Analysis and documentation of progression of Fuchs corneal dystrophy with retroillumination photography. Cornea 25, 485–489. in Fuchs endothelial corneal dystrophy

Purpose: Fuchs corneal dystrophy (FCD) is a degenerative disorder of the cornea that is characterized by the progressive accumulation of guttae, which are small excrescences of Descemet_s membrane. We describe a method for documenting the location and number of guttae, and ask whether disease progression can be observed during relatively short periods. Methods: Patients with FCD were imaged by standard retroillumina-tion photography with a slit lamp. Scanned photographswere analyzed by using NIH ImageJ software to determine the number of individual guttae and areas of confluence. Results: In 4 FCD patients, photographs taken 23 to 30 months apart revealed that, once formed, individual guttae and their relative positions persisted during this period. Very few guttae disappeared, and the emergence of many new guttae was observed. Determination of the area with confluent guttae was used to quantify disease stage