Descemet membrane (DM) fold, Causes, treatment, vogts striae

What is descemet membrane ?

Descemet's membrane (Descemet membrane) is the basement membrane that lies between the corneal stroma, and the endothelial layer of the cornea. It is composed of different kinds of collagen than the stroma.

Descemet membrane is the basement membrane of the corneal endothelium and measures approximately 3 μm in thickness in children, gradually thickening to 10 μm in adults.

What is the function of corneal descemet membrane layer ?

Descemet's membrane of cornea plays an important role in corneal structure and homeostasis, as well as in the maintenance of the corneal transparency. 

Descemet's membrane act as strong bond for endothelium to the cornea, while simultaneously allowing the entry of nutrients and macromolecules into the corneal stroma.

Descemet's membrane contributes to corneal integrity that is critical to corneal hydration and transparency 

What is DM fold ?

Descemet membrane means the Presence of folds in the Descemet membrane, which is the basement membrane of the endothelial (inner) cell layer of the cornea. 

Descemet membrane folds are generally a manifestation of inflammation or edema of the cornea.

What are the causes of Corneal descemet membrane fold ?

Descemet folds are due to corneal edema endothelial dysfunction from infections, from infiltrations, or following surgery. 

Descemet folds also are associated with corneal inflammation due to infections or infiltrations or cataract surgery.

What are the symptoms of DM fold of cornea ?

Pain - External-type pain alleviated by topical anesthesia

Blurry vision - Mild to moderate if only stromal edema; moderate to severe if epithelial edema too; can severely affect vision

Foreign body sensation – External symptoms alleviated by topical anesthetic

Tearing due to external symptoms

Eyelid swelling if corneal edema is severe

How to treat corneal descemet membrane fold ?

Medical treatment of Descemet membrane folds requires the treatment of the underlying cause of ocular inflammation.

This includes topical steroidal, nonsteroidal, and osmotic agents, as well as topical antibiotics, as needed, for ocular infection.

What is vogts striae line in cornea of eye ?

Vogt's striae are vertical lines in the posterior stroma of Descemet's membrane of the cornea. They disappear with pressure applied to the cornea. Vogt's striae have been reported to be horizontal in only two cases in the literature. Vogt's striae are a feature of keratoconus, but they are also found in healthy eyes

DM fold associated with cataract surgery

DM fold occurs after cataract surgery or any other eye surgery becouse the handling of tissue and Grade of cataract or hardness or size of nucleous.

In hypermature cataract Surgery comes more descemet membrane fold

History of Fuchs dystrophy to the cataract surgery is by far the most common risk factor for corneal swelling after cataract surgery. Other eye surgeries such as glaucoma surgery or retinal surgery, eye trauma, also increase the risk of corneal swelling after cataract surgery.