Evaluation Of Scleral Thickness In Patients With Fuchs Endothelial Dystrophy

To evaluate scleral thickness using anterior segment optic coherence tomography (AS-OCT) in Fuchs endothelial dystrophy and compare the results with healthy individuals.

This prospective, comparative study was conducted at Ege University Department of Ophthalmology, Turkey.

Eighteen eyes of 18 patients with Fuchs endothelial dystrophy (Group 1) and 30 eyes of 30 age, gender, spherical equivalent and axial length matched healthy participants (Group 2) were included in the study. All subjects underwent a detailed ophthalmological examination. Endothelial cell density was measured by specular microscopy (Nidek Co, Ltd, Gamagori, Japan), and central corneal thickness (CCT) was measured by Scheimpflug camera (Pentacam, Oculus Optikgerte GmbH, Wetzlar, Germany).  Scleral thickness was measured by AS-OCT (Swept Source OCT Triton, Topcon, Japan) in 4 quadrants (superior, inferior, nasal and temporal). The reference point was 6 mm posterior to the scleral spur as previously defined in the literature.

The mean ages were 66.8±10.4 (47-81) for Group 1; 64±8.1 (48-81) for Group 2. CCT was significantly greater in Group 1 (580.6±28.1; range 514-622) than in the Group 2 (545.0±20.7; range 503-587)(p=0.002). In Group 1, mean scleral thickness in the superior, inferior, nasal and temporal quadrants were 422.0±28.0 (371-460), 432.7±19.7 (395-465), 440.5±23.2 (399-483), 430.7±21.9 (386-466), respectively. In Group 2, the mean scleral thickness in the superior, inferior, nasal and temporal quadrants were 381.3±21.8 (341-436), 383.2±17.0 (352-436), 389.2±21.8 (353-440), 383.1±20.6 (349-4440), respectively. The mean scleral thickness was significantly higher in all quadrants in Group 1 than in Group 2 (respectively, p=0.006;p<0.001;p<0.001;p=0.002).

In patients with Fuchs endothelial dystrophy, scleral thickness as measured by AS-OCT was found to be significantly higher in all quadrants compared to the control group. Fuchs endothelial dystrophy is a progressive disease that affects the endothelium and results in the accumulation of extracellular material in the cornea. These findings suggest that the accumulation of extracellular deposits in Fuchs endothelial dystrophy may not be limited to the corneal endothelium but may also affect the sclera. Therefore, scleral thickness can be used as a parameter for the diagnosis and progression of Fuchs endothelial dystrophy. However, further studies with histopathological assessments are still needed.