Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Fuchs Endotelyal Distrofisinde Descemet Membran Kalınlığının Ön Segment Optik Koherens Tomografi ile Değerlendirilmesi ve Santral Korneal Kalınlık Ölçümlerinin Farklı Cihazlarda Karşılaştırılması
Evaluation of Descemet Membrane Thickness with Anterior Segment Optical Coherence Tomography and Comparison of Central Corneal Thickness Measurements with Different Devices in Fuchs Endothelial Dystrophy
İlayda KORKMAZa, Özlem BARUT SELVERa, Melis PALAMARa
aEge Üniversitesi Tıp Fakültesi, Göz Hastalıkları ABD, İzmir, TÜRKİYE
Turkiye Klinikleri J Ophthalmol. 2021;30(1):17-23
doi: 10.5336/ophthal.2020-75876
Article Language: TR
Full Text
ÖZET
 Amaç: Fuchs endotelyal distrofili hastaların speküler mikroskopi, Scheimpflug kamera ve ön segment optik koherens tomografi (ÖS-OKT) ile ölçülen kornea parametrelerinin incelenmesi. Gereç ve Yöntemler: Fuchs endotelyal distrofili, 20 hastanın 20 gözü (Grup 1) ile 19 sağlıklı bireyin sağ gözleri (Grup 2) çalışmaya dâhil edildi. Tüm gönüllülere, detaylı oftalmolojik muayenenin yanı sıra Scheimpflug kamera, ÖS-OKT ve speküler mikroskopi incelemeleri yapıldı. Bulgular: Scheimpflug kamera, speküler mikroskopi, ÖS-OKT ile ölçülen ortalama santral kornea kalınlığı (SKK) değerleri sırasıyla; Grup 1 için 618±32 (555-659), 580±41 (528-700), 592±30 (541-648) μm; Grup 2 için 531±37 (464-613), 537±38 (470-641), 533±35 (475-635) μm olup, gruplar arası fark istatistiksel olarak anlamlıydı (p<0,001). SKK açısından Grup 1'de cihazlar arası uyum zayıf [Sınıf içi korelasyon katsayısı (ICC)=0,391] iken; Grup 2'de cihazlar arası uyum mükemmel (ICC=0,961) olarak saptandı. OKT'de ölçülen ortalama Descemet membran kalınlığı (DMK), Grup 1'de 29,7±7 (19-37) μm, Grup 2'de 13,8±2(10-18) μm olup, aradaki fark istatistiksel olarak anlamlıydı (p<0,001). DMK/SKK oranı, Grup 1'de 0,05±0,012, Grup 2'de 0,026±0,004 olup, aradaki fark istatistiksel olarak anlamlıydı (p<0,001). Yaşın DMK'ye oranı, Grup 1'de 2,43± 0,61; Grup 2'de 4,87±1,10 olup, aradaki fark istatistiksel olarak anlamlı bulundu (p<0,001). Sonuç: Fuchs endotelyal distrofisinde SKK ölçümleri cihazlar arasında farklılık gösterebildiğinden; bu hastalarda SKK'nin, kontrollerde aynı cihaz ile ölçülmesi hastalık progresyon takibinde daha doğru sonuçlar elde edilmesine olanak sağlayacaktır. ÖS-OKT, Fuchs endotelyal distrofisinde, kornea parametrelerinin değerlendirilmesinde DMK ölçümüne de izin vererek, hastalık yönetiminde önemli bir araç olma potansiyeline sahiptir.

Anahtar Kelimeler: Fuchs endotelyal distrofisi; kornea; optik koherens tomografi; korneal pakimetri
ABSTRACT
 Objective: To assess the corneal parameters with specular microscopy, Scheimpflug camera and anterior segment-optic coherance tomography (AS-OCT) in patients with Fuchs' endothelial dystrophy. Material and Methods: Twenty eyes of 20 patients with Fuchs' endothelial dystrophy (Group 1) and 19 eyes of 19 controls (Group 2) were enrolled. In all cases a complete ophthalmological examination was performed, including Scheimpflug camera, AS-OCT, specular microscopy. Results: The average central corneal thickness (CCT) (μm) measured by Scheimpflug camera, specular microscopy and AS-OCT were 618±32 (555-659); 580±41 (528-700); 592±30 (541-648) in Group 1; 531±37 (464-613); 537±38 (470- 641); 533±35 (475-635) in Group 2, respectively. The difference between two groups was statistically significant (p<0.001). Interclass correlation between three modalities for CCT was poor for Group 1 [interclass correlation coefficient (ICC)=0.391], excellent for Group 2 (ICC=0.961). Mean Descemet membrane thickness (DMT) (μm) measured by AS-OCT was 29.7±7 (19-37) in Group 1; 13.8±2 (10-18) in Group 2 (p<0.001). The ratio of DMT/ CCT was 0.05 ± 0.012 in Group 1, 0.026 ± 0.004 in Group 2. (p<0.001) The ratio of age to DMT was 2.43± 0.61 in Group 1; 4.87±1.10 in Group 2 (p<0.001). Conclusion: In eyes with Fuchs' endothelial dystrophy, CCT measurements may differ between devices so using the same device at each visit will provide more accurate results in progression analysis. The ASOCT is an important technique for imaging corneal layers and measuring DM thickness. Thus, AS-OCT may has a significant role in the evaluation and management of patients with Fuchs endothelial dystrophy.

Keywords: Fuchs endothelial dystrophy; cornea; optic coherance tomography; corneal pachymetry
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