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.
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.
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