Scheimpflug backscatter imaging of the fibrillar layer in Fuchs endothelial corneal dystrophy
Abstract
PURPOSE
A central collagen-rich subendothelial fibrillar layer (FL) correlates with areas of accentuated loss of corneal endothelial cells in advanced Fuchs endothelial corneal dystrophy (FECD). The present study sought to investigate if the FL may be visualized by en face Scheimpflug backscatter imaging in vivo.
DESIGN
Retrospective analysis of a prospective observational case series.
METHODS
Thirty-four eyes (34 subjects) undergoing Descemet membrane endothelial keratoplasty (DMEK) surgery with preoperative high-quality Scheimpflug backscatter imaging data were included. The Descemet endothelium complex (DEC) was retrieved during DMEK surgery and immunofluorescence staining was performed for collagens I, III, and IV. FL morphology in en face Scheimpflug backscatter and immunofluorescence imaging was compared and agreement of FL parameters was analyzed using intraclass correlation coefficients (ICC) and Bland-Altman plots.
RESULTS
Scheimpflug backscatter imaging delineated the FL in n=26 eyes and was FL-negative in n=8 eyes with deviation compared to immunofluorescence in one case and good agreement of morphology characteristics. Horizontal caliper diameter±standard deviation was 4.84±0.85mm, vertical caliper diameter was 3.92±0.78mm, maximum caliper diameter was 5.12±0.82mm and surface area was 12.43±4.74mm2. Compared to immunofluorescence imaging, mean difference (95% limits of agreement (LOA)) and ICC were for horizontal caliper diameter 0.13mm(-0.81 to 1.1mm) and 0.88,…
How strong is the evidence?
Evidence Hub reads this as a case series. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 34 participants or records.
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