Young Min Park; Beom Seok Choi; Jong Soo Lee

doi:10.3341/jkos.2013.54.9.1435

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Park, Choi, and Lee: Confocal Microscopic Findings of Corneal Tissue in Fuchs’ Corneal Endothelial Dystrophy

Original Article

J Korean Ophthalmol Soc 2013;54(9):1435-1439.

Published online: 7 September 2013

DOI: https://doi.org/10.3341/jkos.2013.54.9.1435

Confocal Microscopic Findings of Corneal Tissue in Fuchs’ Corneal Endothelial Dystrophy

Young Min Park, MD, Beom Seok Choi, MD, Jong Soo Lee, MD, PhD

Department of Ophthalmology, Pusan National University School of Medicine, Busan, Korea

Address reprint requests to Jong Soo Lee, MD, PhD Department of Ophthalmology, Pusan National University Hospital, #179 Gudeok-ro, Seo-gu, Busan 602-739, Korea Tel: 82-51-240-7323, Fax: 82-51-242-7341 E-mail: jongsool@pusan.ac.kr

∗ This study was presented as e-poster at the 109th Annual Meeting of the Korean Ophthalmological Society 2013.

∗ This study was supported by a grant of the Korean Health Technology R&D Project, Ministry of Health and Welfare, Republic of Korea (A070001).

Received 4 March 20137 May 2013 Accepted 17 July 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To analyze the morphology and density of corneal tissue in patients with early stage Fuchs’ corneal endothelial dystrophy (FCED) by in vivo confocal microscopy (IVCM).

Case summary

Each layer of the cornea in 2 patients with early-stage FCED was examined with IVCM (ConfoScan 4.0, NIDEK, Co. Ltd., albignasego, Italy). Cross-sectioned corneal images of the corneal epithelium, Bowman’s layer, stromal layer, Descemet’s membrane, and endothelium were evaluated. Corneal epithelium, Bowman’s layer, and anterior stroma of both patients showed no abnormalities. Case 1 was diagnosed as Stage 1 FCED, demonstrating typical changes including pleomorphism, polymegathism, and the presence of guttae in the corneal endothelial layer. Case 2 was diagnosed as Stage 2 FCED, showing several hyper-reflective whitish dots in the posterior stroma, hypo-reflective vertical strands in the stroma adjacent to Descemet’s membrane, and pleomorphism, polymegathism, and guttae in the corneal endothelial layer.

Conclusions

IVCM is a non-invasive and effective tool to diagnose early-stage FCED.

Keywords: Confocal microscopy, Fuchs’, corneal endothelial dystrophy

References

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Figure 1.

(Case 1) Corneal images obtained from the left eye of a Fuchs dystrophy patient by confocal biomicroscopy. (A) There were no visible hypo-reflective strands in the posterior stroma. (B) The corneal guttata were visible in the corneal endothelial layer.

Figure 2.

(Case 2) Corneal images obtained from the left eye of a Fuchs dystrophy patient by confocal biomicroscopy. (A) There were some hyper-reflective whitish dots and thicker nerve near the corneal stromal cells. (B) The hypo-reflective vertical strands were seen in the stroma adjacent to the descemet membrane. (C) The corneal guttata were visible in the corneal endothelial layer.

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