The influence of obesity, diabetes mellitus and smoking on fuchs endothelial corneal dystrophy (FECD).

To detect environmental factors, which may be possible risk factors in the disease course of Fuchs' endothelial corneal dystrophy (FECD). Evaluation of patients with FECD registered in the FECD genetics database of the Center for Ophthalmology, University Hospital Cologne. For the evaluation, disease onset, central corneal thickness, best spectacle corrected visual acuity (BSCVA, logMAR), and modified Krachmer grading (grades 1-6) were correlated with the presence of diabetes mellitus (DM), body mass index (BMI), and smoking behavior. To put the age-related increase in Krachmer grading into perspective, a correction of grading were formed. Depending on the variables studied, differences between groups were examined by Mann-Whitney U test and chi-square test. The significance level was 5%. 403 patients with FECD were included in the analysis. The mean age of the patients was 70.0 ± 10.32 (range 28-96) years. The mean age at diagnosis of those patients was 63.1 ± 13.2 years. The female-to-male ratio was 1.46:1. Patients with a BMI > 30.0 kg/m2 developed FECD significantly earlier than patients with a BMI < 30 kg/m2, p = 0.001. Patients with DM showed significantly more often an Krachmer grade of 5, p = 0.015. Smoking had a negative effect on Krachmer grading (p = 0.024). Using the mediation analysis, the presence of DM correlated Krachmer Grade 5 (p = 0.015), and the presence of DM correlated with BMI > 30.0 kg/m2 (p = 0.012). In addition to smoking and DM our study shows for the first time that obesity may have a negative impact on the development of FECD. Whether dietary interventions and hormones can influence the development or progression of the disease needs to be investigated in future studies.

[Diagnostic image (106). A girl with blurred vision. Unilateral juvenile glaucoma with ectropion uveae]. / Diagnose in beeld (106). Een meisje met wazig zicht. Enkelzijdig juveniel glaucoom met ectropion uveae (iridotrabeculaire dysgenesis).

A 10-year-old girl showed ectropion uveae of the iris of her right eye. Ocular examination established severe unilateral juvenile glaucoma: iridotrabecular dysgenesis.

Peripheral retinal nonperfusion associated with essential thrombocytosis.

PURPOSE: To describe a patient with retinal complications of essential thrombocytosis. METHOD: Case report. A 24-year-old man with acute vitreous hemorrhage of the right eye underwent ocular and systemic examinations to elucidate the origin of this condition. RESULTS: Fluorescein angiography of the right eye showed an avascular peripheral retina with marked capillary nonperfusion, arteriovenous anastomosis, and sea fan neovascularization. Blood studies showed thrombocytosis without other associated systemic diseases. The peripheral retinal capillary nonperfusion and sea fan neovascularization were treated with dye-laser photocoagulation, and aspirin, 80 mg daily, was given for systemic treatment. CONCLUSIONS: In our patient, the avascular retina was associated with essential thrombocytosis, which may cause an avascular peripheral retina with neovascularization and vitreous hemorrhage in otherwise healthy persons.