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

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

• Park YM
• Choi BS
• Lee JS

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.

Keyword

Confocal microscopy; Fuchs' corneal endothelial dystrophy

MeSH Terms

Cornea
Descemet Membrane
Endothelium
Epithelium, Corneal
Humans
Microscopy, Confocal

Figure

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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.

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  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.

Reference

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