Comparison of Corneal Endothelium in Patients with Uveitis and Healthy Subjects Using Specular Microscopy

Article Information

Title: Comparison of Corneal Endothelium in Patients with Uveitis and Healthy Subjects Using Specular Microscopy

Authors: Qurat ul Ain Ghazanfar, Omar Zafar, Noman Nazir Ahmed, Muhammad Manzoor Awan

Journal: Pakistan Armed Forces Medical Journal (PAFMJ)

HEC Recognition History

Category	From	To
Y	2024-10-01	2025-12-31
Y	2023-07-01	2024-09-30
Y	2021-07-01	2022-06-30
Y	2020-07-01	2021-06-30
Y	1900-01-01	2005-06-30

Publisher: Army Medical College, Rawalpindi.

Country: Pakistan

Year: 2022

Volume: 72

Issue: 5

Language: English

DOI: 10.51253/pafmj.v72i5.3168

Keywords: Anterior uveitisCorneal endotheliumSpecular microscopy

Abstract

Objective: To evaluate changes in corneal endothelium in patients with anterior uveitis by using specular microscopy and compare it with the corneal endothelium of healthy subjects.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi Pakistan, from Jun 2018 to Jun 2019.
Methodology: This study included 65 eyes of 65 patients with anterior uveitis and 65 eyes of healthy subjects. Corneal endothelium was assessed in all participants of both Groups by using Specular microscopy. Corneal endothelial markers like central corneal thickness (CCT), cell density (CD), cell minimum area, cell maximum area, the average of cell size, percent of hexagonality (HEX%), coefficient of variation (CV) were compared in both Groups. The Uveitis Group was further subdivided into active and inactive Uveitis Subgroups, and corneal endothelium markers were also compared in these Subgroups.
Results: The mean endothelial cell density was 2626.0±413.0 cells/mm² in patients with uveitis, whereas cell density was 2766.0±327.0 cells/mm² in healthy subjects. The difference in endothelial cell density was statistically significant between the Groups (p=0.03). The difference between central corneal thickness, maximum cell area, average cell size and hexagonality values between Groups was also statistically significant, whereas there was no difference in terms of cell minimum area between these Groups. There was no statistically significant difference between inactive and active uveitis when corneal endothelial markers were compared between them (p&gt;0.05).
Conclusion: There was an effect of uveitis on central corneal thickness, endothelial cell density, cell size, and morphology compared to healthy subjects,......

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Research Objective

To evaluate changes in corneal endothelium in patients with anterior uveitis using specular microscopy and compare it with healthy subjects.

Methodology

Comparative cross-sectional study conducted at Armed Forces Institute of Ophthalmology, Rawalpindi Pakistan, from June 2018 to June 2019. Included 65 eyes of 65 patients with anterior uveitis and 65 eyes of healthy subjects. Corneal endothelium was assessed using specular microscopy, measuring CCT, CD, cell minimum area, cell maximum area, average cell size, HEX%, and CV. The uveitis group was subdivided into active and inactive subgroups. Statistical analysis was performed using SPSS version 20.0 with independent sample t-tests and Pearson's correlation.

Methodology Flowchart

                        graph TD
    A[Patient Recruitment Uveitis & Healthy] --> B[Specular Microscopy];
    B --> C[Data CollectionCCT, CD, etc.];
    C --> D[Data Analysis SPSS];
    D --> E[Comparison of Groups];
    E --> F[Conclusion: Impact of Uveitis on Endothelium];

Discussion

The study found decreased CD in patients with uveitis compared to healthy subjects, consistent with other studies. Increased average cell size was also observed in uveitis patients. The study also found a negative effect of anterior chamber inflammation on corneal endothelial cell morphology.

Key Findings

Mean endothelial cell density was significantly lower in uveitis patients (2626.0±413.0 cells/mm²) compared to healthy subjects (2766.0±327.0 cells/mm²) (p=0.03). Significant differences were also found in CCT, maximum cell area, average cell size, and hexagonality values between the groups. No significant difference was observed in cell minimum area. No statistically significant difference was found between active and inactive uveitis subgroups for most corneal endothelial markers (p>0.05), except for CV.

Conclusion

Uveitis affects central corneal thickness, endothelial cell density, cell size, and morphology compared to healthy subjects. There was no difference in corneal endothelial markers in patients with active uveitis and inactive uveitis.

Fact Check

1. The study included 65 eyes of 65 patients with anterior uveitis and 65 eyes of healthy subjects. Confirmed in the Methodology section.
2. The mean endothelial cell density in uveitis patients was 2626.0±413.0 cells/mm² and 2766.0±327.0 cells/mm² in healthy subjects. Confirmed in the Results section.
3. The study was conducted from June 2018 to June 2019. Confirmed in the Methodology section.

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