title: Mathematical projection model of visual loss due to fuchs corneal dystrophy.
abstract: PURPOSE. To devise a mathematical disease classification model for eyes with primary guttata cornea, on the bases of endothelial loss trajectory and probability of advanced disease. METHODS. A series of 1971 patients (3281 eyes), some with and some without guttata corneas, undergoing specular microscopy were retrospectively reviewed. The eyes were classified into four stages; stage 0, without guttae; 1, guttata cornea without edema; 2, mild Fuchs' corneal dystrophy (FCD); and 3, severe FCD, according to clinical records, and patient age and corneal endothelial cell density (ECD) were plotted. Nonparametric density smoothing was used to create a contour map, and a best-fit curve for ECD loss was calculated. The relation between ECD decrease rate and the stages were evaluated. RESULTS. Endothelial decrease rate in stage 0 was 0.44%/year, which was compatible with that of normal eyes reported in previous studies. Decrease rates of stages 1, 2, and 3 were 0.81%, 2.65%, and 3.08%/ year, respectively. The age-ECD loss curves of 1.40%/year (ECO(1.4)) and 2.00%/year (ECO(2.0)) further divided stage 1 into three subgroups; stage 1a, asymptomatic guttata cornea; 1b, borderline guttata cornea; and 1c, pre-FCD. The ECO(2.0) cutoff line differentiated eyes with FCD from those without edema with a sensitivity and specificity of >90%. Stage 1c eyes were below ECO(2.0) and had a decrease rate as high as FCD. CONCLUSIONS. This mathematical model can be used to predict the prognosis of patients with primary guttata cornea.
authors.affiliation: Department of Ophthalmology, Keio University School of Medicine, Shinjuku, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Hatou
authors.forename: Shigeto
authors.initials: S
authors.lastname: Shimmura
authors.forename: Jun
authors.initials: J
authors.lastname: Shimazaki
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Usui
authors.forename: Shiro
authors.initials: S
authors.lastname: Amano
authors.forename: Hideaki
authors.initials: H
authors.lastname: Yokogawa
authors.forename: Akira
authors.initials: A
authors.lastname: Kobayashi
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Zheng
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shiraishi
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ohashi
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Inatomi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tsubota
mesh_terms: D000368:Aged; D001766:Blindness / Q000175:diagnosis*; D002452:Cell Count; D055954:Corneal Endothelial Cell Loss / Q000175:diagnosis*; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000145:classification / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D011379:Prognosis; D012189:Retrospective Studies; D015354:Vision, Low / Q000175:diagnosis*; D014792:Visual Acuity