Fuchs Endothelial Corneal Dystrophy Associations with Systemic Disease, Lifestyle, and Nutritional Intake

To evaluate associations between Fuchs endothelial corneal dystrophy (FECD) and systemic comorbidities, lifestyle factors, and dietary patterns, aiming to identify modifiable risk factors and inform therapeutic strategies.

Case-control study integrating a cross-sectional survey with a retrospective chart review conducted at a tertiary referral center.

The cohort included 100 individuals from the Cornea Service at Massachusetts Eye and Ear Infirmary: 50 patients with FECD and 50 age- and sex-matched controls within a 10-year range. Four controls were excluded due to protocol adherence.

Data collection involved chart reviews and a validated 152-item semiquantitative food frequency questionnaire. Smoking and exercise behaviors were assessed through structured questionnaires. Nutrient intake was adjusted for energy using the residual method. Thus, the energy-adjusted intake estimate is the residual from a regression model in which total energy intake is the independent variable and absolute nutrient intake is the dependent variable. Statistical comparisons included Wilcoxon rank-sum and Fisher exact tests (P < 0.05).

Prevalence and statistical significance of systemic comorbidities, lifestyle behaviors, and dietary intake associated with FECD.

Fuchs endothelial corneal dystrophy was associated with hyperlipidemia (74% vs. 50%, P = 0.023) and atrial fibrillation (26% vs. 8%, P = 0.031). Cumulative tobacco exposure was higher in patients with FECD (11.2 ± 15.1 vs. 6.1 ± 14.1 pack-years, P = 0.017). Patients with FECD had higher caloric intake (1862 ± 673 vs. 1463 ± 584 kcal, P = 0.027), reduced total fat (P = 0.036) and monounsaturated fat (P = 0.024), and increased sodium intake (P = 0.021). Elevated intake of zinc (P = 0.011), manganese (P = 0.043), and selenium (P = 0.007) was also observed.

Fuchs endothelial corneal dystrophy exhibits significant associations with cardiovascular comorbidities, cumulative tobacco exposure, and specific nutritional factors. The identified associations suggest possible directions for future intervention studies as on cardiovascular management, smoking cessation, and dietary modification. Further studies are warranted to explore mechanistic links and develop preventive and therapeutic strategies.

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