Associations Of Fuchs Endothelial Corneal Dystrophy With Systemic Comorbidities, Lifestyle, And Nutrition

Fuchs endothelial corneal dystrophy (FECD) is a multifactorial disease caused by genetic and environmental factors. Systemic health contributions to FECD pathophysiology are incompletely characterized. This study aims to identify possible FECD associations with systemic comorbidities, lifestyle, and nutrition. 

Department of Ophthalmology, Massachuttes Eye and Ear Infirmary in Boston, USA. 

In this case-control study 50 FECD patients and 50 age/sex-matched control patients were enrolled. A cross-sectional survey was conducted and a retrospective chart review performed. Inclusion criterion for the FECD group was FECD clinical diagnosis, and inclusion criteria for the control group were no FECD diagnosis and no guttae. The chart review examined demographics, FECD stage, medical history, and body mass index (BMI). The survey used a validated semiquantitative food frequency questionnaire (SFFQ) and a smoking & exercise questionnaire. Statistical methods were Fisher exact text and Mann Whitney U test. For nutrition analysis an energy-adjustment of nutrition factors was performed using the residual method. 

Cardiovascular diseases had signficantly greater occurrence in FECD compared to controls: hyperlipidemia (p=0.02), atrial fibrillation (p=0.03), hypertension (p=0.10), coronary artery disease (p=0.15), and aortic stenosis (p=0.20). Diabetes had similar occurrence (p=1.00). No difference was observed for having ever smoked (p>0.05), but FECD patients had significantly higher current daily smoking behavior, smoking duration, and total smoking exposure (p<0.05). There were no differences in BMI or exercise activity (p>0.05). SFFQ computed levels for 231 nutritional items. Differences in nutritional items included: sodium (2036.12mg vs 436.22mg, p=0.021), insulinogenic load (711 vs 667.79, p=0.077), and total fat (67.00g vs 71.00g, p=0.036).

FECD and control patients showed statistically significant different rates of cardiovascular diseases, smoking behavior, and sodium intake. Further investigation with a larger cohort may confirm these associations. Conclusions from the nutritional profile are limited by the single timepoint provided by a cross-sectional survey contrasting with the longitudinal nature of FECD pathogenesis. It might be prudent to counsel FECD patients about concomitant cardiovascular disease control, moderation of salt intake, and smoking cessation.