Diurnal Functional And Structural Changes In Patients With Mild Form Of Fuchs Endothelial Corneal Dystrophy: Better Late Than Never?
Published 2022 - 40th Congress of the ESCRS
Reference: FPS03.09 | Type: Free paper | DOI: 10.82333/mmgw-sk34
Authors: Iva Krolo* 1 , Aida Kasumovic 2 , Ivana Radman 2 , Ivan Sabol 3 , Armin Kasumovic 2 , Ivanka Petric Vickovic 2 , Zoran Vatavuk 2
1University Department of Ophthalmology,University Hospital Center Sestre milosrdnice,Zagreb,Croatia;Optical Express Group,Zagreb,Croatia, 2University Department of Ophthalmology,University Hospital Center Sestre milosrdnice,Zagreb,Croatia, 3Rudjer Boskovic Institute,Zagreb,Croatia
Purpose
To investigate the functional and structural daily variations in eyes with mild form of Fuchs endothelial corneal dystrophy (FECD).
Setting
University Department of Ophthalmology, University Hospital Center Sestre milosrdnice, Zagreb, Croatia
Methods
40 eyes at the beginning stage of FECD, without visible corneal edema were included. Patients' subjective visual disability was assesed using The Visual Function and Corneal Health Status (V-FUCHS) instrument. They underwent 3 daily measurements at 8AM, 2PM and 8PM. Visual function testing included: uncorrected distance visual acuity (UCDVA), twilight vision (TV) and spatial frequency contrast sensitivity (CS) testing (Vista Vision Far-Pola, DMD MedTech). Daily structural changes were measured using endothelial microscopy (EM) (Tomey EM-4000, Germany), as well as epithelial and stromal mapping on Pachymetry (P) and Pachymetry wide (PW) maps, using anterior segment optical coherent tomography (ASOCT, AngioVue, AvantiRTVue-XR, Optovue, CA).
Results
Mean V-FUCHS score was 36.0. UCDVA was significantly lowest in the morning (0.4 logMAR, p=0.00001) with improvement during the day. TV showed highest values at 2PM (0.1 logMAR, p=0.011), as did CS, in spatial frequencies B, C and F (p<0.00006, p=0.013, p<0.05, respectively). Central corneal thickness (CCT) was highest in the morning and decreasing to the lowest values at 8PM (547-543 µm, p<0.00001). There was no significant change in central epithelial thickness (CET) values. Central stromal thickness (CST) mapping showed significant changes, with highest values at 8AM, and lowest in the evening on P (493-489 µm, p=0.0002) and PW (494-488 µm, p<0.00001). UCDVA and CET had a positive (p<0.05), and TV and CST negative correlation (p<0.0006).
Conclusions
Structural corneal changes in patients with mild form of FECD correlated well with their visual performances. CET demonstrated no significant diurnal patterns, but showed a positive correlation with UCDVA. CCT and CST were highest in the morning and showed a negative correlation with visual quality function, implying stromal contribution on that regard. AS OCT corneal mapping could be a very useful tool for monitoring patients even at FECD onset.