Predicting corneal decompensation in Fuchs endothelial corneal dystrophy with Scheimpflug tomography and clinical parameters
Purpose: This study aims to evaluate the efficacy of various tomographic indices, both established and novel, in predicting endothelial decompensation leading to either spontaneous corneal transplantation or transplantation following cataract surgery in patients with Fuchs endothelial corneal dystro...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-01-01
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| Series: | Indian Journal of Ophthalmology |
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| Online Access: | https://journals.lww.com/10.4103/IJO.IJO_828_24 |
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| author | Nilufer Yesilirmak Vaël Souédan Aurélie Pison Jean Louis Bourges |
| author_facet | Nilufer Yesilirmak Vaël Souédan Aurélie Pison Jean Louis Bourges |
| author_sort | Nilufer Yesilirmak |
| collection | DOAJ |
| description | Purpose:
This study aims to evaluate the efficacy of various tomographic indices, both established and novel, in predicting endothelial decompensation leading to either spontaneous corneal transplantation or transplantation following cataract surgery in patients with Fuchs endothelial corneal dystrophy (FECD).
Methods:
In this cross-sectional, retrospective study, we reviewed the files of 93 eyes from 54 FECD patients undergoing regular follow-up. We recorded clinical metrics such as morning visual disturbance (MVD) and corrected distance visual acuity. In addition, we extracted topographic measurements including central corneal thickness (CCT); corneal volumes (CVs) within 3, 5, and 7 mm diameters (CV3, CV5, CV7); corneal central-to-peripheral volume ratios (CPVRs) for 3/5 mm (CPVR-3/5) and 3/7 mm (CPVR-3/7); peripheral volume index; thinnest point; corneal thickness spatial profile at 2, 4, 6, and 8 mm (CTSP2, CTSP4, CTSP6, CTSP8); corneal central-to-peripheral thickness ratio at 4 mm (CPTR4); and percentage of thickness increase at 2, 4, and 6 mm (PTI2, PTI4, PTI6), loss of regular isopachs (LRI), displacement of the thinnest point (DTP), and focal posterior surface depression (FPSD).
Results:
Receiver operating characteristic curves revealed a CCT area under the curve (AUC) of 0.732, with an optimal threshold of 596.5 µm yielding 79.7% sensitivity and 63.6% specificity. CTSP4 demonstrated an AUC of 0.706 with a 616.5-µm threshold (77.4% sensitivity, 60.6% specificity), and CPTR4 showed an AUC of 0.588 with a 0.963 threshold (62.3% sensitivity, 60.6% specificity). Notably, MVD presented a statistically significant odds ratio of 4.63 (95% confidence interval = 1.76–12.86). In univariate analyses, LRI, DTP, and FPSD were risk factors for progression, whereas in multivariate analyses, LRI was an independent risk factor for progression.
Conclusion:
The findings suggest that MVD and LRI serve as most significant predictive markers, while CCT, CTSP4, and CPTR4 were average predictive markers for FECD progression, underscoring their potential in guiding clinical decisions and interventions. |
| format | Article |
| id | doaj-art-146d5131af0a4878bfb8187f4d7405a3 |
| institution | Kabale University |
| issn | 0301-4738 1998-3689 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Ophthalmology |
| spelling | doaj-art-146d5131af0a4878bfb8187f4d7405a32025-01-07T06:27:42ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47381998-36892025-01-01731525810.4103/IJO.IJO_828_24Predicting corneal decompensation in Fuchs endothelial corneal dystrophy with Scheimpflug tomography and clinical parametersNilufer YesilirmakVaël SouédanAurélie PisonJean Louis BourgesPurpose: This study aims to evaluate the efficacy of various tomographic indices, both established and novel, in predicting endothelial decompensation leading to either spontaneous corneal transplantation or transplantation following cataract surgery in patients with Fuchs endothelial corneal dystrophy (FECD). Methods: In this cross-sectional, retrospective study, we reviewed the files of 93 eyes from 54 FECD patients undergoing regular follow-up. We recorded clinical metrics such as morning visual disturbance (MVD) and corrected distance visual acuity. In addition, we extracted topographic measurements including central corneal thickness (CCT); corneal volumes (CVs) within 3, 5, and 7 mm diameters (CV3, CV5, CV7); corneal central-to-peripheral volume ratios (CPVRs) for 3/5 mm (CPVR-3/5) and 3/7 mm (CPVR-3/7); peripheral volume index; thinnest point; corneal thickness spatial profile at 2, 4, 6, and 8 mm (CTSP2, CTSP4, CTSP6, CTSP8); corneal central-to-peripheral thickness ratio at 4 mm (CPTR4); and percentage of thickness increase at 2, 4, and 6 mm (PTI2, PTI4, PTI6), loss of regular isopachs (LRI), displacement of the thinnest point (DTP), and focal posterior surface depression (FPSD). Results: Receiver operating characteristic curves revealed a CCT area under the curve (AUC) of 0.732, with an optimal threshold of 596.5 µm yielding 79.7% sensitivity and 63.6% specificity. CTSP4 demonstrated an AUC of 0.706 with a 616.5-µm threshold (77.4% sensitivity, 60.6% specificity), and CPTR4 showed an AUC of 0.588 with a 0.963 threshold (62.3% sensitivity, 60.6% specificity). Notably, MVD presented a statistically significant odds ratio of 4.63 (95% confidence interval = 1.76–12.86). In univariate analyses, LRI, DTP, and FPSD were risk factors for progression, whereas in multivariate analyses, LRI was an independent risk factor for progression. Conclusion: The findings suggest that MVD and LRI serve as most significant predictive markers, while CCT, CTSP4, and CPTR4 were average predictive markers for FECD progression, underscoring their potential in guiding clinical decisions and interventions.https://journals.lww.com/10.4103/IJO.IJO_828_24corneal decompensationcorneal tomographyfuchs endothelial dystrophypredictive factors |
| spellingShingle | Nilufer Yesilirmak Vaël Souédan Aurélie Pison Jean Louis Bourges Predicting corneal decompensation in Fuchs endothelial corneal dystrophy with Scheimpflug tomography and clinical parameters Indian Journal of Ophthalmology corneal decompensation corneal tomography fuchs endothelial dystrophy predictive factors |
| title | Predicting corneal decompensation in Fuchs endothelial corneal dystrophy with Scheimpflug tomography and clinical parameters |
| title_full | Predicting corneal decompensation in Fuchs endothelial corneal dystrophy with Scheimpflug tomography and clinical parameters |
| title_fullStr | Predicting corneal decompensation in Fuchs endothelial corneal dystrophy with Scheimpflug tomography and clinical parameters |
| title_full_unstemmed | Predicting corneal decompensation in Fuchs endothelial corneal dystrophy with Scheimpflug tomography and clinical parameters |
| title_short | Predicting corneal decompensation in Fuchs endothelial corneal dystrophy with Scheimpflug tomography and clinical parameters |
| title_sort | predicting corneal decompensation in fuchs endothelial corneal dystrophy with scheimpflug tomography and clinical parameters |
| topic | corneal decompensation corneal tomography fuchs endothelial dystrophy predictive factors |
| url | https://journals.lww.com/10.4103/IJO.IJO_828_24 |
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