Investigators recently found that not one but three Scheimpflug tomography pachymetry map and posterior elevation map patterns can predict Fuchs’ endothelial corneal dystrophy (FECD) prognosis independent of central corneal thickness (CCT).

This cross-sectional study evaluated 96 eyes of 56 subjects with various stages of FECD. Their corneas were graded according to the area and confluence of guttae and the presence of clinically definite edema. Masked and randomized Scheimpflug imaging pachymetry map and posterior elevation map patterns were assessed for the loss of regular isopachs, displacement of the thinnest point of the cornea and presence of posterior surface depression

The team discovered a handful of risk factors for FECD progression and intervention, of which loss of regular isopachs and displacement of the thinnest point were independent and clinically important. Other predictors included focal posterior surface depression, anterior corneal backscatter and CCT. They also learned that the five-year cumulative risks of disease progression was only 7% when no map patterns were present, but the risk jumped to 48% with the presence of one or two map parameters. That number skyrocketed to 89% if all three pachymetry map and posterior elevation map parameters were present. They add that the four-year cumulative risks of disease progression after uncomplicated cataract surgery were 0%, 50% and 75%, respectively, based on the presence of none, one or two, or three map patterns.

“The risk of FECD progression/intervention, including after uncomplicated cataract surgery, increases according to the number of parameters present,” the study authors concluded.