STUDY OF THE CORNEAL ENDOTHELIUM DURING INFLAMMATION OF THE ANTERIOR SEGMENT (ABOUT 14 CASES)

 

 

We conducted a prospective comparative study over a period of 6months(May 2021-October2021) in the ophthalmology B department  at the Specialty Hospital, Ibn Sina,Rabat,Morroco on 14 patients admitted for their first episode of unilateral uveitis including anterior segment involvement

Patients with pre-existing endothelial damage,diabetics,glaucoma,smokers and those who had ocular surgery were excluded.All our patients underwent a complete bilateral ophthalmological examination with measurement of the corrected ocular tone, as well as an exploration by specular microscopy of both eyes with evaluation of various qualitative and quantitative corneal parameters:Central corneal pachymetry,central corneal endothelial cell density, percentage of hexagonal cells,coefficient of variation of size,and number of cells analyzed by comparing the endothelial status of the affected eyes with the healthy eyes

28 eyes were included,Uveitis with anterior involvement alone was the most represented with a rate of 64.2%.The etiological investigation was conclusive in 3patients with 1case of Toxoplasmosis,1 Sarcoidosis and 1 Ankylosing spondylitis.Central corneal endothelial cell density was decreased in affected eyes with a mean of 2587cells/mm2 and extremes between [1810-3100cells/mm2] compared with healthy eyes (mean of 2688 and extremes between [1928-3115 cells/mm2]).The mean central corneal thickness values had no significant difference between the 2 eyes with a mean of 507μm for affected eyes and a mean of 514 μm for healthy eyes. The mean percentage of hexagonal cells was decreased in affected eyes 51%[46-68%] compared with healthy eyes 55% [47-71%].The coefficient of variation was greater in the affected eyes with an average of 37% compared with 31% for the healthy eyes.Ocular hypertonia was found in 2 patients,Corneal edema was not found in any of the patients.The inflammatory process during anterior uveitis may be responsible for endothelial cell loss with modification of their shape.Indeed, the study of endothelial density showed in our study as in the literature a decrease in cell density in eyes with anterior uveitis compared to healthy eyes,unlike the central corneal thickness which was not significantly modified.The study of morphology showed a decrease in the percentage of hexagonal cells,as described in the literature

Inflammation of the anterior segment is associated with a decrease in central corneal endothelial density as well as variations in cellular morphological characteristics,which imposes an exploration of the endothelium prior to surgical procedures that must be adapted to reduce the risk of further damage