Regional Variation in Guttae Distribution in Fuchs Endothelial Corneal Dystrophy

IF 3.2 Q1 OPHTHALMOLOGY

Ophthalmology science Pub Date : 2025-05-02 DOI:10.1016/j.xops.2025.100817

Yasufumi Tomioka MD, PhD , Morio Ueno MD, PhD , Akihisa Yamamoto PhD , Koji Kitazawa MD, PhD , Hideki Fukuoka MD, PhD , Motomu Tanaka PhD , Chie Sotozono MD, PhD , Ula V. Jurkunas MD , Shigeru Kinoshita MD, PhD

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Abstract

Purpose

To investigate regional variations in guttae distribution in Fuchs endothelial corneal dystrophy (FECD) and evaluate its relationship with anatomical ultraviolet (UV) protection by the eyelid.

Design

A prospective observational study.

Participants

This study involved 19 eyes of 19 patients with FECD between April 2022 and June 2024 at Kyoto Prefectural University of Medicine.

Methods

Using slit-scanning wide-field contact specular microscopy, we analyzed guttae distribution in 5 corneal regions (central, superior, temporal, nasal, and inferior). Marginal reflex distance (MRD) was measured to assess the eyelid position. Proportion of guttae was quantified using image analysis.

Main Outcome Measures

Regional differences in guttae distribution and correlation with MRD measurements.

Results

The superior region demonstrated a significantly lower proportion of guttae (29.4%) compared with central (69.0%), temporal (57.4%), and nasal areas (57.5%) (all P < 0.05). The difference between superior and inferior areas (45.6%) was not significant (P = 0.08). Margin reflex distance measurements showed no significant correlation with superior guttae distribution (P = 0.40).

Conclusions

Our study reveals a distinct regional variation in FECD progression, with relative sparing of the superior cornea suggesting potential UV-protective mechanisms. Although not directly correlated with eyelid position, these findings indicate that environmental factors may influence disease progression. This insight suggests the potential benefit of UV protection as a preventive strategy, particularly in early-stage FECD patients.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

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Fuchs内皮性角膜营养不良患者点滴分布的区域差异

目的探讨Fuchs内皮性角膜营养不良（FECD）患者眼绒毛分布的区域差异，并探讨其与眼睑解剖性紫外线防护的关系。设计前瞻性观察性研究。这项研究涉及京都立医科大学2022年4月至2024年6月期间19名FECD患者的19只眼睛。方法采用裂隙扫描宽视场接触式镜面显微镜，对角膜中央、上、颞、鼻、下5个区域的滴痕分布进行分析。边缘反射距离（MRD）测定眼睑位置。利用图像分析定量测定骨痂的比例。主要结果测量：不同地区的肠管分布差异及与MRD测量的相关性。结果上区鼻窦区比例（29.4%）明显低于中央区（69.0%）、颞区（57.4%）和鼻区（57.5%）(P <；0.05)。上下区（45.6%）差异无统计学意义（P = 0.08）。边缘反射距离测量结果显示与上沟分布无显著相关性（P = 0.40）。结论我们的研究显示FECD的进展存在明显的区域差异，上角膜的相对保留提示潜在的紫外线保护机制。虽然与眼睑位置没有直接关系，但这些发现表明环境因素可能影响疾病的进展。这一发现表明紫外线防护作为一种预防策略的潜在益处，特别是在早期FECD患者中。财务披露专有或商业披露可在本文末尾的脚注和披露中找到。

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