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Purpose <p>To investigate the association between subjective symptoms and severity in patients with Fuchs endothelial corneal dystrophy (FECD).</p> Study design <p>Observational case series.</p> Methods <p>This study included patients with FECD registered in the Japanese National FECD registry with recorded subjective symptoms, including morning blur, ocular pain, visual disturbance, and glare. Severity assessments included central corneal thickness (CCT) and modified Krachmer grading using the more severely affected eye with greater CCT for each patient. The area under the curve (AUC) was used to evaluate the predictive ability of subjective symptoms based on disease severity.</p> Results <p>This study included 137 cases (mean age: 69±11 years; men, n=32) with subjective symptom records. The threshold values of CCT for predicting subjective symptoms based on the Youden index were 623 µm for morning blur compared to that at night (AUC, 0.76), 653 µm for ocular pain (AUC, 0.79), 623 µm for visual disturbance (AUC, 0.69), and 581 µm for glare (AUC, 0.60). The threshold values of the modified Krachmer grading for predicting subjective symptoms were grade 5 for morning blur compared to that at night (AUC, 0.85), and grade 6 for ocular pain (AUC, 0.79), grade 5 for visual disturbance (AUC, 0.72), and grade 4 for glare (AUC, 0.70).</p> Conclusion <p>The predictive ability of subjective symptoms based on disease severity in patients with FECD was relatively high using the modified Krachmer grading. The severity threshold for each subjective symptom was considered helpful in deciding on interventional treatment.</p>

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Association between subjective symptoms and severity in patients with Fuchs endothelial corneal dystrophy

  • 期刊论文

  • 发表日期：

    2026年7月3日

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  • Yo Koizumi,
  • Yoshinori Oie,
  • Sayo Maeno,
  • Nozomi Nishida,
  • Chifune Kai,
  • Rei Kamuro,
  • Kazunori Miyata,
  • Hideaki Yokogawa,
  • Natsuko Mori,
  • Akira Kobayashi,
  • Hideki Fukuoka,
  • Chie Sotozono,
  • Masakazu Yamada,
  • Takahiko Hayashi,
  • Takefumi Yamaguchi,
  • Atsushi Shiraishi,
  • Satoru Nakatani,
  • Masahiro Yamaguchi,
  • Tomohiko Usui,
  • Masatoshi Hirayama,
  • Ryo Kawasaki,
  • Kohji Nishida

摘要

Purpose

To investigate the association between subjective symptoms and severity in patients with Fuchs endothelial corneal dystrophy (FECD).

Study design

Observational case series.

Methods

This study included patients with FECD registered in the Japanese National FECD registry with recorded subjective symptoms, including morning blur, ocular pain, visual disturbance, and glare. Severity assessments included central corneal thickness (CCT) and modified Krachmer grading using the more severely affected eye with greater CCT for each patient. The area under the curve (AUC) was used to evaluate the predictive ability of subjective symptoms based on disease severity.

Results

This study included 137 cases (mean age: 69±11 years; men, n=32) with subjective symptom records. The threshold values of CCT for predicting subjective symptoms based on the Youden index were 623 µm for morning blur compared to that at night (AUC, 0.76), 653 µm for ocular pain (AUC, 0.79), 623 µm for visual disturbance (AUC, 0.69), and 581 µm for glare (AUC, 0.60). The threshold values of the modified Krachmer grading for predicting subjective symptoms were grade 5 for morning blur compared to that at night (AUC, 0.85), and grade 6 for ocular pain (AUC, 0.79), grade 5 for visual disturbance (AUC, 0.72), and grade 4 for glare (AUC, 0.70).

Conclusion

The predictive ability of subjective symptoms based on disease severity in patients with FECD was relatively high using the modified Krachmer grading. The severity threshold for each subjective symptom was considered helpful in deciding on interventional treatment.