Tomographic findings of subclinical edema help predict Fuchs’ progression

PARIS — With a median of 5 years of follow-up, three easily identifiable tomography patterns predict prognosis in Fuchs’ endothelial corneal dystrophy, according to a study presented at EuCornea 2019.

“In this study, we asked the question whether Scheimpflug tomography [Pentacam, Oculus] could predict the prognosis of Fuchs’ dystrophy,” Sanjay V. Patel, MD, said.

The cross-sectional cohort study enrolled 96 eyes with a range of severity of Fuchs’ dystrophy based on the area and confluence of guttae. Most eyes were phakic, and all eyes with Fuchs’ endothelial corneal dystrophy anatomical grade 6 had abnormal tomographic findings, Patel said.

Pachymetry and posterior elevation maps that evaluated presence of subclinical edema, specifically, loss of parallel isopachs, displacement of thinnest point and focal posterior depression, predicted a higher chance for progression to Fuchs’ dystrophy (all P < .001). These parameters are measured independent of central corneal thickness, which did not itself statistically significantly affect prognosis.

“If the tomographic features are present, there is a high likelihood of progression over a 5-year period,” Patel said.

Risk for progression was 7% when none of the features were present compared with 94% when all features were present.

Tomography can help classify Fuchs’ dystrophy corneas for clinical trials, identify eyes at risk for progression and provide objective outcome measures of intervention, Patel said. – by Patricia Nale, ELS



Patel S. Scheimpflug tomography to predict the prognosis of eyes with Fuchs endothelial corneal dystrophy. Presented at: EuCornea; Sept. 13-14, 2019; Paris.