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Corneal endothelial morphology in patients with herpetic keratitis attending tertiary eye centre
Barsha Kumari Singh1, Sanjeeta Sitaula2, Sanjeev Bhattarai2
1Department of Ophthalmology, Maharajgunj Medical Campus, Institute of Medicine, B.P. Koirala Lions Centre for Ophthalmic Studies, Tribhuvan University, Kathmandu, Nepal. singhbarsha432@gmail.com.
Background:
Herpetic keratitis is a common cause of infectious corneal disease and can result in long term visual morbidity. While its effects on the corneal epithelium and stroma are well recognized, its impact on the corneal endothelium remains less clearly understood. This study aimed to evaluate and compare corneal endothelial morphology, including endothelial cell density, cell size variability, and hexagonality, between eyes affected by herpetic keratitis and their contralateral unaffected eyes.
Methods:
This hospital-based cross-sectional comparative study included 39 patients with unilateral herpetic keratitis, comprising 39 affected eyes and 39 contralateral unaffected eyes. All participants underwent corneal evaluation using non-contact specular microscopy (NIDEK CEM-530, NIDEK Co., Japan). Endothelial cell density, coefficient of variation, and percentage of hexagonal cells were recorded as measures of endothelial cell density and morphology. Central corneal thickness was also measured. Comparisons between affected and contralateral unaffected eyes were performed using paired statistical analysis.
Results:
Mean endothelial cell density was significantly lower in eyes affected by herpetic keratitis compared with contralateral unaffected eyes (2555.38 ± 474.05 vs. 2879.00 ± 270.26 cells/mm², p < 0.001). Affected eyes demonstrated a significantly higher coefficient of variation (34.92 ± 6.35% vs. 29.77 ± 6.57%, p < 0.001), indicating greater variability in endothelial cell size. The percentage of hexagonal cells was significantly reduced in affected eyes compared with unaffected eyes (61.10 ± 5.04% vs. 66.82 ± 3.97%, p = 0.02). Central corneal thickness did not differ significantly between affected and contralateral unaffected eyes.
Conclusions:
Eyes with unilateral herpetic keratitis demonstrated reduced corneal endothelial cell density and hexagonality, along with increased variability in cell size compared with contralateral unaffected eyes, indicating corneal endothelial alterations associated with the disease.
