How Would Nature See Our Corneal Triumphs? The LXXIX Edward Jackson Lecture - 07/06/24
Résumé |
PURPOSE |
To describe discrepancies between clinical observation and current teachings in corneal endothelial disease, particularly in Fuchs endothelial dystrophy and its potential association with primary open angle glaucoma.
DESIGN |
Perspective.
METHODS |
A perspective is presented on Fuchs dystrophy, a disorder that commonly presents with a compromised endothelium but minimal stromal edema, indicating that the corneal imbibition pressure is relatively “too high.”
RESULTS |
The discrepancy between the relative lack of stromal edema in the absence of an endothelial cell layer cannot be explained by the current theories involving a circulatory pumping mechanism over the endothelial cell layer, but may point to the following: (1) secondary involvement of the corneal endothelium in Fuchs dystrophy; (2) separate hydration systems for maintaining the imbibition pressure (vertical static hydration) and corneal nutrition (horizontal dynamic hydration); (3) the cornea as net contributor of aqueous humor; (4) a close relationship between the corneal imbibition and intraocular pressure, with potentially a shared regulatory system; and (5) a potential steroid-type hormone dependency of this regulatory system.
CONCLUSIONS |
Clinical observation shows that the stromal imbibition pressure is “too high” in Fuchs endothelial dystrophy, indicating that it may not primarily be an endothelial disease, but a type of “corneal glaucoma.”
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Vol 263
P. 11-22 - juillet 2024 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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