Fuchs' endothelial corneal dystrophy is characterized by bilateral, primary endothelial dysfunction. Which of the following correctly describes the histopathological finding and clinical consequence?
- A Guttae — excrescences on Descemet membrane — causing reduced endothelial cell density, stromal and epithelial oedema, and painful bullous keratopathy ✓
- B Stromal collagen dysplasia causing progressive thinning and ectasia of the cornea
- C Deposition of abnormal collagen (guttae) on Descemet membrane by dysfunctional endothelial cells, leading to reduced pump function, corneal oedema, and Haab's striae
- D Amyloid deposits in Bowman's layer causing recurrent corneal erosions and anterior stromal haze
Explanation
Fuchs' endothelial dystrophy features guttae — small, wart-like excrescences of abnormal collagen secreted onto Descemet membrane by stressed/dysfunctional endothelial cells — giving the endothelium a beaten-bronze appearance on specular microscopy. Progressive loss of endothelial cells reduces corneal deturgesence (pump function), causing stromal oedema (corneal clouding), followed by epithelial oedema, and ultimately painful bullous keratopathy with surface bullae rupturing. Treatment is Descemet membrane endothelial keratoplasty (DMEK) or DSAEK. Haab's striae are associated with congenital glaucoma. Amyloid in Bowman's layer is seen in lattice dystrophy.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.