Clinical and Specular microscopy characteristics and corelation in Iridocorneal endothelial syndrome without corneal edema

Abstract

ABSTRACT Purpose To investigate endothelial imaging patterns in ICE syndrome and correlate these with the observed clinical features in the affected eye. Methods Of the 70 patients of ICE syndrome referred from the glaucoma clinic between 2017 and 18, 17 patients had a clear cornea for reliable endothelial imaging were included in the study. Results Mean age was 47(range 29–63) years; 9 males and 8 females. The right eye was involved in 10 and left eye in 7 patients. Mean best corrected visual acuity was 20/30 (20/20-20/80) in the affected eye. All 17 patients had clear and compact central cornea and reasonably good vision at the time of specular microscopy. Those with best corrected visual acuity <20/20 had cataract as a co-morbidity. Endothelial abnormalities were noted in all patients and were documented using Hirst and modified Sherrard’s classification system. As per the modified Sherrard’s classification system, 9 eyes were categorised into total ICE, 5 eyes into subtotal ICE, in 3 eyes grading could not be applied. Of the 4 subtotal ICE, 1 was subtotal ICE (+) and 3 were subtotal ICE (-). 12/17 patients had glaucomatous disc. Conclusions Specular microscopy provides information on the various morphological pattern of endothelial abnormalities and helps in mapping out the areas with abnormal/diseased endothelium. These have implications in the management of ICE syndrome.