Patient: 58 years of age, female, BCVA 0.6 at OD, 0.7 at OS, pachymetry 589 µm/ 602 µm.
Ocular Medical History: decrease of vision, not improvable by glasses.
General Medical History: empty.
Purpose: to show slitlamp- and specular microscopy- images of endothelial cells.
Methods: Colour Photography Anterior Segment, non-contact Specular Microscopy Konan Medical.
Findings:
Colour Photography Anterior Segment: thickening of Descemet’s membrane, microscopic collagenous excrescences (guttae).
Non-contact Specular Microscopy Konan Medical: pleomorphism, polymegathism with increased variation in the sizes of the endothelial cells , guttae appearing as dark areas, cell loss, morphing of surrounding cells to fill in the compromised endothelium.
Discussion:
Fuchs’ endothelial dystrophy (FED) is a familial, and slowly progressive disorder affecting the corneal endothelial cell monolayer. In the United States, FED affects about 4 % of the population over the age of forty. Li et al. (1) performed a meta-analysis suggesting that there is a genetic association between four TCF4 polymorphisms (rs613872, rs2286812, rs17595731, and rs9954153) and the risk of fuchs' endothelial dystrophy.
Literature:
(1) Li D, Peng X, Sun H. Association of TCF4 polymorphisms and fuchs' endothelial dystrophy: a meta-analysis. BMC Ophthalmol. 2015 Jun 19;15(1):61.
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