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Demographic profile and clinical course of Fuchs endothelial corneal dystrophy in Mexican patients

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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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Fig. 1

Adapted from: Adamis AP, Filatov V, Tripathi BJ, Tripathi RC (1993) Fuchs' endothelial dystrophy of the cornea. Surv Ophthalmol 38:149–68. https://doi.org/10.1016/0039-6257(93)90099-s

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Acknowledgements

The authors want to thank Susana Imperial Sauceda for her technical support in performing all specular microscopy studies.

Funding

Partially supported by The Immuneye Foundation, Monterrey, Mexico.

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Authors and Affiliations

  1. Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences, Monterrey, México

    Maximiliano Barrera-Sanchez, Julio C. Hernandez-Camarena, Raul E. Ruiz-Lozano, Jorge E. Valdez-Garcia & Alejandro Rodriguez-Garcia

  2. 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

    Alejandro Rodriguez-Garcia

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Contributions

MBS contributed to study protocol preparation, Ethics and Research Committees submission and revision, patients´ assignment, data collection and analysis, manuscript writing and editing; JCHC contributed to study design, statistical analysis, manuscript writing, and revision; RERL contributed to data collection, manuscript writing and revision, tables, and figures editing; ARG contributed to original idea, project coordination, study design, funds raising, manuscript writing and editing. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Alejandro Rodriguez-Garcia.

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Conflict of interest

The authors declare no conflicts of interest nor financial disclosures.

Data availability

Data of this study are available upon request from the corresponding author. The data are not publicly available because the study was approved under informed consent for research purposes, protecting the participants´ privacy, prohibiting sharing information with third parties according to the Mexican General Law for the Protection of Personal Data in Possession of Obliged Parties.

Ethical approval

The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Ethics (Registration No. P000355-CCEDEFM-CEIC-CR002) and Research (Registration No. P000355-CCEDEFM-CI-CR002) Committees of our institution (License No. CONBIOETICA 19 CEI 011–2016-10–17 and COFEPRIS 20 CI 19 039 002, respectively).

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Informed consent by the patient was obtained to disclose health information and publish clinical images.

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Barrera-Sanchez, M., Hernandez-Camarena, J.C., Ruiz-Lozano, R.E. et al. Demographic profile and clinical course of Fuchs endothelial corneal dystrophy in Mexican patients. Int Ophthalmol 42, 1299–1309 (2022). https://doi.org/10.1007/s10792-021-02117-0

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