Fuchs' Endothelial and Myotonic Dystrophies: Corneal Dystrophy in Myotonic Patients.

We read with great interest the article by Mootha et al. concerning a possible correlation between Fuchs’ endothelial corneal dystrophy (FECD) and myotonic dystrophy (MD). We thank the authors because, among the studies we made trying to understand the reason of low intraocular pressure in patients with MD, they cited one study we published in 2010 where we examined the endothelial cells characteristics in these patients. In this study, we found the endothelial cells characteristics to be normal, and we found no patients with FECD. Mootha et al. found 46% of their myotonic dystrophy type 1 (DM1) patients affected by FECD and suggested that this difference could be due to the different age of the patients we examined. In fact, our patients presented a mean age of 38 13.3 (SD) years, whereas they screened DM1 subjects over the age of 40 years because FECD is a disease of middle age. This could be a correct explanation, but none of our patients older than 40 presented with FECD, and their hypothesis contradicts the paper of Heringer et al. that reported two MD patients; one patient was 26 year old. It may not be the age, but the severity of the disease or a subset of this disease that was not present in our patients, that could be another explanation for FECD.