Regional 3D endothelium/Descemet’s membrane complex thickness (En/DMT) in Fuchs’ endothelial corneal dystrophy (FECD) is a novel, reliable diagnostic tool that can be used to quantify disease severity, according to recent findings. 

An observational, case-control study imaged 104 eyes of 79 participants (64 eyes of 41 FECD patients and 40 eyes of 38 healthy age- and gender-matched controls). The researhers classified FECD into early- (without edema) and late-stage (with edema). The team performed automatic and manual segmentation of the corneal layers, conducted regional En/DMT, regional total cornea thickness (TCT) and central to peripheral TCT ratio measurements and correlated them with the clinical severity of the disease and assessed the reliability of the repeated measurements.

The investigators observed a significant increase in En/DMT, the central to peripheral TCT ratio and TCT in FECD patients. They noted that average En/DMT of paracentral and peripheral regions achieved 94% sensitivity and 100% specificity, while the central to peripheral TCT ratio had 94% sensitivity with a specificity of 73%. To discriminate early-stage FECD from controls, they added that average En/DMT of central zones achieved 92% sensitivity and 97% specificity, while the central to peripheral TCT ratio had 90% sensitivity and 88% specificity.

The researchers also concluded that average En/DMT of central, paracentral and peripheral regions was highly correlated with the clinical stage of FECD, while the central to peripheral TCT ratio and mean TCT of paracentral zones was not.

Eleiwa T, Elsawy A, Tolba M, et al. Diagnostic performance of three-dimensional thickness of endothelium/Descemet complex in Fuchs’ endothelial cell corneal dystrophy. Ophthalmology. January 18, 2020. [Epub ahead of print].