Corneal Oedema: Aetiology, Diagnostic Testing, and Treatment.

Autor: Zander DB; Eye Center, Medical Center - University of Freiburg, Freiburg, Germany., Jiang J; Eye Center, Medical Center - University of Freiburg, Freiburg, Germany., Reinhard T; Eye Center, Medical Center - University of Freiburg, Freiburg, Germany., Wacker K; Eye Center, Medical Center - University of Freiburg, Freiburg, Germany.
Jazyk: angličtina
Zdroj: Klinische Monatsblatter fur Augenheilkunde [Klin Monbl Augenheilkd] 2022 Jun; Vol. 239 (6), pp. 752-759. Date of Electronic Publication: 2022 Apr 14.
DOI: 10.1055/a-1759-3834
Abstrakt: Corneal oedema results from an underlying pathology, which can be diverse in origin, and may be mechanical, dystrophic, or inflammatory, and affect any layer of the cornea. Diagnostic tools such as Scheimpflug imaging and anterior segment optical coherence tomography have standardised quantification of corneal oedema and have become important aids in clinical practice. Timely diagnosis and treatment are key to preventing irreversible damage to the corneal ultrastructure, such as anterior corneal fibrosis or endothelial cell damage. The oedema usually resolves quickly when the underlying cause has been addressed. Symptomatic treatment using hyperosmolar agents has failed to show any benefits in oedema resolution or improvement in visual acuity compared to placebo. In contrast, rho-associated protein kinase (ROCK) inhibitors offer a promising option for medical treatment in cases of endothelial dysfunction, but their safety and efficacy must be further validated in large scale clinical trials. Until then, endothelial or penetrating keratoplasties remain the mainstay treatment where structural changes to the cornea have occurred.
Competing Interests: Dr. Wacker is a consultant for ProQR Therapeutics, the Netherlands. Dr. Wacker developed the V-FUCHS instrument that is licensed by Mayo Clinic to Aerie Pharmaceuticals, Inc.
(Thieme. All rights reserved.)
Databáze: MEDLINE