Prediction of corneal graft rejection using central endothelium/Descemet’s membrane complex thickness in high-risk corneal transplants

To determine whether measurements of Endothelium/Descemet complex thickness (En/DMT) are of predictive value for corneal graft rejection after high-risk corneal transplantation, we conducted this prospective, single-center, observational case series including sixty eyes (60 patients) at high risk fo...

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Autores principales: Eleiwa, Taher, Elsawy, Amr, Ozcan, Eyup, Chase, Collin, Feuer, William, Yoo, Sonia H., Perez, Victor L., Abou Shousha, Mohamed F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8282599/
https://www.ncbi.nlm.nih.gov/pubmed/34267265
http://dx.doi.org/10.1038/s41598-021-93892-4
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author Eleiwa, Taher
Elsawy, Amr
Ozcan, Eyup
Chase, Collin
Feuer, William
Yoo, Sonia H.
Perez, Victor L.
Abou Shousha, Mohamed F.
author_facet Eleiwa, Taher
Elsawy, Amr
Ozcan, Eyup
Chase, Collin
Feuer, William
Yoo, Sonia H.
Perez, Victor L.
Abou Shousha, Mohamed F.
author_sort Eleiwa, Taher
collection PubMed
description To determine whether measurements of Endothelium/Descemet complex thickness (En/DMT) are of predictive value for corneal graft rejection after high-risk corneal transplantation, we conducted this prospective, single-center, observational case series including sixty eyes (60 patients) at high risk for corneal graft rejection (GR) because of previous immunologic graft failure or having at least two quadrants of stromal vascularization. Patients underwent corneal transplant. At 1st, 3rd, 6th, 9th, and 12th postoperative month, HD-OCT imaging of the cornea was performed, and the corneal status was determined clinically at each visit by a masked cornea specialist. Custom-built segmentation tomography algorithm was used to measure the central En/DMT. Relationships between baseline factors and En/DMT were explored. Time dependent covariate Cox survival regression was used to assess the effect of post-operative En/DMT changes during follow up. A longitudinal repeated measures model was used to assess the relationship between En/DMT and graft status. Outcome measures included graft rejection, central Endothelium/Descemet’s complex thickness, and central corneal thickness (CCT). In patients with GR (35%), the central En/DMT increased significantly 5.3 months (95% CI: 2, 11) prior to the clinical diagnosis of GR, while it remained stable in patients without GR. During the 1-year follow up, the rejected grafts have higher mean pre-rejection En/DMTs (p = 0.01), compared to CCTs (p = 0.7). For En/DMT ≥ 18 µm cut-off (at any pre-rejection visit), the Cox proportional hazard ratio was 6.89 (95% CI: 2.03, 23.4; p = 0.002), and it increased to 9.91 (95% CI: 3.32, 29.6; p < 0.001) with a ≥ 19 µm cut-off. In high-risk corneal transplants, the increase in En/DMT allowed predicting rejection prior to the clinical diagnosis.
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spelling pubmed-82825992021-07-19 Prediction of corneal graft rejection using central endothelium/Descemet’s membrane complex thickness in high-risk corneal transplants Eleiwa, Taher Elsawy, Amr Ozcan, Eyup Chase, Collin Feuer, William Yoo, Sonia H. Perez, Victor L. Abou Shousha, Mohamed F. Sci Rep Article To determine whether measurements of Endothelium/Descemet complex thickness (En/DMT) are of predictive value for corneal graft rejection after high-risk corneal transplantation, we conducted this prospective, single-center, observational case series including sixty eyes (60 patients) at high risk for corneal graft rejection (GR) because of previous immunologic graft failure or having at least two quadrants of stromal vascularization. Patients underwent corneal transplant. At 1st, 3rd, 6th, 9th, and 12th postoperative month, HD-OCT imaging of the cornea was performed, and the corneal status was determined clinically at each visit by a masked cornea specialist. Custom-built segmentation tomography algorithm was used to measure the central En/DMT. Relationships between baseline factors and En/DMT were explored. Time dependent covariate Cox survival regression was used to assess the effect of post-operative En/DMT changes during follow up. A longitudinal repeated measures model was used to assess the relationship between En/DMT and graft status. Outcome measures included graft rejection, central Endothelium/Descemet’s complex thickness, and central corneal thickness (CCT). In patients with GR (35%), the central En/DMT increased significantly 5.3 months (95% CI: 2, 11) prior to the clinical diagnosis of GR, while it remained stable in patients without GR. During the 1-year follow up, the rejected grafts have higher mean pre-rejection En/DMTs (p = 0.01), compared to CCTs (p = 0.7). For En/DMT ≥ 18 µm cut-off (at any pre-rejection visit), the Cox proportional hazard ratio was 6.89 (95% CI: 2.03, 23.4; p = 0.002), and it increased to 9.91 (95% CI: 3.32, 29.6; p < 0.001) with a ≥ 19 µm cut-off. In high-risk corneal transplants, the increase in En/DMT allowed predicting rejection prior to the clinical diagnosis. Nature Publishing Group UK 2021-07-15 /pmc/articles/PMC8282599/ /pubmed/34267265 http://dx.doi.org/10.1038/s41598-021-93892-4 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Eleiwa, Taher
Elsawy, Amr
Ozcan, Eyup
Chase, Collin
Feuer, William
Yoo, Sonia H.
Perez, Victor L.
Abou Shousha, Mohamed F.
Prediction of corneal graft rejection using central endothelium/Descemet’s membrane complex thickness in high-risk corneal transplants
title Prediction of corneal graft rejection using central endothelium/Descemet’s membrane complex thickness in high-risk corneal transplants
title_full Prediction of corneal graft rejection using central endothelium/Descemet’s membrane complex thickness in high-risk corneal transplants
title_fullStr Prediction of corneal graft rejection using central endothelium/Descemet’s membrane complex thickness in high-risk corneal transplants
title_full_unstemmed Prediction of corneal graft rejection using central endothelium/Descemet’s membrane complex thickness in high-risk corneal transplants
title_short Prediction of corneal graft rejection using central endothelium/Descemet’s membrane complex thickness in high-risk corneal transplants
title_sort prediction of corneal graft rejection using central endothelium/descemet’s membrane complex thickness in high-risk corneal transplants
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8282599/
https://www.ncbi.nlm.nih.gov/pubmed/34267265
http://dx.doi.org/10.1038/s41598-021-93892-4
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