Fuchs’ endothelial dystrophy is a progressive disease resulting in clouding of the cornea and eventual reduction in vision. It affects the corneal endothelial cells which are a specialized single layer of cells on the back surface of the cornea that pump water out of it. When healthy, this keeps the cornea thin and clear.
Endothelial cells do not have the ability to regenerate and hence if they are damaged the cornea gradually begins to swell with water, making it hazy and leading to loss of vision.
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A healthy cornea is clear and bright, however, in advanced Fuchs’ dystrophy, the cornea can become hazy and dull due to swelling which affects your quality of vision. Typical symptoms include:
While early signs of Fuchs’ dystrophy can be detected by an eye surgeon even in patients in their thirties, it is relatively uncommon for patients to become symptomatic and require surgery until they are in their fifties.
Some reduction in endothelial cells is normal and happens because of ageing. A baby is born with roughly 4000 endothelial cells per square millimetre, whilst an 80-year-old without Fuchs’ dystrophy has an endothelial cell count usually between 1500-2500 per square millimetre. The cornea remains clear even up to around 800 cells per square millimetre. However, in a patient with Fuchs’ there is an accelerated rate of cell loss, such that a 50 years old may have less than 500 cells per square millimetre.
In addition, endothelial cells in Fuchs’ patients are abnormal and can accumulate abnormal proteins resulting in small bumps on the back of the cornea called guttata.
Fuchs’ dystrophy occurs as a result of abnormal genes that affect the function of endothelial cells, not all of these are well understood yet. Whilst Fuchs’ can be expressed by different generations of the same family, it can also commonly occur sporadically where there is no previous family history. Inheritance of the Fuchs’ gene is also variable and the fact that you have Fuchs’ doesn’t always mean that your offspring will express Fuchs’ endothelial dystrophy.
The below factors can also contribute to your Glaucoma progression.
Neuroprotection therapy helps protect neurons in your eye from injury such as from eye pressure elevations. Neurotrophins helps to provide the required neuroprotective therapy which prevents from death of the ganglion cells in your eyes.
Vascular dysregulation means that blood flow is not properly flowing. This causes reduced and unstable oxygen supply to the tissues in the eyes. This in turn causes a cacade of events causing glaucomatous optic neuropathy.
Oxidative stress damage is an important factor in development of glaucoma, which triggers trabecular meshwork degeneration, which then leads to intraocular hypertension. Different studies provide cumulating evidence, which supports the association of oxidative stress with different aspects of the neurodegenerative process happening in glaucoma.
Glaucoma is associated with toxic inflammatory factors leading to cell death and disease progression. Trabecular meshwork dysfunction is likely mediated by oxidative stress and inflammatory responses. Ocular surface inflammation may compromise the cornea, conjunctiva and the trabecular meshwork.
Excitotoxicity is increased levels of glutamate and is seen in Glaucoma patients which cause
retinal ganglion cell (RGC) death. If the toxic effects of glutamate aren't blocked, RGC loss can continue, leading to further visual impairment.
Netra Restoration Therapy provides the following benefits for patients with Glaucoma.
The level of loss of nerve fiber layer and optic nerve atrophy will determine the level of the improvement seen.
Most patients start to see subjective improvements in their vision within just 7 days of starting the NRT treatment.
NRT treatment can stop Glaucoma vision loss progression or considerably reduced to preserve the remaining vision.
NRT treatment improves visual field by reinstating dormant and sub-optimally functioning retinal cells. Without treatment these cells would eventually neurodegenerate and be lost forever.
With NRT treatment most glaucoma patients have shown improvement in their visual acuity by a minimum of 1 to 2 lines in distant and near vision.
Most glaucoma patients treated with NRT treatment have shown marked improvement in their color contrast.
Most glaucoma patients treated with NRT treatment have experienced having brighter vision, a reduction in glare, and blurry/cloudy vision.