IN-VIVO CONFOCAL MICROSCOPY OF FUCHS ENDOTHELIAL DYSTROPHY

The purpose of this study is to analyze in vivo confocal microscopic f indings of corneas with Fuchs' endothelial dystrophy. Methods. Central corneas of 17 eyes of 11 patients aged 41-86 years were examined usin g in vivo scanning slit confocal microscopy after being diagnosed with Fuchs' endothelial dystrophy. The cellular structure of the corneas w as analyzed morphologically and quantitatively and compared to control results from 22 healthy corneas. Results, Bullae were detected in the basal epithelial layer of one eye. Eight of 17 eyes (47%) exhibited a n abnormal Bowman's layer: diffuse bright reflection and absence of ne rves. Eleven eyes (65%) exhibited abnormal anterior stroma: lacunae an d diffuse increased light reflection due to edema. In 12 eyes (71%), l acunae or dark bands 5-20 mu m wide against increased background refle ction were noted in the posterior stroma. Descemet's membrane was thic kened in all eyes. Dark bands were detected in six eyes (35%). Guttae (137-1,231/mm(2)) 20-40 mu m in diameter were found in every endotheli al cell layer. The mean endothelial cell count was 1,202 +/- 850 (cell s/mm(2) +/- SD; range, 0-2,735). There was a positive correlation betw een endothelial cell counts obtained by specular microscopy and those obtained by confocal microscopy (r = 0.95). Conclusion. In vivo confoc al microscopic findings of Fuchs' endothelial dystrophy are described for the first time in a series of cases. Pathological changes in Fuchs ' dystrophy were detected in all corneal layers, more frequently in th e posterior layers. Endothelial cell counts obtained with confocal mic roscopy were statistically similar to those obtained with standard spe cular microscopy.