Determining Subclinical Edema in Fuchs Endothelial Corneal Dystrophy: Revised Classification using Scheimpflug Tomography for Preoperative Assessment

Ophthalmology
Susan Y SunSanjay V Patel

Abstract

To determine if Scheimpflug tomography can identify subclinical corneal edema in Fuchs endothelial corneal dystrophy (FECD), and to recommend a new classification of FECD for clinical practice and research. Cross-sectional study with follow-up of outcomes. Ninety-three eyes from 57 subjects with a range of severity of FECD and 74 eyes from 40 subjects with normal corneas. Corneas were clinically assessed for FECD and corneal edema by using slit-lamp biomicroscopy, and categorized as having clinically definite edema (obvious visible edema), being suspicious for subclinical edema (possible corneal thickening without obvious edema on slit-lamp examination), or not having edema (no clinical suspicion of edema). Tomographic pachymetry and elevation maps derived from Scheimpflug images were evaluated by 3 masked observers for specific features believed to be consistent with corneal edema. FECD clinical disease course and outcomes were reviewed from the time of Scheimpflug image acquisition to the last available follow-up. Presence of tomographic features: (1) loss of parallel isopachs, (2) displacement of the thinnest point of the cornea, and (3) focal posterior corneal surface depression. Clinical outcomes included the change in cen...Continue Reading

Citations

Nov 8, 2018·Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft·K WackerP Maier
Jul 26, 2019·Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft·Viviane GrewingKatrin Wacker
May 31, 2019·Journal of Ophthalmology·Katarzyna KrysikAnita Lyssek-Boron
Dec 2, 2020·Investigative Ophthalmology & Visual Science·Marcus WalcklingSimone Baltrusch
Aug 3, 2020·Ophthalmology·Sanjay V PatelKeith H Baratz
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