/ico.0000000000001292
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发表时间：
2017-10
期刊：
影响因子：
2.8
通讯作者：
Jurkunas UV
中科院分区：
文献类型：
--
作者：
Syed ZA;Tran JA;Jurkunas UV
在晚期Fuchs的内皮性角膜营养不良（FECD）中，中心内皮改变与疾病严重程度无关。外周内皮细胞计数（ECC）尚未作为FECD严重程度的标志物进行研究。本研究的目的是确定晚期feecd患者外周血ECC与已知临床指标之间的关系。在2013年1月1日至2016年9月1日期间由一位角膜专家检查的FECD患者被确定。审查了所有先前就诊的电子病历，包括在同一天进行临床评估的高质量中央和外周体内共聚焦显微镜（IVCM）图像。内皮细胞照片用于进行中央和周围的人工细胞计数。在裂隙灯下对FECD进行1 ~ 4级临床分级。我们确定了126例患者的154只眼睛符合纳入本研究的标准。随着疾病等级的升高，中央ECC和外周ECC降低，视力恶化，中央角膜厚度（CCT）增加（p < 0.05）。在晚期疾病患者中（定义为3级或4级，CCT为700或中心ECC < 350），外周ECC是疾病严重程度的最佳预测因子，与竞争变量相比，与其他疾病临床标志物具有最高的统计学显著相关性。在晚期FECD中，与中央ECC相比，外周ECC、视力、临床疾病分级和CCT最能确定严重程度。
In advanced Fuchs’ endothelial corneal dystrophy (FECD), central endothelial changes do not correlate with disease severity. Peripheral endothelial cell count (ECC) has not been studied as a marker for FECD severity. The goal of this study is to determine the relationship between peripheral ECC and known clinical markers of FECD in advanced cases. Patients with FECD examined between January 1, 2013 and September 1, 2016 by one cornea specialist were identified. Electronic medical records from all prior visits were reviewed to include eyes with high-quality central and peripheral in vivo confocal microscopy (IVCM) images performed on the same day as a clinical evaluation. Endothelial photographs were used to perform manual cell counts centrally and peripherally. Clinical grading of FECD from 1 to 4 was performed at the slit lamp. We identified 154 eyes of 126 patients that met criteria for inclusion in this study. With higher disease grades, central ECC and peripheral ECC decreased, visual acuity worsened, and central corneal thickness (CCT) increased (all p < 0.05). In patients with advanced disease (defined as either grade of 3 or 4, CCT > 700, or central ECC < 350), peripheral ECC was the best predictor of disease severity and had the highest number of statistically significant correlations with other clinical markers of disease as compared to competing variables. In advanced FECD, severity is best determined by peripheral ECC as compared to central ECC, visual acuity, clinical disease grade, and CCT.