Age-Related Changes in Endothelial Cell Density of the Central and Peripheral Corneal Endothelium

PURPOSE: To determine peripheral corneal endothelial cell density (ECD) changes with age compared with central ECD changes. METHODS: Seventy-five phakic subjects with normal corneas were stratified prospectively into 3 age groups (20-39, 40-59, and 60-79 years, n = 25/group). Specular microscopic images were captured of the central, mid-peripheral, and peripheral cornea (3, 4, and 4.5 mm from the center, with 6, 4, and 2 targets, respective to the diameter). ECD was graded by 2 image analysts from a reading center at all locations with adjudication if ECD differed between the 2 graders >5%. RESULTS: Central, mid-peripheral, and peripheral mean ECD decreased significantly with age. Central mean ECD decreased by 83 cells/mm 2 per decade ( P = 0.008). Mid-peripheral to peripheral mean ECD decreased by 86, 92, and 83 cells/mm 2 at 3, 4, and 4.5 mm from the center, respectively, per decade increase in age ( P = 0.003, 0.002, and 0.006, respectively). Estimated mean ECD differences by location for all participants showed an increase in ECD at 3 mm compared with the center and 4.5 mm (ECD greater by 91 and 102 cells/mm 2 , P 's < 0.001, respectively), as well as ECD at 4 mm compared with the center and 4.5 mm (ECD greater by 80 and 91 cells/mm 2 , P = 0.003 and <0.001, respectively). CONCLUSIONS: Central, mid-peripheral, and peripheral corneal ECD decreases significantly with age. There appears to be higher ECDs at 3 mm and 4 mm from the center, varying with age. These normative data could be useful in evaluating peripheral endothelial changes longitudinally in endothelial disease and surgery.