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Título

DIFFERENCES OF THE ENDOTHELIAL MOSAIC OF FUCHS ENDOTHELIAL DYSTROPHY EXAMINED BY NON-CONTACT AND CONTACT CORNEAL SPECULAR MICROSCOPES

Fundamentação/Introdução

The Descemet Membrane Excrescences (DME) characterizes Fuchs Endothelial Dystrophy (FED). The most severely affected areas of the Endothelial Mosaic (EM) are the central and paracentral, the most preserved is superior. Specular Microscopy is a non-invasive examination to access the EM. The selection of the best CSM, Non-Contact (NC) or Contact (C), helps to understand the degree of EM involvement in the FED, as a whole.

Objetivos

To know the profile and the degree of impairment of the EM by DME in the central area (CA) and in the furthest areas from the CA possible to be evaluated in FED patients examined by NC CSM and C CSM.

Delineamento e Métodos

Cross-sectional study: 34 eyes of 17 patients with FED diagnosis at the Clinica de Olhos Prof. Dr. Fernando Abib (Curitiba, Brazil).
NC CSM (Tomey EM4000, USA) and C CSM (BioOptics, USA) were used to score the damage of the EM by EMD (Figure 1) in examinations performed consecutively by the same examiner. The scored areas of the EM: CA and furthest areas from the CA at 4 hours (4h), 8 hours (8h), and 12 hours (12h). The mean score (MS) of the examined areas was presented by statistical descriptive. The comparison of the MS between the studied areas with NC and C CSM will be reported in percentage of total agreement and up to one degree of disagreement (Δ1). Comparisons of MS of NC CSM versus C CSM were made at CA, 4h, 8h, and 12h using the T-Test for 2 dependent means (level of significance <0.05).

Resultados

Percentage of agreement:
CA: total agree 44%, Δ1 Agree 85%;
4h: total agree 2.9%, Δ1 agree 20%;
8h: total agree 11.7%, Δ1 agree 14.7%;
12h: total agree 0%, Δ1 agree 14.7%.
Comparison between NC and C CSM in the studied areas:
CA not significant (p>.05);
4h significant (p<.05);
8h significant (p<.05);
12h significant (p<.05).

Conclusões/Considerações Finais

Examinations performed on FED patients, by NC CSM and C CSM in the CA of the EM, show similar results; at the most distant EM areas possible to be examined from the center by these devices (4h, 8h, 12h) the results are different.
The endothelial mosaic least affected by EMD was found when the same eyes were examined by C CSM, which means that NC CSM acquires EM images closer to the central area and C CSM gets images beyond those acquired by NC CSM. It is confirmed that C CSM assesses the periphery of EM, NC CSM does not.

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CÓRNEA