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  • Atlas Entry - Guttae in Fuchs endothelial corneal dystrophy
    Guttae, Latin for Guttae, Latin for "drops," are excrescences of collagen produced by stressed corneal endothelial cells They can have a dimpled or "beaten metal" appearance at the slit lamp When found as an age-related change in the corneal periphery of normal individuals they are termed Hassall-Henle bodies
  • Fuchs’ Endothelial Corneal Dystrophy
    Preoperative specular microscopy shows confluence of the guttae and variability in corneal cell size (polymegathism) and shape (pleomorphism) In contrast, postoperative specular microscopy demonstrates a healthy, hexagonal endothelial cell morphology with improved endothelial cell count
  • EyeRounds. org: Fuchs endothelial dystrophy
    The dark areas on the specular microscopy are regions where the endothelial cells have died (guttae) Because these cells are terminally differentiated cells, they do not divide, so the remaining cells have to stretch to cover more area
  • Corneal Imaging: An Introduction - University of Iowa
    Figure 16 Fuchs endothelial dystrophy showing characteristic guttae (dark areas) and reduced endothelial cell density on confocal microscopy Figure 17 Endothelial decompensation within a penetrating keratoplasty graft There are no identifiable endothelial cells on confocal microscopy Figure 18 Acanthamoeba keratitis as seen on confocal
  • Descemet’s membrane endothelial keratoplasty (DMEK) for Fuchs . . .
    56 year-old woman with decreased vision for the past year was referred from comprehensive clinic with cataract and endothelial guttae She was told she had Fuchs dystrophy 14 years prior to presentation Over the last year, her vision had been declining progressively She described poor vision in the first 2 hours of the morning as well as increasing glare and difficulty driving She denied
  • Corneal edema with Descemets membrane folds after DMEK
    After several days, the corneal edema eventually cleared and guttae were visible centrally in the graft tissue, consistent with Fuchs' endothelial dystrophy of the donor
  • Atlas Entry - Punctate epithelial erosions (PEE) secondary to exposure . . .
    Punctate epithelial erosions (PEE) are evidence of ocular surface dryness They represent areas of epithelial cell loss and therefore stain positively with fluorescein
  • INITI AL PRESENTATION - University of Iowa
    Additional Testing Specular Microscopy: Figure 2: Specular microscopy of the right (OD) and left eye (OS) on presentation Most adults over age 40 have an endothelial cell density between 2000-3000 cells mm2 with a uniform, hexagonal endothelial monoloayer In this patient, the endothelial cell density is significantly reduced in both eyes Confluent guttae are seen in both eyes with





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