The cornea guttata and Fuchs' dystrophy
Written by:The guttata and Fuchs corneal dystrophy are two pathologies of ophthalmology particularly affecting women over 40 with a family history.
Guttate cornea is the initial disturbance of Fuchs dystrophy, corneal disease with several phases. It is a common condition that usually affects both eyes. It is characterized by a loss of cells in the innermost layer of the cornea endothelium. The cornea has five layers: epithelium, Bowman's membrane, stroma, Descemet's membrane and endothelium.
Fuchs' dystrophy is more common in women. In half the cases, no family history of the disease. It comes from 40 years of slowly progressive.
Clinic
The Fuchs disfrofia evolves into four phases: guttate cornea, corneal edema, bullous keratopathy and fibrosis.
1. In the phase of the patient's cornea guttata usually not notice symptoms. However, in exploring the ophthalmologist finds some dark spots shaped drops which are located in the innermost layer of the cornea endothelial layer. These "drops" are increasing and are spreading gradually from the central part of the cornea to the periphery. In addition, they will also appear accumulations of microscopic spots of brown pigment.
2. In the second phase of Fuchs' dystrophy, corneal edema appears: it accumulates excess fluid in the cornea progressively. This causes a loss of transparency of it and the patient notices decreased vision.
3. Bullous keratopathy. When persistent epithelial edema, bullae are they form (blisters) microscopic epithelium, which subsequently break down and produce corneal ulcers and pain.
4. In the final stage, fibrosis occurs in the stroma. They are "scars", which are not transparent and blurred vision occur.
Treatment
In the early stages of corneal guttata and mild corneal edema eye drops and ointments are used antiedema. In later stages, the current surgical treatment is the endothelial transplantation. Good results are obtained in most cases. It is to replace the diseased endothelium by a healthy endothelium from a deceased donor. The two types of endothelial transplantation are DSAEK (Descemet Stripping Automated Endothelial Keratoplasty) and DMEK (Descemet Membrane Endothelial Keratoplasty).
