ArticleClinical ophthalmology (Auckland, N.Z.)2025
Vision and Quality of Life in Fuchs' Endothelial Dystrophy Using a Prototype Aberrometer: A Cross-Sectional Study.
Article in Clinical ophthalmology (Auckland, N.Z.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Fuchs' endothelial corneal dystrophy (FECD) is a progressive disease that affects vision and quality of life (QoL). While best distance-corrected visual acuity (BDCVA) is commonly used to assess visual function, the role of optical aberrations and high-resolution imaging in explaining patient-reported outcomes remains unclear. This study aims to evaluate how clinical, optical, and QoL parameters interrelate in patients with FECD. Methods: Prospective, cross-sectional study. Patients underwent ophthalmic evaluation including best distance-corrected BDCVA, refraction, central corneal thickness, endothelial cell density (ECD), and aberrometry using a high-resolution device. FECD severity was clinically graded (modified-Krachmer scale). Eyes were classified by lens status and presence of edema, pigment, or fibrosis. Quality of life was assessed using the NEI Visual Function Questionnaire (VFQ-25). Correlations were analyzed using univariate tests and multivariate regression. Results: Eyes exhibiting corneal edema detected by slit-lamp examination had significantly lower BDCVA compared to those without edema (mean difference 0.2 [95% CI: 0.08-0.32], adjusted p<0.001). Eyes with fibrosis also had worse visual acuity compared to those without (mean difference 0.137 [95% CI: 0.02-0.26], adjusted p=0.01). The Fuchs' grading scale showed strong correlation with BDCVA (r=-0.68, p<0.001) and moderate correlation with advanced wavefront metrics (RMS; r=0.3, p<0.001). VFQ-25 total score had the strongest correlation with the worst eye's visual acuity (r=0.42, p<0.001). Incorporating additional variables or more complex models did not significantly enhance prediction. Conclusion: Worse-eye BDCVA correlates with patient-reported quality of life in FECD; however, adding high-resolution optical metrics (eg, wavefront/HPFM) did not meaningfully improve explanatory or predictive performance beyond simple clinical variables. These findings highlight a current gap: advanced optical metrics are not yet sufficient to reliably predict the subjective patient experience. Any conclusions from this study should be considered highly preliminary pending confirmation by further research.
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