Quantitative analysis of endothelial mosaic pattern changes in anterior keratoconus

Area of Science:

• Ophthalmology
• Corneal Diseases
• Cellular Biology

Background:

• Keratoconus is a progressive corneal disorder characterized by thinning and ectasia.
• Early detection of keratoconus, especially in fellow eyes of unilateral cases, is crucial for timely intervention.
• Corneal endothelial cell morphology changes may serve as an indicator of corneal health.

Purpose of the Study:

• To investigate corneal endothelial cell morphology in eyes with anterior keratoconus and their fellow eyes.
• To compare endothelial cell characteristics between keratoconus patients, latent keratoconus eyes, and healthy controls.
• To assess the utility of specular microscopy and computerized cell shape analysis for early keratoconus detection.

Main Methods:

• Specular microscopy was performed on 21 eyes with keratoconus and 15 age-matched control eyes.
• Corneal endothelial photographs were analyzed using a computerized digitizer for cell area and shape.
• Polymegethism (cell area variation) and pleomorphism (cell shape variation) were quantified.

Main Results:

• Keratoconus eyes exhibited significantly increased polymegethism and pleomorphism compared to controls.
• The mean cell area was within normal limits, but the frequency of hexagonal cells was significantly lower in keratoconus.
• Latent keratoconus eyes showed no significant cell area alterations but displayed similar pleomorphic characteristics to fellow keratoconic eyes.

Conclusions:

• Corneal endothelial cell shape analysis, not just cell area, is a sensitive indicator of keratoconus.
• Specular microscopy with computerized cell shape analysis can detect subclinical changes in fellow eyes of unilateral keratoconus.
• This technique offers potential for early diagnosis of keratoconus, even in asymptomatic eyes.