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Namwase S, Ruvuma S, Onyango J, Kwaga T, Ebong A, Atwine D, Mukunya D, Arunga S. Corneal endothelial cell density and associated factors among adults at a regional referral hospital in Uganda: a cross-sectional study. BMC Ophthalmol 2024; 24:165. [PMID: 38616259 PMCID: PMC11017535 DOI: 10.1186/s12886-024-03435-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 04/04/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND To assess the prevalence of low corneal endothelial cell density and correlates of corneal endothelial cell density among adults attending Mbarara University and Referral Hospital Eye Centre in Uganda. METHODS In this hospital-based cross-sectional study, participants 18 years and older, were enrolled. We obtained informed consent, and basic demographic data. We also conducted visual acuity, a detailed slit lamp examination, intra-ocular pressure, corneal diameter, tear-film break-up time, keratometry, A-scan, and pachymetry on all participants. A confocal microscope Heidelberg HRT3 was used to examine the central cornea and to obtain the mean cell density (cells/mm2). To calculate the proportion of low endothelial cell density, descriptive statistics were used, whereas correlates of endothelial cell density were assessed, using linear regression analyses. RESULTS We evaluated a total of 798 eyes of 404 participants aged between 18 and 90 years (males = 187, females = 217). The average endothelial cell density was 2763.6 cells/mm2, and there was a decrease in endothelial cell density with increasing age, irrespective of gender. There was no significant difference in endothelial cell density between males and females. Increasing age (adjusted coefficient - 10.1, p < 0.001), history of smoking (adjusted coefficient - 439.6, p = 0.004), history of ocular surgery (adjusted coefficient - 168.0, p = 0.023), having dry eye (adjusted coefficient - 136.0, p = 0.051), and having arcus senilis (adjusted coefficient - 132.0, p = 0.08), were correlated with lower endothelial cell density. However, increasing corneal diameter (adjusted coefficient 134.0, p = 0.006), increasing central corneal thickness (adjusted coefficient 1.2, p = 0.058), and increasing axial length (adjusted coefficient 65.8, p = 0.026), were correlated with higher endothelial cell density. We found five eyes (0.63%) from different participants with a low endothelial cell density (< 1000cells/mm2). CONCLUSION Our study established baseline normal ranges of ECD in a predominantly black African population, and found that low ECD is rare in our population. The elderly, smokers, and those with past ocular surgery are the most vulnerable. The low prevalence could be due to a lack of reference values for the black African population.
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Affiliation(s)
- Shamiim Namwase
- Department of Ophthalmology, Mbarara University of Science and Technology, Mbarara, Uganda.
| | - Sam Ruvuma
- Department of Ophthalmology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - John Onyango
- Department of Ophthalmology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Teddy Kwaga
- Department of Ophthalmology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Abel Ebong
- Department of Ophthalmology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Daniel Atwine
- Department of Ophthalmology, Mbarara University of Science and Technology, Mbarara, Uganda
- Soar Research Foundation, Mbarara, Uganda
| | - David Mukunya
- Department of Community and Public Health, Busitema University, Mbale, Uganda
- Department of Research, Nikao Medical Center, Kampala, Uganda
| | - Simon Arunga
- Department of Ophthalmology, Mbarara University of Science and Technology, Mbarara, Uganda
- London School of Hygiene & Tropical Medicine, London, UK
- Dr. Arunga's Eye Hospital, Mbarara, Uganda
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Ono T, Sakisaka T, Takada K, Tokuda S, Mori Y, Nejima R, Iwasaki T, Miyai T, Miyata K. Long-term effect of using hard contact lenses on corneal endothelial cell density and morphology in ophthalmologically healthy individuals in Japan. Sci Rep 2023; 13:7649. [PMID: 37169893 PMCID: PMC10175498 DOI: 10.1038/s41598-023-34756-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 05/06/2023] [Indexed: 05/13/2023] Open
Abstract
The adverse effects of hard contact lenses (HCL) on the corneal endothelium have been studied in the short term; however, long-term effects remain still unclear. In this study, we analyzed the effect of long-term HCL use on corneal endothelial cell density (ECD) and morphology in healthy Japanese individuals. This cross-sectional observational study included individuals using HCL for refractive errors examined at a single specialty eye hospital. Patient age, duration of HCL usage, ECD, coefficient of variation of the cell area (CV), and rate of appearance of hexagonal cells (6A) obtained via non-contact specular microscopy were assessed. We analyzed 8604 eyes (mean age: 35.6 ± 10.0 years, 837 males, 3465 females). The mean duration of HCL usage was 14.7 ± 9.1 (range, 1-50) years. Multivariate analysis revealed that ECD significantly correlated with age (P < 0.001) but not with duration of usage; however, CV and 6A significantly correlated with both factors (P < 0.001). Univariate analysis revealed that CV and 6A correlated with duration of usage (all, P < 0.001). According to our results, CV and 6A correlated with the duration of HCL usage in ophthalmologically healthy Japanese individuals. Therefore, it is important to monitor corneal endothelial morphology in long-term HCL wearers.
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Affiliation(s)
- Takashi Ono
- Department of Ophthalmology, Miyata Eye Hospital, 6-3, Kuraharacho, Miyakonojo, Miyazaki, 885-0051, Japan.
- Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Toshihiro Sakisaka
- Department of Ophthalmology, Miyata Eye Hospital, 6-3, Kuraharacho, Miyakonojo, Miyazaki, 885-0051, Japan
| | - Keita Takada
- Department of Ophthalmology, Miyata Eye Hospital, 6-3, Kuraharacho, Miyakonojo, Miyazaki, 885-0051, Japan
| | - Shota Tokuda
- Department of Ophthalmology, Miyata Eye Hospital, 6-3, Kuraharacho, Miyakonojo, Miyazaki, 885-0051, Japan
| | - Yosai Mori
- Department of Ophthalmology, Miyata Eye Hospital, 6-3, Kuraharacho, Miyakonojo, Miyazaki, 885-0051, Japan
| | - Ryohei Nejima
- Department of Ophthalmology, Miyata Eye Hospital, 6-3, Kuraharacho, Miyakonojo, Miyazaki, 885-0051, Japan
| | - Takuya Iwasaki
- Department of Ophthalmology, Miyata Eye Hospital, 6-3, Kuraharacho, Miyakonojo, Miyazaki, 885-0051, Japan
| | - Takashi Miyai
- Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazunori Miyata
- Department of Ophthalmology, Miyata Eye Hospital, 6-3, Kuraharacho, Miyakonojo, Miyazaki, 885-0051, Japan
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Wang Z, Zuo X, Liu L, Chen X, Li R, Zhu H, Huang D, Tong H, Zhao X, Yan W, Shen S, Wang Y, Li X, Zhao A, Chen D, Ding R, Li S, Liu H. Corneal endothelial cell density and its correlation with birth weight, anthropometric parameters, and ocular biometric parameters in Chinese school children. BMC Ophthalmol 2022; 22:334. [PMID: 35933331 PMCID: PMC9356483 DOI: 10.1186/s12886-022-02561-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 07/28/2022] [Indexed: 11/20/2022] Open
Abstract
Background To describe the distribution of corneal endothelial cell density (ECD), and to explore its correlation with birth weight (BW), anthropometric parameters, and ocular biometric parameters in Chinese school children. Methods In the population-based cross-sectional Nanjing Eye Study, children were measured for anthropometric information, for ECD by the noncontact specular microscope and for ocular biometric parameters by the optic low-coherent reflectometer. Data from right eyes were analyzed to illustrate the distribution of ECD and for determining correlated factors with ECD using univariate and multiple linear regression analysis. Comparisons among three different BW groups were performed using a one-way ANOVA analysis followed by the Bonferroni correction for pairwise comparisons. Results Of 1171 children, the mean (± standard deviation) ECD was 2875.34 ± 195.00 cells/mm2. In the Multiple Linear Regression analysis, BW, gender and central corneal thickness were significantly associated with ECD. The ECD increased by 36.16 cells/mm2 with BW increasing by 1 kg (P = 0.001) and increased by 0.44 cells/mm2 for every additional 1 mm in central corneal thickness (P = 0.01). The ECD of girls was 54.41 cells/mm2 higher than boys (P < 0.001). Children born with low BW presented significantly lower ECD than those born with normal BW (P < 0.05) and high BW (P < 0.05). Age and axial length were not significantly associated with ECD (P = 0.06 and P = 0.21, respectively). Conclusions In Chinese school children aged 82 to 94 months, the ECD is positively correlated with BW and central corneal thickness, in which BW is a newly identified associated factor. It is like that gender plays an important role in ECD distribution while girls have relatively greater ECD than boys.
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Affiliation(s)
- Zijin Wang
- Department of Ophthalmology, The First Affiliated Hospital With Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Xiaoxia Zuo
- Department of Ophthalmology, The First Affiliated Hospital With Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Lei Liu
- Department of Ophthalmology, The First Affiliated Hospital With Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Xuejuan Chen
- Department of Ophthalmology, The First Affiliated Hospital With Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Rui Li
- Department of Ophthalmology, The First Affiliated Hospital With Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Hui Zhu
- Department of Ophthalmology, The First Affiliated Hospital With Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Dan Huang
- Department of Child Healthcare, The First Affiliated Hospital With Nanjing Medical University, Nanjing, China
| | - Haohai Tong
- Eye Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoyan Zhao
- Department of Ophthalmology, the Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Wen Yan
- Department of Ophthalmology, The Fourth Affiliated Hospital of Nantong University, Yancheng, China
| | - Shiya Shen
- Department of Ophthalmology, The First Affiliated Hospital With Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Yun Wang
- Department of Ophthalmology, The First Affiliated Hospital With Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Xiaoxiao Li
- Department of Ophthalmology, Children's Hospital of Soochow University, Suzhou, China
| | - Andi Zhao
- Department of Ophthalmology, The First Affiliated Hospital With Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Danni Chen
- Department of Ophthalmology, The First Affiliated Hospital With Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Ranran Ding
- The Fourth School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Shiding Li
- The Fourth School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Hu Liu
- Department of Ophthalmology, The First Affiliated Hospital With Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
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Vaiciuliene R, Rylskyte N, Baguzyte G, Jasinskas V. Risk factors for fluctuations in corneal endothelial cell density (Review). Exp Ther Med 2022; 23:129. [PMID: 34970352 PMCID: PMC8713183 DOI: 10.3892/etm.2021.11052] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 10/29/2021] [Indexed: 12/17/2022] Open
Abstract
The cornea is a transparent, avascular and abundantly innervated tissue through which light rays are transmitted to the retina. The innermost layer of the cornea, also known as the endothelium, consists of a single layer of polygonal endothelial cells that serve an important role in preserving corneal transparency and hydration. The average corneal endothelial cell density (ECD) is the highest at birth (~3,000 cells/mm2), which then decrease to ~2,500 cells/mm2 at adulthood. These endothelial cells have limited regenerative potential and the minimum (critical) ECD required to maintain the pumping function of the endothelium is 400-500 cells/mm2. ECD < the critical value can result in decreased corneal transparency, development of corneal edema and reduced visual acuity. The condition of the corneal endothelium can be influenced by a number of factors, including systemic diseases, such as diabetes or atherosclerosis, eye diseases, such as uveitis or dry eye disease (DED) and therapeutic ophthalmological interventions. The aim of the present article is to review the impact of the most common systemic disorders (pseudoexfoliation syndrome, diabetes mellitus, cardiovascular disease), eye diseases (DED, uveitis, glaucoma, intraocular lens dislocation) and widely performed ophthalmic interventions (cataract surgery, intraocular pressure-lowering surgeries) on corneal ECD.
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Affiliation(s)
- Renata Vaiciuliene
- Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania
| | - Neda Rylskyte
- Faculty of Medicine, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania
| | - Gabija Baguzyte
- Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania
| | - Vytautas Jasinskas
- Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania
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Hamza MN, Roshdy MM, Seleet MM, El Raggal TM. Correlation between ocular biometric parameters and corneal endothelium in a sample of young Egyptian adults. MEDICAL HYPOTHESIS, DISCOVERY & INNOVATION OPHTHALMOLOGY JOURNAL 2021; 10:121-128. [PMID: 37641708 PMCID: PMC10460222 DOI: 10.51329/mehdiophthal1430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/21/2021] [Indexed: 08/31/2023]
Abstract
Background To evaluate the normative values of corneal endothelial cell parameters within a group of healthy young Egyptian adults using specular microscopy and to examine any correlations between endothelial parameters and refractive or biometric parameters. Methods In this cross-sectional study, specular microscopy was used to study the right eyes of 150 healthy young volunteers and evaluated endothelial cell parameters, including cellular density, hexagonality (HEX), and coefficient of variation (CV) at 15 different points on the back corneal surface, which were later grouped into the central zone and either four quadrants or three annular zones. The same eyes underwent refractive and biometric assessments. Results Hundred fifty healthy adults were examined, and the age ranged from 20 to 30 years, with a median of 23 (interquartile range, 21‒27) years. The mean (standard deviation) of central cell density was 2902.7 (270.7) cells/mm2. The superior paracentral area had the lowest mean density (2895.8 cells/mm2), but the highest mean HEX (67.7%), while the inferior peripheral area had the highest mean density (3100.5 cells/ mm2) but the lowest mean HEX (64%). The difference in cell density among the three annular zones was not statistically significant (P = 0.365). However, HEX and CV in the central and paracentral zones differed statistically significantly from those of the peripheral zone (P < 0.001 and P = 0.014, respectively). Weak but non-significant correlations were detected between endothelial cell density and all measured refractive and biometric parameters. Conclusions The findings of this study provided useful normative biometric and specular data in a specific age group and a specific population, and could be useful in planning intraocular surgery in young Egyptian adults. However, future longitudinal studies with a larger sample could refine more endothelial cell parameter specifications over time.
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Affiliation(s)
- Mohamed N. Hamza
- Ophthalmology Department, Ain Shams University Hospitals, Cairo, Egypt
| | | | - Mouamen M. Seleet
- Ophthalmology Department, Ain Shams University Hospitals, Cairo, Egypt
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Barrera-Sanchez M, Hernandez-Camarena JC, Ruiz-Lozano RE, Valdez-Garcia JE, Rodriguez-Garcia A. Demographic profile and clinical course of Fuchs endothelial corneal dystrophy in Mexican patients. Int Ophthalmol 2021; 42:1299-1309. [PMID: 34743257 DOI: 10.1007/s10792-021-02117-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 10/21/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe the demographic characteristics and clinical course of Fuchs endothelial corneal dystrophy (FECD) in a Mexican-mestizo population. METHODS A retrospective observational and longitudinal study was performed in consecutive patients with the clinical diagnosis of Fuchs endothelial corneal dystrophy seen at our institution. Initial and last follow-up best-corrected visual acuity, slit-lamp findings, and specular microscopy endothelial morphometric parameters were analyzed. RESULTS One hundred and two eyes belonging to 51 patients were included in the analysis. Median age at the time of diagnosis was 69 years (range, 25-87 years) with a female-to-male ratio of 3.3:1. Visual loss (40%) followed by glare (13.3%) and fluctuating matutine vision loss (13.3%) was the most common complaints at presentation. Regarding FECD staging, 65 (63.7%) were classified as stage-I FECD, 21 (20.6%) stage-II, and 15 (14.7%) as stage-III. A high percentage of eyes (44.1%) presented visual impairment ( ≤ 20/50) at presentation, and the presence of isolated corneal guttata was the most common stage of presentation (64%) at slit-lamp examination. While fifty-nine (57.8%) eyes did not require any medical or surgical management, 17 (16.7%) eyes were managed with hypertonic saline eyedrops alone or in combination with bandage contact lens, and 18 (17.6%) required corneal transplantation. Penetrating keratoplasty alone (8 eyes, 44.4%), or in combination with cataract extraction and intraocular lens implantation (3 eyes, 16.7%), was the most frequent surgical technique performed. CONCLUSION Demographical characteristics of Fuchs dystrophy regarding age at presentation, gender distribution, and clinical stage at the time of diagnosis did not differ significantly from other international reports. Almost 20% of these patients will require keratoplasty during the disease, emphasizing the need for safer and more reproducible keratoplasty techniques.
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Affiliation(s)
- Maximiliano Barrera-Sanchez
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences, Monterrey, México
| | - Julio C Hernandez-Camarena
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences, Monterrey, México
| | - Raul E Ruiz-Lozano
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences, Monterrey, México
| | - Jorge E Valdez-Garcia
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences, Monterrey, México
| | - Alejandro Rodriguez-Garcia
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences, Monterrey, México.
- Instituto de Oftalmologia y Ciencias Visuales Centro Medico Zambrano Hellion, Av. Batallon de San Patricio No. 112. Col. Real de San Agustin, 66278, San Pedro Garza Garcia, N.L., Mexico.
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Ono T, Mori Y, Nejima R, Iwasaki T, Miyai T, Miyata K. Corneal endothelial cell density and morphology in ophthalmologically healthy young individuals in Japan: An observational study of 16842 eyes. Sci Rep 2021; 11:18224. [PMID: 34521951 PMCID: PMC8440503 DOI: 10.1038/s41598-021-97776-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 08/20/2021] [Indexed: 11/16/2022] Open
Abstract
We aimed to investigate the cell density and morphology of the corneal endothelium in ophthalmologically healthy young Japanese, given the lack of normative data in literature. This observational study included eyes without ophthalmologic diseases, besides refractive errors, examined between 1996 and 2015 at Miyata Eye Hospital. Eyes with a history of ophthalmologic diseases or contact lens usage were excluded. Correlation of corneal endothelial cell density (ECD), coefficient of variation (CV), appearance rate of hexagonal cells (6A), and cell area with age were examined. Multivariate linear regression analysis was performed to determine the predictors of corneal parameters. We included 16842 eyes of 8421 individuals (19.6 ± 8.7 years). ECD was 3109.0 ± 303.7 cells/mm2 and significantly reduced with age (p < 0.001). The ECD reduction rate was 0.42%/year in the total population. On multivariate analysis, age and sex were significantly correlated with ECD, CV, 6A, and cell area (all p < 0.001). ECD, 6A, CV, and cell area are significantly associated with age in healthy young Japanese individuals. Monitoring their corneal endothelium is essential to assess the risk of endothelial damage.
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Affiliation(s)
- Takashi Ono
- Department of Ophthalmology, Miyata Eye Hospital, 6-3, Kuraharacho, Miyakonojo, Miyazaki, 885-0051, Japan. .,Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Yosai Mori
- Department of Ophthalmology, Miyata Eye Hospital, 6-3, Kuraharacho, Miyakonojo, Miyazaki, 885-0051, Japan
| | - Ryohei Nejima
- Department of Ophthalmology, Miyata Eye Hospital, 6-3, Kuraharacho, Miyakonojo, Miyazaki, 885-0051, Japan
| | - Takuya Iwasaki
- Department of Ophthalmology, Miyata Eye Hospital, 6-3, Kuraharacho, Miyakonojo, Miyazaki, 885-0051, Japan
| | - Takashi Miyai
- Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazunori Miyata
- Department of Ophthalmology, Miyata Eye Hospital, 6-3, Kuraharacho, Miyakonojo, Miyazaki, 885-0051, Japan
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Kelekele JTK, Kayembe DL, Mwanza JC. Profile of central corneal thickness and corneal endothelial cell morpho-density of in healthy Congolese eyes. BMC Ophthalmol 2021; 21:185. [PMID: 33888064 PMCID: PMC8063471 DOI: 10.1186/s12886-021-01947-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 04/12/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose To determine the pachymetric and corneal endothelial cell morphometric features and their relationship to ocular and systemic factors in healthy Congolese subjects. Methods Non-contact specular microscopy was used in 278 healthy eyes (278 subjects) to measure central corneal thickness (CCT), corneal endothelial cell density (CECD) along with cell size, coefficient of variation (CV) in cell size, and hexagonality (HEX). The lower and upper reference limits and average values for each parameter were determined. Correlation and association of average values with anthropo-demographic and clinical variables were assessed. Results The mean age was 38.9 ± 17.2 years (10.9–80.7 years). Average values were 504.2 ± 30.7 μm (CCT), 2907.1 ± 290.9 cells/mm2 (CECD), 348.5 ± 38.4 μm2 (cell size), 32.9 ± 3.6% (CV), and 51.8 ± 7.2% (HEX). CCT was 504.9 ± 33.6 μm in men and 503.6 ± 28.3 μm in women (p = .73); values for CECD were 2917.1 ± 253.5 cells/mm2 and 2899.2 ± 317.8 cells/mm2 (p = 0.61), respectively. Lower and upper reference limits were 449.6 μm and 566.0 μm for CCT, and 2165.3 cells/mm2 and 3414.4 cells/mm2 for CECD, respectively. CCT correlated with body mass index (BMI), (r = − 0.12, P = 0.04). CECD decreased with age (r = − 0.49, P < 0.001), BMI (r = − 0.20, P = 0.001), intraocular pressure (r = − 0.13, P = 0.029) and ocular perfusion pressure (r = − 0.28, P = 0.028). CECD decayed by 8.3 cells/mm2 or 0.30% per year of age and CCT decreased by 0.72 μm per kg/m2. Conclusions Mean central cornea was thinner, CECD higher, and references limits lower than reported in other African populations. The CCT and CECD normative values reported herein will be useful for both clinical and research purposes in this population. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-021-01947-x.
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Affiliation(s)
| | - David L Kayembe
- Department of Ophthalmology, University Hospital of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Jean-Claude Mwanza
- Department of Ophthalmology, University Hospital of Kinshasa, Kinshasa, Democratic Republic of Congo.,Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Aketa N, Uchino M, Kawashima M, Uchino Y, Yuki K, Ozawa Y, Sasaki M, Yamagishi K, Sawada N, Tsugane S, Tsubota K, Iso H. Myopia, corneal endothelial cell density and morphology in a Japanese population-based cross-sectional study: the JPHC-NEXT Eye Study. Sci Rep 2021; 11:6366. [PMID: 33737603 PMCID: PMC7973534 DOI: 10.1038/s41598-021-85617-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 03/03/2021] [Indexed: 01/27/2023] Open
Abstract
This population-based cross-sectional study was performed to determine the mean corneal endothelial cell density (ECD), coefficient of variation (CV), and hexagonality (HEX), and their associations with myopia in Japanese adults living in Chikusei city. Of 7109 participants with available data, 5713 (2331 male and 3382 female) participants were eligible for analysis. After assessing the relationship between participant characteristics and spherical equivalent refraction (SER), the association of SER with the abnormal value of ECD (< 2000 cells/mm), CV (≥ 0.40), and HEX (≤ 50%) were determined using the logistic regression models adjusting for potential confounders (age, intraocular pressure, keratometric power, height, and antihypertensive drug use). In male participants, there was no statistically significant relationships between SER and endothelial parameters. In female participants, compared to emmetropia, SER ≤ − 6 D had significantly higher odds ratio (OR) of having the abnormal value of CV (OR = 2.07, 95% confidence interval [CI] 1.39–3.10) and HEX (OR = 2.04, 95% CI 1.29–3.23), adjusted for potential confounders, indicating that the high myopia was associated with the abnormal values of CV and HEX. Further adjustment for contact lenses wear partly attenuated these associations. Association between the SER and ECD was not detected.
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Affiliation(s)
- Naohiko Aketa
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Miki Uchino
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Motoko Kawashima
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yuichi Uchino
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kenya Yuki
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yoko Ozawa
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Mariko Sasaki
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan. .,Ibaraki Western Medical Center, Chikusei, Japan.
| | - Norie Sawada
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.,Tsubota Laboratory, Inc., Tokyo, Japan
| | - Hiroyasu Iso
- Department of Public Health, Graduate School of Medicine, Osaka University, Suita, Japan
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10
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Tananuvat N, Khumchoo N. Corneal thickness and endothelial morphology in Normal Thai eyes. BMC Ophthalmol 2020; 20:167. [PMID: 32345246 PMCID: PMC7187506 DOI: 10.1186/s12886-020-01385-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 03/11/2020] [Indexed: 11/10/2022] Open
Abstract
Background This study aimed to determine the influence of age on central corneal thickness and corneal endothelial morphology as well as to identify the relationship between them in normal Thai eyes. Methods Non-contact specular microscopy was performed in volunteers stratified into seven age groups ranging from 11 to 88 years. The corneal endothelial parameters studied included central corneal thickness (CCT), endothelial cell density (ECD), coefficient of variation in cell size (CV), cell area (CA) and percentage of regular hexagonal cells. Results In a total of 501 subjects (1002 eyes), the mean age was 43.12 ± 18.80 years and 347(69.3%) were females. The mean CCT, ECD, CV, CA, and hexagonality was 533.80 ± 33.00 μm, 2732 ± 258 cell/mm2, 37.61 ± 6.76%, 369.04 ± 37.90 μm, and 49.03 ± 7.53%, respectively. There was a significant inverse correlation between age and CCT (r = − 0.215, P < 0.001), ECD (r = − 0.496, P < 0.001),and hexagonality (r = − 0.265, P < 0.001). The CV and CA directly correlated with age (r = 0.242, P < 0.001 and r = 0.470, P < 0.001). The estimate rate of endothelial cell loss was 0.2% per year. There was no correlation between CCT and ECD (P = 0.106). Conclusion Normative data for corneal endothelial morphology in healthy Thai eyes showed that CCT, ECD, and hexagonality were significantly decreased, while the endothelial cell area and the variation in cell size were increased with aging. The central corneal thickness did not correlate with the endothelial cell density.
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Affiliation(s)
- Napaporn Tananuvat
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
| | - Natawan Khumchoo
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
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11
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Malhotra D, Casey JR. Molecular Mechanisms of Fuchs and Congenital Hereditary Endothelial Corneal Dystrophies. Rev Physiol Biochem Pharmacol 2020; 178:41-81. [PMID: 32789790 DOI: 10.1007/112_2020_39] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The cornea, the eye's outermost layer, protects the eye from the environment. The cornea's innermost layer is an endothelium separating the stromal layer from the aqueous humor. A central role of the endothelium is to maintain stromal hydration state. Defects in maintaining this hydration can impair corneal clarity and thus visual acuity. Two endothelial corneal dystrophies, Fuchs Endothelial Corneal Dystrophy (FECD) and Congenital Hereditary Endothelial Dystrophy (CHED), are blinding corneal diseases with varied clinical presentation in patients across different age demographics. Recessive CHED with an early onset (typically age: 0-3 years) and dominantly inherited FECD with a late onset (age: 40-50 years) have similar phenotypes, although caused by defects in several different genes. A range of molecular mechanisms have been proposed to explain FECD and CHED pathology given the involvement of multiple causative genes. This critical review provides insight into the proposed molecular mechanisms underlying FECD and CHED pathology along with common pathways that may explain the link between the defective gene products and provide a new perspective to view these genetic blinding diseases.
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Affiliation(s)
- Darpan Malhotra
- Department of Biochemistry, University of Alberta, Edmonton, AB, Canada
- Membrane Protein Disease Research Group, University of Alberta, Edmonton, AB, Canada
| | - Joseph R Casey
- Department of Biochemistry, University of Alberta, Edmonton, AB, Canada.
- Membrane Protein Disease Research Group, University of Alberta, Edmonton, AB, Canada.
- Department of Physiology, University of Alberta, Edmonton, AB, Canada.
- Department of Ophthalmology and Visual Science, University of Alberta, Edmonton, AB, Canada.
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Corneal Endothelial Cell Density and Morphology in Healthy Egyptian Eyes. J Ophthalmol 2019; 2019:6370241. [PMID: 30918718 PMCID: PMC6409007 DOI: 10.1155/2019/6370241] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 12/22/2018] [Accepted: 02/10/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the corneal endothelial cell density and morphology in normal Egyptian eyes. Methods In total, 568 healthy eyes of 568 Egyptian volunteers aged 20 to 85 years were examined using noncontact specular microscopy for the central corneal thickness (CCT), mean endothelial cell density (MCD), coefficient of variation (CV) in cell area, mean cell area (MCA), and hexagonal cell (Hex) percentage. Variables were compared between sexes and between different age groups. Results The mean CCT, MCD, and MCA were 514.45 ± 43.04 μm, 2647.50 ± 382.62 cells/mm2, and 390.59 ± 149.94 μm2, respectively. MCD and MCA showed no significant differences between men and women (P=0.171 and 0.099, respectively), whereas CV (%) and Hex (%) showed significant differences (P=0.024 and 0.015, respectively). CCT (P=0.007, r = −0.113) and MCD (P < 0.001, r = −0.357) exhibited a significant negative correlation with age, whereas CV (%) (P < 0.001, r = 0.341) and MCA (P=0.008, r = 0.111) exhibited a significant positive correlation. The mean rate of endothelial cell loss from 20 to 85 years of age was 0.3% per year. Conclusions Our results provide normative data for the corneal endothelium in healthy Egyptian eyes, thus increasing the knowledge base for corneal endothelial cell parameters in healthy Egyptian eyes. Furthermore, our findings can be used as baseline values for comparisons between Egyptian and other populations and for studies of the endothelial cell reserve and capacity for intraocular surgery and corneal transplantation.
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Age related changes in corneal morphological characteristics of healthy Pakistani eyes. Saudi J Ophthalmol 2017; 31:86-90. [PMID: 28559719 PMCID: PMC5436377 DOI: 10.1016/j.sjopt.2017.02.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 02/09/2017] [Accepted: 02/28/2017] [Indexed: 11/20/2022] Open
Abstract
Purpose To determine the age related changes in corneal morphological characteristics in normal healthy adult Pakistani population. Methods Four hundred and sixty-four eyes of 232 healthy volunteers with ages between 10 and 80 years of either gender were included. Corneal endothelial cell density (CED), morphology and central corneal thickness (CCT) were evaluated in each subject with non-contact specular microscope (SP-3000 P, Topcon Corporation, Japan) and average of three readings per eye was used for final analysis. All the findings including demographic data, and corneal parameters were endorsed on a pre-devised proforma. Results Mean age of study population was 39.52 ± 18.09 years with 123 (53%) males and 109 (47%) females. Mean CED of study population was 2722.67 ± 349.67 cells/mm2, while mean CCT was 505.72 ± 32.82 µm. Corneal morphological parameters among various age groups showed statistically significant difference in all parameters (p < 0.01). Correlation statistics revealed that CED (r = −0.497, p < 0.01), CCT (r = −0.216, p < 0.01) and hexagonality (r = −0.397, p < 0.01) decreased significantly with increasing age, while average cell size (r = 0.492, p < 0.01) and CV of size (r = 0.454, p < 0.01) increased with age. Conclusion This study showed that CED in Pakistani eyes was less than that reported in Chinese eyes, higher than Portuguese, Iranian and Indian eyes and comparable to the values in Turkish, Nigerian and Thai eyes.
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