Modern Diagnostic Modalities for Fuchs' Endothelial Corneal Dystrophy: A Comparative Analysis Using Scheimpflug...

Background and Objectives: Fuchs' endothelial corneal dystrophy (FECD) is a progressive disorder characterized by endothelial cell loss, corneal edema, and reduced transparency. Scheimpflug tomography enables objective evaluation of the corneal structure, including densitometry as a marker of optical quality. This study aimed to assess topographic and microstructural corneal parameters in FECD patients using Pentacam tomography and to evaluate their diagnostic utility. Materials and Methods: A total of 89 subjects (178 eyes) were included: 47 patients with FECD (94 eyes) and 42 healthy controls (84 eyes). Participants were stratified by age and sex. All underwent comprehensive ophthalmic examination and corneal imaging with Pentacam HR. Corneal densitometry was analyzed in four concentric zones (0-2, 2-6, 6-10, and 10-12 mm) and three layers (anterior, central, posterior). Statistical analysis was performed using SPSS v.19, with p < 0.05 considered significant. Results: Densitometry values increased with age in both groups, with significantly higher values in FECD patients, particularly in peripheral zones (6-12 mm). The highest backscatter was consistently observed in the anterior corneal layer. Significant differences between FECD and controls were found in specific age subgroups and corneal regions. A progressive increase in backscatter from Descemet's membrane was observed, corresponding to a transition in densitogram patterns from a "high-backed chair" to a "hammock" configuration. Disease progression appeared more pronounced in male patients. Conclusions: Corneal densitometry obtained by Scheimpflug tomography provides reliable quantitative and qualitative indicators of FECD progression. Its combined use with topographic parameters enhances early diagnosis and disease monitoring.