Demographic and Clinical Factors Associated with Fuchs Endothelial Corneal Dystrophy: A Nationwide Population-Based Study

Purpose To identify demographic and clinical factors associated with Fuchs endothelial corneal dystrophy (FECD) in Israel.Methods We conducted a population-based nested case-control study using data from Israel’s largest healthcare provider covering the years 2005 to 2023. FECD patients were identified and compared with ten age and sex-matched controls per case, selected using risk-set sampling. Demographic factors and comorbidities were analyzed using conditional logistic regression.Results We identified 591 FECD patients. The mean age at diagnosis was 64.35 ± 11 years; 198 (33.5%) were male. Multivariable analysis revealed several factors significantly associated with FECD: Medium and high SES (OR = 1.308, p = 0.014) and (OR = 1.456, p = 0.017), cataract (OR = 4.836, p < 0.001), skin cancer (OR = 1.362, p = 0.01), keratoconus (OR = 4.349, p = 0.002), hypermetropia (OR = 1.839, p < 0.001), glaucoma (OR = 1.726, p = 0.003) and uveitis (OR = 3.082, p < 0.001).Conclusions This population-based study identifies several factors significantly associated with FECD, including medium and high SES, cataract, skin cancer, keratoconus, hypermetropia, glaucoma and uveitis. These findings improve understanding of the demographic and clinical context associated with FECD and inform future longitudinal and mechanistic studies.