Hribek, Agathe, Clahsen, Thomas, Horstmann, Jens, Siebelmann, Sebastian, Loreck, Niklas, Heindl, Ludwig M., Bachmann, Bjorn O., Cursiefen, Claus and Matthaei, Mario (2021). Fibrillar Layer as a Marker for Areas of Pronounced Corneal Endothelial Cell Loss in Advanced Fuchs Endothelial Corneal Dystrophy. Am. J. Ophthalmol., 222. S. 292 - 302. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1879-1891

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Abstract

PURPOSE: We sought to assess the correlation of corneal endothelial cell (CEC) density to alterations of collagen composition of Descemet membrane (DM) in advanced Fuchs endothelial corneal dystrophy (FECD) and to image such changes by slit-lamp biomicroscopy in vivo. DESIGN: Prospective, observational consecutive case series. METHODS: Fifty eyes (50 subjects) with advanced FECD were enrolled. After slit-lamp biomicroscopy and corneal Scheimpflug imaging, the Descemet endothelium complex (DEC) was retrieved during DM endothelial keratoplasty (DMEK) surgery. The expression of collagens I, III, and IV (COL I, COL III, and COL IV) and corresponding CEC density were analyzed by immunofluorescence flat mount-staining. Presence, diameter and surface area of collagen expression, and CEC density served as the main outcome measures. RESULTS: Immunofluorescence staining revealed central coherent collagen positive areas (mean surface area = 10 mm(2) +/- 6 mm(2)) corresponding to a fibrillar layer burying the guttae of DM in 84% (42/50) of DECs. CEC density overlying the fibrillar layer compared with the periphery was significantly reduced (- 54.8%, P < .0001) with a steep decline of CEC density at its borders. Subgroup analysis revealed that the fibrillar layer may be imaged by slit-lamp biomicroscopy in vivo with significant positive correlation of mean maximum diameter detected by slit-lamp biomicroscopy (d(SL max) = 4.1 mm +/- 0.9 mm) and by immunofluorescence staining (d(IF max) = 4.7 mm +/- 1.1 mm; r = 0.76; P = .001). CONCLUSION: A fibrillar layer with a clear geographic pattern marks areas of pronounced loss of CEC density in advanced FECD eyes and may be imaged by slit-lamp biomicroscopy in vivo. (C) 2020 Elsevier Inc. All rights reserved.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Hribek, AgatheUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Clahsen, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Horstmann, JensUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Siebelmann, SebastianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Loreck, NiklasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heindl, Ludwig M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bachmann, Bjorn O.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cursiefen, ClausUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Matthaei, MarioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-569790
DOI: 10.1016/j.ajo.2020.09.030
Journal or Publication Title: Am. J. Ophthalmol.
Volume: 222
Page Range: S. 292 - 302
Date: 2021
Publisher: ELSEVIER SCIENCE INC
Place of Publication: NEW YORK
ISSN: 1879-1891
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
OphthalmologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/56979

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