Fuchs dystrophy: insight into disease pathophysiology and treatment Review article
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Abstract
Fuchs endothelial corneal dystrophy (FECD) is a bilateral, progressive disease originating in corneal endothelial cells. Fuchs endothelial corneal dystrophy slowly progresses, causing endothelial cell loss, subsequent corneal stromal and epithelial edema, leading to visual acuity impairment and ocular pain. Fuchs endothelial corneal dystrophy was first documented more than a hundred years ago – in 1910, when Viennese ophthalmologist Ernst Fuchs reported 13 elderly patients with bilateral central clouding. Since then, there have been a far-reaching progress in terms of pathogenesis, knowledge of etiological factors, as well as progress in diagnosis and treatment. Despite that, there are still many questions remaining unanswered, especially in the field of the genetic basis of FECD and the molecular pathomechanisms. The aim of this review is to present and discuss clinical, genetic, pathophysiologic, diagnostic and therapeutic aspects of this common corneal dystrophy. The article also focuses on innovative methods of imagining including high-resolution optical coherence tomography. Moreover, we highlight and discuss the development of traditional surgical treatment options and new minimally invasive techniques such as descemetorhexis without endothelial keratoplasty (DWEK) and Rho-associated kinase inhibitor (ROCK inhibitors) eye drops.
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Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
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