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Nanotopography by chromatic confocal microscopy of the endothelium in Fuchs endothelial corneal dystrophy, pseudophakic bullous keratopathy and healthy corneas
  1. Hanielle Vaitinadapoulé1,
  2. Sylvain Poinard1,2,
  3. Zhiguo He1,
  4. Alina Pascale-Hamri3,
  5. Justin Thomas1,
  6. Philippe Gain1,2,
  7. Jean-Yves Thuret4,
  8. Frédéric Mascarelli5,
  9. Gilles Thuret1,2
  10. French Fuchs Study Group (FFSG)
    1. 1Laboratory of Biology, Engineering, and Imaging for Ophthalmology, BiiO, Jean Monnet University, Saint-Etienne, France
    2. 2Ophthalmology Department, University Hospital Centre Saint-Étienne, Saint-Etienne, France
    3. 3GIE Manutech USD, Saint-Etienne, France
    4. 4University of Paris-Saclay, CEA, CNRS, Institute for Integrative Biology of the Cell (I2BC), Gif-sur-Yvette, Île-de-France, France
    5. 5Centre de Recherche des Cordeliers, UMR S INSERM 1138, Université Paris Descartes, Paris, Île-de-France, France
    1. Correspondence to Professor Gilles Thuret, Laboratory of Biology, Engineering, and Imaging for Ophthalmology, BiiO, Jean Monnet University, Saint-Etienne F-42055, France; gilles.thuret{at}


    Aim To investigate the interest of chromatic confocal microscopy (CCM) to characterise guttae in Fuchs endothelial corneal dystrophy (FECD).

    Methods Descemet’s membranes (DM) were obtained during endothelial keratoplasty in patients with FECD and pseudophakic bullous keratopathy (PBK). They were compared with healthy samples obtained from body donation to science. Samples were fixed in 0.5% paraformaldehyde and flat mounted. Surface roughness of DMs was quantified using CCM and the AltiMap software that provided the maximum peak (Sp) and valley (Sv) heights, the mean square roughness (Rq) and the asymmetry coefficient (Ssk).

    Results The physiological roughness of healthy samples was characterised by an Rq of 0.12±0.05 µm, which was two times rougher than in PBK (Rq=0.06±0.03 µm), but both were still flat with a symmetrical distribution between peaks and valleys (Ssk close to 0, npeaks=nvalleys), smaller than 1 µm. In FECD, the maximum peak height was 5.10±2.40 µm, up to 5.8 and 8.3 times higher than the control and PBK, respectively. The maximum valley depth was half than the peak (2.28±0.89 µm). The surface with guttae was very rough (Rq=0.45±0.14 µm) and the Ssk=1.84± 0.43 µm, greater than 0, confirms an asymmetric surface with high peaks and low valleys (npeaks>nvalleys). Moreover, the CCM provided quantitative parameters allowing to distinguish different types of guttae from different patients.

    Conclusions CCM is an innovative approach to describe and quantify different morphologies of guttae. It could be useful to analyse the different stages of FECD and define subgroups of patients.

    • Cornea
    • Dystrophy
    • Imaging
    • Pathology
    • Physiology

    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplementary information.

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplementary information.

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    • FM and GT contributed equally.

    • Collaborators The collaborator group name : French Fuchs Study Group (FFSG) Hôpital universitaire de Brest: Béatrice Cochener ; Hôpital universitaire de Strasbourg: Tristan Bourcier ; Hôpital universitaire de Rouen, Charles Nicolle: Marc Muraine; Hôpital universitaire de Reims, Robert Debré: Alexandre Denoyer ; Fondation Adolphe de Rothschild: Damien Gatinel, Eric Gabison, Alain Saad, Damien Guindolet; Hôpital universitaire les Quinze-Vingts National: Vincent Borderie ; Hôpital universitaire Cochin APHP: Jean-Louis Bourges, Marc Labetoulle, Antoine Rousseau, Clémence Bonnet; Hôpital régional de Thionville: Jean-Marc Perone; Hôpital universitaire de Nantes (site Hôtel Dieu HME): Bertrand Vabres; Institut Ophtalmologique de l’Ouest Jules Verne, Société Ophtalliance : Jean-Michel Bosc, Pierre-Yves Santiago; Hôpital universitaire et régional Dijon, Le Bocage: Florian Baudin, Catherine Creuzot-Garcher, Louis Arnould ; Hôpital universitaire et régional de Besançon: Anne-Sophie Gauthier, Bernard Delbosc, Romain Montard; Centre d’ophtalmologie de Kleber: Nicolas Duquesne; Hôpital universitaire de Clermont-Ferrand, Gabriel Montpied: Frédéric Chiambaretta; Hôpital universitaire de Montpellier: Vincent Daien; Hôpital universitaire de Bordeaux, groupe hospitalier Pellegrin: David Touboul; Hôpital universitaire de Grenoble: Diane Bernheim; Centre d’ophtalmologie de Monticelli-Vélodrome: Louis Hoffart; Hôpital universitaire de Toulouse, Pierre-Paul Riquet: Pierre Fournie; Hôpital universitaire d’Antibes, Juan-les-Pins: Alexandra Rabot; Hôpital universitaire de Caen, Côte de Nacre: Jean-Claude Quintyn; Centre Hospitalier Universitaire de Limoges - Hôpital Dupuytren : Pierre Yves Robert ; Centre Hospitalier Universitaire de Lille : Jean François Rouland ; Hôpital universitaire de Liège: Bernard Duchesne; Centre d’ophtalmologie de Lausanne: François Majo ;

    • Contributors Planning (conception and design): HV, SP, ZHE, AP-H, J-YT, PG, FM, GT and FFSG. Conduct (acquisition data): HV, AP-H, JT, FM and GT. Reporting (analysis, interpretation data, writing): HV, SP, ZHE, AP-H, J-YT, PG, FM and FFSG. Guarantor: GT.

    • Funding Grants: Supported by Fondation de France, Bourse Berthe FOUASSIER 2020 (Hanielle VAITINADAPOULE) and ANR AAPG 2022 CORNEA (Jean-Yves THURET)

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.