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Corneal guttata

MedGen UID:
488833
Concept ID:
C0271288
Finding
Synonyms: Cornea guttata; Corneal guttae
SNOMED CT: Corneal guttata (373424008); Nodular deposits in Descemet's membrane (373424008)
 
HPO: HP:0012038

Definition

Corneal guttata are droplet-like accumulations of non-banded collagen on the posterior surface of Descemet's membrane. The presence of focal thickenings of Descemet's membrane histologically named guttae. Cornea guttata can be easily diagnosed in vivo and ex vivo by means of specular microscopy as it gives dark areas where no endothelial cells are visible. [from HPO]

Conditions with this feature

Posterior polymorphous corneal dystrophy 3
MedGen UID:
322978
Concept ID:
C1836724
Disease or Syndrome
Posterior polymorphous corneal dystrophy-3 (PPCD3) is a rare disorder involving metaplasia and overgrowth of corneal endothelial cells (Krafchak et al., 2005). In patients with PPCD, these cells manifest in an epithelial morphology and gene expression pattern, produce an aberrant basement membrane, and sometimes spread over the iris and nearby structures in a way that increases the risk for glaucoma. Symptoms range from very aggressive to asymptomatic and nonprogressive, even within the same family. The age of diagnosis is most often in the second or third decade of life. PPCD3 is often associated with corneal steepening, and some patients may be diagnosed with keratoconus before PPCD (Fernandez-Gutierrez et al., 2023). Retrocorneal membranes have been reported, sometimes extending onto the lens (Moroi et al., 2003). For a discussion of genetic heterogeneity of posterior polymorphous corneal dystrophy, see PPCD1 (122000).
Corneal dystrophy, Fuchs endothelial, 1
MedGen UID:
338172
Concept ID:
C1850959
Disease or Syndrome
Fuchs endothelial corneal dystrophy (FECD) is a progressive, bilateral condition characterized by dysfunction of the corneal epithelium, leading to reduced vision. The prevalence of FECD has been estimated at about 5% among persons over the age of 40 years in the United States. The vision loss in patients with FECD results from a loss of corneal transparency associated with irregularity of inner corneal layers in early disease and edema of the cornea in advanced disease. Ultrastructural features of FECD include loss and attenuation of endothelial cells, with thickening and excrescences of the underlying basement membrane. These excrescences, called guttae, are the clinical hallmark of FECD and become more numerous with progression of the disease. As the endothelial layer develops confluent guttae in the central cornea, the cells are no longer able to keep the cornea dehydrated and clear (summary by Baratz et al., 2010). Genetic Heterogeneity of Fuchs Endothelial Corneal Dystrophy More common, late-onset forms of FECD have been shown to be caused by mutation in the SLC4A11 gene (610206) on chromosome 20p13 (FECD4; 613268), in the ZEB1 gene (189909) on chromosome 10p11.2 (FECD6; 613270), and in the AGBL1 gene (615496) on chromosome 15q25 (FECD8; 615523). Other loci for late-onset FECD have been identified on chromosomes 13pter-q12.13 (FECD2; 610158), 18q21.2-q21.32 (FECD3; 613267), 5q33.1-q35.2 (FECD5; 613269), and 9p (FECD7; 613271).
Corneal dystrophy, fuchs endothelial, 2
MedGen UID:
347552
Concept ID:
C1857800
Disease or Syndrome
Late-onset Fuchs endothelial corneal dystrophy (FECD) is a degenerative disorder affecting roughly 4% of the population older than 40 years. It is distinguished from other corneal disorders by the progressive formation of guttae, which are microscopic refractile excrescences of the Descemet membrane, a collagen-rich basal lamina secreted by the corneal endothelium. From onset, it usually takes 2 decades for FECD to impair endothelial cell function seriously, leading to stromal edema and impaired vision (Sundin et al., 2006). For a discussion of genetic heterogeneity of Fuchs endothelial corneal dystrophy, see FECD1 (136800).
Snowflake vitreoretinal degeneration
MedGen UID:
395476
Concept ID:
C1860405
Disease or Syndrome
The appearance of yellow/white crystalline-like (hence the name) spots in the retina and thickening of the peripheral part of the vitreous.
Corneal dystrophy, Fuchs endothelial, 6
MedGen UID:
442478
Concept ID:
C2750448
Disease or Syndrome
Fuchs endothelial corneal dystrophy (FECD) is the most common genetic disorder of the corneal endothelium. Late-onset FECD is marked by thickening of Descemets membrane and excrescences, called guttae, that typically appear in the fourth or fifth decade. Disease progression results in decreased visual acuity as a result of increasing corneal edema, and end-stage disease is marked by painful epithelial bullae (summary by Riazuddin et al., 2013). Patients with keratoconus have been observed (Lechner et al., 2013). For a discussion of genetic heterogeneity of Fuchs endothelial corneal dystrophy, see FECD1 (136800).
Corneal dystrophy, Fuchs endothelial, 4
MedGen UID:
413309
Concept ID:
C2750450
Disease or Syndrome
Fuchs endothelial corneal dystrophy (FECD) is the most common genetic disorder of the corneal endothelium. Late-onset FECD is marked by thickening of Descemets membrane and excrescences, called guttae, that typically appear in the fourth or fifth decade. Disease progression results in decreased visual acuity as a result of increasing corneal edema, and end-stage disease is marked by painful epithelial bullae (summary by Riazuddin et al., 2013). For a discussion of genetic heterogeneity of Fuchs endothelial corneal dystrophy, see FECD1 (136800).
Corneal dystrophy, Fuchs endothelial, 3
MedGen UID:
442479
Concept ID:
C2750451
Disease or Syndrome
Late-onset Fuchs endothelial corneal dystrophy (FECD) is a degenerative disorder affecting roughly 4% of the population older than 40 years. It is distinguished from other corneal disorders by the progressive formation of guttae, which are microscopic refractile excrescences of the Descemet membrane, a collagen-rich basal lamina secreted by the corneal endothelium. From onset, it usually takes 2 decades for FECD to impair endothelial cell function seriously, leading to stromal edema and impaired vision (Sundin et al., 2006). For a discussion of genetic heterogeneity of Fuchs endothelial corneal dystrophy, see FECD1 (136800).
Corneal dystrophy, Fuchs endothelial, 8
MedGen UID:
816128
Concept ID:
C3809798
Disease or Syndrome
Fuchs endothelial corneal dystrophy (FECD) is the most common genetic disorder of the corneal endothelium. Late-onset FECD is marked by thickening of Descemets membrane and excrescences, called guttae, that typically appear in the fourth or fifth decade. Disease progression results in decreased visual acuity as a result of increasing corneal edema, and end-stage disease is marked by painful epithelial bullae (summary by Riazuddin et al., 2013). For a discussion of genetic heterogeneity of FECD, see FECD1 (136800).

Professional guidelines

Recent clinical studies

Etiology

Mutwaly RF, Alrasheed SH, Elmadina AEM, Aldakhil S
J Med Life 2023 Dec;16(12):1808-1812. doi: 10.25122/jml-2023-0251. PMID: 38585539Free PMC Article
Maier PC, Reinhard T
Klin Monbl Augenheilkd 2022 Jun;239(6):767-774. Epub 2022 Apr 14 doi: 10.1055/a-1756-5199. PMID: 35426114
Viberg A, Byström B
J Cataract Refract Surg 2021 Mar 1;47(3):358-365. doi: 10.1097/j.jcrs.0000000000000451. PMID: 33086292
Viberg A, Samolov B, Claesson Armitage M, Behndig A, Byström B
J Cataract Refract Surg 2020 Jul;46(7):961-966. doi: 10.1097/j.jcrs.0000000000000207. PMID: 32271268
Viberg A, Liv P, Behndig A, Lundström M, Byström B
J Cataract Refract Surg 2019 Jun;45(6):803-809. Epub 2019 Apr 6 doi: 10.1016/j.jcrs.2018.12.023. PMID: 30967299

Diagnosis

Ashkenazy N, Sengillo JD, Iyer PG, Negron CI, Yannuzzi NA, Berrocal AM
Ophthalmic Genet 2023 Oct;44(5):505-508. Epub 2022 Nov 28 doi: 10.1080/13816810.2022.2149816. PMID: 36440807
Maier PC, Reinhard T
Klin Monbl Augenheilkd 2022 Jun;239(6):767-774. Epub 2022 Apr 14 doi: 10.1055/a-1756-5199. PMID: 35426114
Fram NR, Bedrood S, Durr GM, Liaboe CA, Samuelson TW, Shah M, McCabe C
J Cataract Refract Surg 2022 Feb 1;48(2):254. doi: 10.1097/j.jcrs.0000000000000882. PMID: 35082239
Giasson CJ, Solomon LD, Polse KA
Ophthalmology 2007 Aug;114(8):1469-75. Epub 2007 May 15 doi: 10.1016/j.ophtha.2006.11.022. PMID: 17507098
Jackson AJ, Robinson FO, Frazer DG, Archer DB
Eye (Lond) 1999 Dec;13 ( Pt 6):737-43. doi: 10.1038/eye.1999.219. PMID: 10707136

Therapy

Ventura BV, Silvestre F, Lima NC, Ventura MC
J Refract Surg 2021 Jul;37(7):466-471. Epub 2021 Jul 1 doi: 10.3928/1081597X-20210406-01. PMID: 34236908
Viberg A, Samolov B, Claesson Armitage M, Behndig A, Byström B
J Cataract Refract Surg 2020 Jul;46(7):961-966. doi: 10.1097/j.jcrs.0000000000000207. PMID: 32271268
Vroman DT, Solomon KD, Holzer MP, Peng Q, Apple DJ, Bowie EM
J Cataract Refract Surg 2002 Nov;28(11):2045-9. doi: 10.1016/s0886-3350(01)01352-9. PMID: 12457684
Wilhelmus KR
Ophthalmic Surg 1992 Aug;23(8):533-7. PMID: 1508483
Carden RG
Am J Optom Physiol Opt 1978 Sep;55(9):642-6. doi: 10.1097/00006324-197809000-00006. PMID: 369377

Prognosis

Schönit S, Maamri A, Zemova E, Munteanu C, Safi T, Daas L, Seitz B
Cornea 2022 Dec 1;41(12):1495-1502. Epub 2022 Feb 2 doi: 10.1097/ICO.0000000000002971. PMID: 35696636
Maier PC, Reinhard T
Klin Monbl Augenheilkd 2022 Jun;239(6):767-774. Epub 2022 Apr 14 doi: 10.1055/a-1756-5199. PMID: 35426114
Viberg A, Byström B
J Cataract Refract Surg 2021 Mar 1;47(3):358-365. doi: 10.1097/j.jcrs.0000000000000451. PMID: 33086292
Viberg A, Samolov B, Claesson Armitage M, Behndig A, Byström B
J Cataract Refract Surg 2020 Jul;46(7):961-966. doi: 10.1097/j.jcrs.0000000000000207. PMID: 32271268
Jackson AJ, Robinson FO, Frazer DG, Archer DB
Eye (Lond) 1999 Dec;13 ( Pt 6):737-43. doi: 10.1038/eye.1999.219. PMID: 10707136

Clinical prediction guides

Mutwaly RF, Alrasheed SH, Elmadina AEM, Aldakhil S
J Med Life 2023 Dec;16(12):1808-1812. doi: 10.25122/jml-2023-0251. PMID: 38585539Free PMC Article
Barrera-Sanchez M, Hernandez-Camarena JC, Ruiz-Lozano RE, Valdez-Garcia JE, Rodriguez-Garcia A
Int Ophthalmol 2022 Apr;42(4):1299-1309. Epub 2021 Nov 7 doi: 10.1007/s10792-021-02117-0. PMID: 34743257
Viberg A, Liv P, Behndig A, Lundström M, Byström B
J Cataract Refract Surg 2019 Jun;45(6):803-809. Epub 2019 Apr 6 doi: 10.1016/j.jcrs.2018.12.023. PMID: 30967299
Giasson CJ, Solomon LD, Polse KA
Ophthalmology 2007 Aug;114(8):1469-75. Epub 2007 May 15 doi: 10.1016/j.ophtha.2006.11.022. PMID: 17507098
Jackson AJ, Robinson FO, Frazer DG, Archer DB
Eye (Lond) 1999 Dec;13 ( Pt 6):737-43. doi: 10.1038/eye.1999.219. PMID: 10707136

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