How Would Nature See Our Corneal Triumphs? The LXXIX Edward Jackson Lecture.
Am J Ophthalmol
; 263: 11-22, 2024 Jul.
Article
em En
| MEDLINE
| ID: mdl-38281570
ABSTRACT
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."
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Endotélio Corneano
/
Distrofia Endotelial de Fuchs
/
Pressão Intraocular
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article