Corneal Endothelium in Patients with Anterior Uveitis.
To investigate a possible effect of intraocular inflammation on corneal endothelium by describing corneal endothelial cell density (ECD) and morphologic variables in eyes with anterior uveitis, and to investigate factors that may influence these findings.



Cross-sectional, observational study. Observers were not masked.



Volunteers with histories of unilateral or bilateral anterior segment inflammation (anterior, intermediate, or panuveitis); included were 52 patients (84 eyes with uveitis).



Endothelial cell density and morphologic variables of both eyes of all study participants were determined by specular microscopy; central corneal thickness was determined by ultrasound pachymetry.



Central corneal ECD, coefficient of variability, percentage hexagonality, and central corneal thickness.



Central ECD was lower among eyes that had undergone cataract or glaucoma surgery or both (n = 28; P = 0.0004). After exclusion of eyes with surgery, variables for eyes with uveitis (n = 56) were compared with 2 historical populations of normal, age-matched controls and with contralateral eyes in individuals with unilateral uveitis. Central ECD was lower in eyes with uveitis than in control eyes for all age groups (P ≤ 0.01 for four of six 10-year age intervals compared with the primary control group). Among patients with unilateral uveitis who had not undergone surgery in either eye (n = 12), central ECD was lower in eyes with uveitis (2324 cells/mm(2) [range, 1543-3289 cells/mm(2)]) than in contralateral eyes (2812.5 cells/mm(2) [range, 1887-3546 cells/mm(2)]; P = 0.0005), and percentage hexagonality was lower in eyes with uveitis (54% [range, 33%-66%]) than in contralateral eyes (58.5% [range, 52%-82%]; P = 0.004). There was no significant difference in central corneal thickness between eyes with and without uveitis (P = 0.27). No eyes had clinically apparent central corneal edema. Relationships remained unchanged after exclusion of eyes with herpetic anterior uveitis. Host and disease-related characteristics were evaluated as risk factors for variations in outcome measures. Central ECD was correlated to the duration of active uveitis (r = -0.41; P < 0.0001), maximum intraocular pressure during the course of disease (r = -0.40; P = 0.0002), and maximum laser flare photometry value (r = -0.26; P = 0.020).



Observed relationships suggest that anterior segment inflammation adversely affects the corneal endothelium. Longitudinal studies are warranted to determine whether long-standing anterior uveitis increases risk of endothelial dysfunction, especially in the setting of intraocular surgery.
Ocular Inflammatory Disease Center, UCLA Stein Eye Institute, Los Angeles, California.
Abdullah M
AM
Alfawaz
Ocular Inflammatory Disease Center, UCLA Stein Eye Institute, Los Angeles, California; Cornea Service, Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California; Glaucoma Service, Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California. Electronic address: uveitis@jsei.ucla.edu.
Gary N
GN
Holland
Ocular Inflammatory Disease Center, UCLA Stein Eye Institute, Los Angeles, California.
Fei
F
Yu
Ocular Inflammatory Disease Center, UCLA Stein Eye Institute, Los Angeles, California.
Mathew S
MS
Margolis
Glaucoma Service, Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California.
JoAnn A
JA
Giaconi
Cornea Service, Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California.
Anthony J
AJ
Aldave
D000293:Adolescent; D000328:Adult; D000368:Aged; D002387:Cataract Extraction; D002452:Cell Count; D002648:Child; D055954:Corneal Endothelial Cell Loss / Q000175:diagnosis / Q000209:etiology*; D063171:Corneal Pachymetry; D003430:Cross-Sectional Studies; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D018463:Filtering Surgery; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014606:Uveitis, Anterior / Q000150:complications* / Q000175:diagnosis