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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
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Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I have recently been diagnosed with Fuchs Dystrophy. Im trying

Customer Question

<p>I have recently been diagnosed with Fuchs Dystrophy. I'm trying to understand the results of the many tests that have been done. The doctor gave me the forms from Konan Medical. What is the "num-4 cells" refer to? Mine are 4, then 10 on another report. What is normal for a 68 yr old? I understand the Pachy significance-thickness of cornea, right? What are the norms of the CD, CV, Hex percentage, AVE, MAX, MIN and SD and what to they refer to? Trying to understand the report. The doctor has an incredibly busy cataract practice, so not much time to explain things. But it's important for me to be a real participant in all of this.</p><p>PS-I've already paid $24 for the month.</p>
Submitted: 3 years ago.
Category: Eye
Expert:  Dr. Rick replied 3 years ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

Is it possible for you to scan your report into your computer? If so you can upload it to me using the following link. When you scan the report save it as a jpeg:

Dr. Rick :

Save your picture on your computer, someplace easy to find it such as your desktop.


Go to www.tinypic.com


Upload your picture to the site tinypic.com by browsing for it as directed.


Once you do that it gives you a bunch of links you can use, one of which says "direct link for layouts" It is important to use this box. It is the forth one down from the top of the page.


Copy the link inside this box and then paste it into your justanswer dialog box and send it to your expert.


 

Dr. Rick :

If you can't upload it then we can go over what data you have as best as possible.

Expert:  Dr. Rick replied 3 years ago.
I am still here and available to answer your question. The Q&A system works better then the chat system for uploading documents etc....this system is a lot like "text messaging"
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 8486
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Customer: replied 3 years ago.

http://i53.tinypic.com/2a9yyiq.jpg

 

Here's the information for Dr Rick.

 

Carol Clement

Expert:  Dr. Rick replied 3 years ago.
Hi. I'm out of town until late Wednesday pm. I can't see the picture very well on my laptop. Would it be ok if I contact you back tomorrow or early Thurs after I've had a chance to print out your data so my old eyes can read it? :)

Just because you paid me already doesn't mean I'm gonna go away before this question is answered......
Customer: replied 3 years ago.

That works fine for me. I'll check on Thurs for updates.

 

Appreciate your help.

Expert:  Dr. Rick replied 3 years ago.
ok, thanks
Expert:  Dr. Rick replied 3 years ago.
Hi. I'm back. Let's review your scan. I'll go through the list in order:

CD: This is cell density. This is the number of endothelial cells (the "pumps" that keep your cornea clear) per cubic mm. This number varies normally with age and can also be lowered by infection, trauma, disease, surgery, etc. For ages 60-69 years old the "normal" is between 2,000 and 2,800. As you can see, your number is much lower then this (812).

CV: This is coefficient of variation. CV is a measure of polymegethism. This is how endothelial cells normally repair wounds and, as such, it is an indirect measure of prior injury and disease. "normal" for this number is 22-31. You are slightly over this number which means your endothelial cells have had to "repair" damage more then "normal" (normal is in quotes as it is hard to define normal in this instance....it is more of a statistical measurement then a state of being....)

Hex: Endothelial cells are normally hexagonal in shape. If this percentage is low, that means more cells are damaged. Pleomorphism is a measurement of this damage and this measurement (hex) gives an indication of the amount of pleomorphism present. If Hex is less then 50% you would be at a higher risk for corneal decompensation after surgery.

I have no idea what NLM is :(

Pachy: This is the measurement of how thick your cornea is. Normal thickness was, historically, thought to be 550 microns. In the last decade the Ocular Hypertension Treatment Study (OHTS) determined that the mean (normal) corneal thickness in the population was 573 microns. Using these data, you cornea would be considered to be of slightly thin thickness at 511. Thin is good, in your case, as Fuch's causes the cornea to get thick as the disease progresses.

AVE: This is the average number of endothelial cells per micrometer. Normal for your age is between 2,000 and 2,800. Yours is low which means you have lost a number of endothelial cells. And, no, you do not grow new ones....you are born with all the endothelial cells you will ever have.

Max: the maximum number of endothelial cells per micrometer

Min: the minimum number of endothelial cells per micrometer.

SD: the standard deviation the above average/maximum/minimum numbers above. This is a statistical thing :)

I also looked at the pictures. They are not that great since they have been printed, scanned and then printed again. I can, however, tell you that I see evidence of stage 4 or 5 corneal guttata. This is consistent with your diagnosis of Fuch's.

Ok. Well, that is what the scan shows. The bottom line? You have fuch's and when, or if, you ever need cataract surgery, special care will have to be taken to prevent damage to your endothelial cells.

I hope this has been helpful. Sorry for the delay.

Let me know if there is anything else I can add to our discussion. Take care.

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Dr. Rick
Dr. Rick
Ophthalmologist & Retina Specialist
5440 Satisfied Customers
Ophthalmology since 1994 with Retina sub-specialty interest