Twenty-three cases of primary cornea guttata

Purpose: To evaluate the clinical aspects of patients with primary cornea guttata and the specular microscopical findings/morphology in their corneal endothelial cells. Methods: Twenty-three patients consulting Kanazawa Medical University Hospital or related hospitals in Ishikawa or Fukui prefectures and diagnosed with primary cornea guttata by slit-lamp examination underwent an analysis of their clinical features and corneal endothelial cells. Results: Most cases were middle-aged to elderly women. None of them complained of visual impairment due to cornea guttata. The 46 eyes of these cases were included in this study. Specular microscopical findings revealed that the size and density of dark areas varied, with asymmetry noted in some cases. The parameters of the endothelial cells comprising mean cell area, the proportion of hexagonal cells, and the coefficient of variation, were almost within normal limits except for 1 eye of a 79-year-old man who was speculated to be at an early stage of Fuchs endothelial corneal dystrophy. Three cases had undergone cataract surgery, but did not show significant changes in endothelial morphology before and after surgery. In a statistical study on endothelial cell morphology, cell parameters except for minimal cell area correlated significantly with age. Although the density and size of dark areas correlated with each other, neither correlated with any of the cell parameters. Conclusion: Cornea guttata does not lead to visual impairment or abnormalities in corneal endothelial cell parameters except for a small number of cases that must be considered to be at an early stage of Fuchs dystrophy. Jpn J Ophthalmol 2001;45:93-98 (C) 2001 Japanese Ophthalmological Society.