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Factors Influencing Visual Acuity in Fuchs’ Endothelial Corneal Dystrophy

Kobashi, Hidenaga, MD, PhD1,2*; Kamiya, Kazutaka, MD, PhD1; Shimizu, Kimiya, MD, PhD1

doi: 10.1097/OPX.0000000000001157
Original Investigations

SIGNIFICANCE In eyes with mild Fuchs’ endothelial corneal dystrophy without significant corneal edema, objective scattering index has the strongest influence on distance visual acuity, followed by the anterior corneal densitometry. Our findings suggest that distance visual acuity deteriorates in eyes with higher forward light scatter.

PURPOSE To evaluate the factors affecting distance visual acuity in patients with Fuchs’ endothelial corneal dystrophy.

METHODS This retrospective study comprised 31 eyes of 31 patients with mild Fuchs’ dystrophy without corneal edema and 25 eyes of 25 age-matched healthy subjects. Stepwise multiple regression analysis was used to assess the relationship between distance acuity with age, sex, forward light scatter, corneal backward scatter, anterior and posterior corneal higher-order aberrations, endothelial cell density, central corneal thickness, and corneal astigmatism.

RESULTS The forward light scatter, corneal backward scatter, and corneal higher-order aberrations were significantly larger in the Fuchs’ dystrophy group than those in the control group (P ≤ .004). In a univariate analysis, with higher forward light scatter, anterior corneal backward scatter, corneal higher-order aberrations, and age, the distance acuity significantly deteriorated in eyes with Fuchs’ dystrophy. In a multiple linear regression analysis, explanatory variables relevant to the distance acuity were the forward light scatter (P < .001, partial regression coefficient B = 0.035) and anterior corneal backward scatter (P = 0.2, B = 0.008) (adjusted R2 = 0.694).

CONCLUSIONS Eyes with higher light scatter, especially forward light scattering, showed deteriorated visual acuity. Results suggest that forward light scatter and corneal backward scatter play a more important role in visual performance than corneal higher-order aberrations in Fuchs’ endothelial corneal dystrophy.

1Department of Ophthalmology University of Kitasato School of Medicine Kanagawa, Japan

2Schepens Eye Research Institute Massachusetts Eye and Ear Infirmary Department of Ophthalmology Harvard Medical School Boston, Massachusetts *

Submitted: December 22, 2016

Accepted: September 17, 2017

Funding/Support: Supported by Grant-in-Aid for Young Scientists 15K20282 from the Japanese Ministry of Education, Culture, Sports, Science, and Technology. The funding organization had no role in the design or conduct of this research.

Conflict of Interest Disclosure: None of the authors have reported a conflict of interest.

Author Contributions: Conceptualization: HK, KS; Data Curation: HK, KK; Formal Analysis: HK; Funding Acquisition: HK, KK; Investigation: HK, KS; Methodology: HK, KK, KS; Project Administration: HK, KS; Software: HK; Visualization: HK, KK, KS; Validation: KS; Writing—Original Draft: HK, KK, KS; Writing—Review Editing: HK, KK, KS.

© 2018 American Academy of Optometry