ESCRS - PP12.17 - Prevalence Of Tomographic Features Associated With Subclinical Edema In Fuchs Dystrophy Across Three Commercially Available Corneal Tomographers

Prevalence Of Tomographic Features Associated With Subclinical Edema In Fuchs Dystrophy Across Three Commercially Available Corneal Tomographers

Published 2023 - 41st Congress of the ESCRS

Reference: PP12.17 | Type: Free paper | DOI: 10.82333/dsq1-d819

Authors: Chiara Ancona* 1 , Matteo Airaldi 2 , Maria Laura Passaro 3 , Rosangela Cucco 1 , Francesco Semeraro 1 , Vito Romano 4

1Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health,University of Brescia,Brescia,Italy, 2Department of Molecular and Translational Medicine,University of Brescia,Brescia,Italy, 3Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health,University of Brescia,Brescia,Italy;Department of Neurosciences, Reproductive Sciences and Dentistry,University of Naples "Federico II",Naples,Italy, 4Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health,University of Brescia,Brescia,Italy;Eye and Vision Science, Institute of Life Course and Medical Sciences,University of Liverpool,Liverpool,United Kingdom

Purpose

Specific tomographic alterations suggestive for subclinical edema have a known impact on FED prognosis. Here, we compare the prevalence of tomographic alterations associated with subclinical edema in patients affected by Fuchs Endothelial Dystrophy (FED) imaged with corneal tomographers employing three different technologies.

Setting

Hospital-based, cross-sectional study conducted at the ASST Spedali Civili di Brescia (Brescia, Italy).

Methods

Patients with a clinical diagnosis of FED underwent tomography with 3 different devices: the Pentacam Scheimpflung camera (Oculus, Germany), the Casia2 AS-OCT (Tomey, Japan), and the Precisio 2 blue-light slit-scanning tomographer (IVIS, Italy). Subjects were classified into FED with no edema, FED with subclinical edema, and FED with clinical edema according to a validated classification based on pachymetric and posterior elevation maps appearance on the Scheimpflung camera. The prevalence of these features was compared across the 3 devices, then two experienced ophthalmologists assigned a 0-3 score according to their evidence. A mixed-effects binomial model estimated Odds Ratios (OR) for the scores of the 3 devices.

Results

A total of 30 eyes were included: 7 eyes presented with clinically defined edema, 18 eyes with no clinical edema but tomographic features suggestive of subclinical edema, and 5 eyes with no edema and no tomographic alterations. The prevalence of Loss of parallel isopachs, Displacement of thinnest point, and Focal posterior depression did not differ between devices. However, identification of Loss of parallel isopachs was most evident on Precisio 2 compared to Pentacam (OR 9.6, p = .007), and the Displacement of thinnest point was most evident on Precisio 2 compared to both Pentacam and Casia2 (OR 6.9, p = .01 and OR 15.1, p = .005). 3 eyes showed alterations only on Precisio 2, one of which was later scheduled for DMEK.

Conclusions

Scheimpflung camera, AS-OCT, and blue-light slit-scanning based tomographers were all able to detect tomographic changes in FED. Nevertheless, our results suggest that the blue laser, slit-scanning tomographer might be able to detect earlier, and delineate better, subclinical changes in FED.