Evidence map›Paper›PMID 41888247›Full record

ArticleScientific reports2026

Imaging improvements reveal guttae development and posterior fibrillar layer formation in fuchs endothelial corneal dystrophy.

Daniel B Zander, Anne-Marie S Kladny, Judith-Lisa Lieberum, Philip Maier, Thabo Lapp, Stefan J Lang, Sonja Heinzelmann-Mink, Claudia Auw-Hädrich, Günther Schlunck, Katrin Wacker and 1 more

Abstract read
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In one paragraph

Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Daniel B ZanderEye Center, Medical Center, Medical Faculty, University of Freiburg, University of Freiburg, Killianstr. 5, 79106, Freiburg, Germany.
Anne-Marie S KladnyEye Center, Medical Center, Medical Faculty, University of Freiburg, University of Freiburg, Killianstr. 5, 79106, Freiburg, Germany.
Judith-Lisa LieberumEye Center, Medical Center, Medical Faculty, University of Freiburg, University of Freiburg, Killianstr. 5, 79106, Freiburg, Germany.
Philip MaierEye Center, Medical Center, Medical Faculty, University of Freiburg, University of Freiburg, Killianstr. 5, 79106, Freiburg, Germany.
Thabo LappEye Center, Medical Center, Medical Faculty, University of Freiburg, University of Freiburg, Killianstr. 5, 79106, Freiburg, Germany.
Stefan J LangEye Center, Medical Center, Medical Faculty, University of Freiburg, University of Freiburg, Killianstr. 5, 79106, Freiburg, Germany.
Sonja Heinzelmann-MinkEye Center, Medical Center, Medical Faculty, University of Freiburg, University of Freiburg, Killianstr. 5, 79106, Freiburg, Germany.
Claudia Auw-HädrichEye Center, Medical Center, Medical Faculty, University of Freiburg, University of Freiburg, Killianstr. 5, 79106, Freiburg, Germany.
Günther SchlunckEye Center, Medical Center, Medical Faculty, University of Freiburg, University of Freiburg, Killianstr. 5, 79106, Freiburg, Germany.
Katrin WackerEye Center, Medical Center, Medical Faculty, University of Freiburg, University of Freiburg, Killianstr. 5, 79106, Freiburg, Germany.
Gottfried MartinEye Center, Medical Center, Medical Faculty, University of Freiburg, University of Freiburg, Killianstr. 5, 79106, Freiburg, Germany. gottfried.martin@uniklinik-freiburg.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Guttae are a hallmark of Fuchs endothelial corneal dystrophy (FECD) and the disease’s progression. A posterior fibrillar layer (PFL) that covers central guttae has been previously described, but its formation and progression remain unclear. This study aims to further investigate the characteristics of guttae and the PFL in FECD. In a well-characterized prospective FECD patient cohort, a total of 43 DMEK (Descemet membrane endothelial keratoplasty) specimens were immunostained for ZO1 or COL1, flat-mounted, and analyzed using differential interference contrast (DIC), autofluorescence (excited at 480 nm), and polarized light microscopy. Guttae and PFL were quantified and correlated with clinical data. Guttae were visualized by DIC and autofluorescence imaging and classified into two types with gradual transition: peripheral, knob-like guttae and central, flat guttae. Guttae with low autofluorescence often were covered by corneal endothelial cells (CEnC). Central guttae were found to be covered by a PFL that contained COL1 and was visualized using polarized light microscopy. The PFL displayed a fibrous structure that blurred guttae in DIC illumination. Its presence correlated with clinical parameters, such as anterior scatter and post-operative corneal edema resolution providing insight into the relation of PFL and FECD severity. The combination of DIC, autofluorescence, and polarized light microscopy provides a robust method for investigating guttae and the PFL. This could facilitate preoperative assessment of corneal donor tissue and enhance postoperative clinical diagnostics by detailed detection of guttae and PFL in patients.

Indexed as

Endothelium, CornealFuchs' Endothelial DystrophyAgedAged, 80 and overDescemet MembraneDescemet Stripping Endothelial KeratoplastyFemaleHumansMaleMiddle AgedProspective StudiesDescemet membrane endothelial keratoplasty (DMEK)Fuchs endothelial corneal dystrophyGuttaeHassall-Henle bodiesPolarized lightPosterior fibrillar layer

Identifiers

PMID41888247
PMCPMC13031840

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.