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Harvey DH, Roberts CJ, Mahmoud AM, Nuñez FM, Ma Y, Fleming GP. Biomechanical and Vascular Metrics Between Eyes of Patients With Asymmetric Glaucoma and Symmetric Glaucoma. J Glaucoma 2024; 33:334-339. [PMID: 38194297 PMCID: PMC11052687 DOI: 10.1097/ijg.0000000000002363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/25/2023] [Indexed: 01/10/2024]
Abstract
PRCIS Corneal hysteresis (CH) and pulsatile ocular blood volume (POBV) were significantly lower in the eye with greater damage in asymmetric glaucoma, without a difference in intraocular pressure (IOP) or central corneal thickness (CCT), and no difference in elastic parameters. OBJECTIVE To compare biomechanical and vascular metrics between the eyes of patients with asymmetric glaucoma (ASYMM) and those with symmetric glaucoma (SYMM). PATIENTS AND METHODS Forty-five patients were prospectively recruited and divided into ASYMM, defined as cup-to-disc (C/D) ratio difference >0.1 between eyes and SYMM, with C/D difference ≤0.1. For ASYMM, the smaller C/D was defined as the best eye ("best") and the fellow eye was defined as the worst eye ("worse"). All metrics were subtracted as "worse" minus "best," including the viscoelastic parameter CH, and elastic parameters from the Corvis ST, including stiffness parameter at first applanation, stiffness parameter at highest concavity, integrated inverse radius, deformation amplitude ratio, IOP, CCT, mean deviation (MD), ganglion cell complex (GCC), and POBV were included. Paired t tests were performed between eyes in both groups. Statistical analyses were performed with SAS using a significance threshold of P <0.05. RESULTS For ASYMM (16 patients), "worse" showed significantly lower CH (-0.76 ± 1.22), POBV (-0.38 ± 0.305), MD (-3.66 ± 6.55), and GCC (-7.9 ± 12.2) compared with "best." No other parameters were significantly different. For SYMM (29 patients), there were no significantly different metrics between eyes. CONCLUSIONS Lower CH, POBV, GCC, and worse MD were associated with greater glaucomatous damage in asymmetric glaucoma without a difference in IOP or CCT. Lower CH and GCC are consistent with previous studies. POBV, a new clinical parameter that may indicate reduced blood flow, is also associated with greater damage.
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Affiliation(s)
| | - Cynthia J Roberts
- Ophthalmology and Visual Sciences, The Ohio State University
- Biomedical Engineering, The Ohio State University
| | - Ashraf M Mahmoud
- Ophthalmology and Visual Sciences, The Ohio State University
- Biomedical Engineering, The Ohio State University
| | | | - Yanhui Ma
- Ophthalmology and Visual Sciences, The Ohio State University
| | - Gloria P Fleming
- Ophthalmology and Visual Sciences, The Ohio State University
- Biomedical Engineering, The Ohio State University
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Coskun C, Çelik G, Zeki Fikret C, Çomçalı S, Evren Kemer Ö. Evaluation of corneal densitometry values with Pentacam in cases of ocular hypertension and pseudoexfoliative glaucoma. Photodiagnosis Photodyn Ther 2024; 46:103988. [PMID: 38368915 DOI: 10.1016/j.pdpdt.2024.103988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND Examination of corneal densitometry measurements using the Pentacam Scheimpflug imaging system in cases of pseudoexfoliative glaucoma (PEXG) and ocular hypertension (OHT). METHODS The study included 50 eyes of 29 PEXG patients, 25 eyes of 16 OHT patients, and 76 eyes of 38 healthy control subjects followed in the glaucoma clinic. Corneal densitometry values of all cases were measured using the Scheimpflug imaging system (Pentacam, Oculus, Germany). Corneal densitometry was assessed based on 4 concentric radial zones (0-2 mm, 2-6 mm, 6-10 mm, and 10-12 mm) and depths (anterior, central, posterior, and total) within the Scheimpflug imaging system. The results were statistically analyzed. RESULTS Corneal densitometry values examined between the OHT and control groups were higher in OHT and statistically significant (p < 0.05). Corneal densitometry values examined between the PEXG and control groups were higher in PEXG and statistically significant (p < 0.05). In comparison between the PEXG and OHT groups, corneal densitometry values in the central 0-2 mm, 2-6 mm, and 6-10 mm; posterior 0-2 mm and 2-6 mm radial zones were higher in PEXG and statistically significant (p < 0.05). CONCLUSIONS It was observed that elevated intraocular pressure levels in OHT cases could lead to changes in the cornea, consequently increasing corneal densitometry values. The higher corneal densitometry values in PEXG cases compared to OHT were attributed to the accumulation of pseudoexfoliative material in the cornea. Based on our study, corneal densitometry could serve as a potential biomarker for early glaucoma detection in OHT cases and could be employed to assess corneal transparency during the follow-up of PEXG cases.
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Affiliation(s)
- Cigdem Coskun
- Department of Ophthalmology, Ankara Bilkent City Hospital, Ankara, Turkey.
| | | | - Cenk Zeki Fikret
- Department of Ophthalmology, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Sebile Çomçalı
- Department of Ophthalmology, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Özlem Evren Kemer
- Department of Ophthalmology, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Turkey
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Baptista PML, Ferreira AS, Silva NP, Figueiredo ARM, Sampaio IC, Reis RVF, Ambrósio R, Menéres PMAM, Beirão JNM, Menéres MJFS. Scheimpflug-Based Corneal Biomechanical Analysis As A Predictor of Glaucoma in Eyes With High Myopia. Clin Ophthalmol 2024; 18:545-563. [PMID: 38410632 PMCID: PMC10895980 DOI: 10.2147/opth.s426635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 01/04/2024] [Indexed: 02/28/2024] Open
Abstract
Purpose To address if corneal biomechanical behavior has a predictive value for the presence of glaucomatous optical neuropathy in eyes with high myopia. Patients and Methods This observational cross-sectional study included 209 eyes from 108 consecutive patients, divided into four groups: high myopia and primary open-angle glaucoma (POAG) - HMG, n = 53; high myopia without POAG - HMNG, n = 53; non-myopic with POAG - POAG, n = 50; non-myopic and non-POAG- NMNG, n = 53. Biomechanical assessment was made through a Scheimpflug-camera-based technology. Receiver operating characteristic curves were made for the discrimination between groups. Multivariable logistic regression models were performed to address the predictive value of corneal biomechanics for the presence of glaucoma. Results Areas Under the Receiver Operating Characteristic (AUROCs) above 0.6 were found in 6 parameters applied to discriminate between HMG and HMNG and six parameters to discriminate between POAG and NMNG. The biomechanical models with the highest power of prediction for the presence of glaucoma included 5 parameters with an AUROC of 0.947 for eyes with high myopia and 6 parameters with an AUROC of 0.857 for non-myopic eyes. In the final model, including all eyes, and adjusted for the presence of high myopia, the highest power of prediction for the presence of glaucoma was achieved including eight biomechanical parameters, with an AUROC of 0.917. Conclusion Corneal biomechanics demonstrated differences in eyes with glaucoma and mainly in myopic eyes. A biomechanical model based on multivariable logistic regression analysis and adjusted for high myopia was built, with an overall probability of 91.7% for the correct prediction of glaucomatous damage.
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Affiliation(s)
- Pedro M L Baptista
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - André S Ferreira
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
- Faculdade de Medicina da Universidade do Porto, Universidade do Porto, Porto, Portugal
| | - Nisa P Silva
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Ana R M Figueiredo
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Isabel C Sampaio
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Rita V F Reis
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Renato Ambrósio
- Rio de Janeiro Corneal Tomography and Biomechanics Study Group, Rio de Janeiro, RJ, Brazil
- Department of Cornea and Refractive Surgery, Instituto de Olhos Renato Ambrósio, Rio de Janeiro, Brazil
- Department of Ophthalmology, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
- Federal University of São Paulo (UNIFESP), São Paulo, Brazil
- Brazilian Study Group of Artificial Intelligence and Corneal Analysis - BrAIN, Rio de Janeiro & Maceió, Brazil
| | - Pedro M A M Menéres
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - João N M Beirão
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Maria J F S Menéres
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
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Wu LY, Lin WP, Wu R, White L, Abass A. FEA-Based Stress-Strain Barometers as Forecasters for Corneal Refractive Power Change in Orthokeratology. Bioengineering (Basel) 2024; 11:166. [PMID: 38391654 PMCID: PMC10886155 DOI: 10.3390/bioengineering11020166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 02/24/2024] Open
Abstract
PURPOSE To improve the effectivity of patient-specific finite element analysis (FEA) to predict refractive power change (RPC) in rigid Ortho-K contact lens fitting. Novel eyelid boundary detection is introduced to the FEA model to better model the effects of the lid on lens performance, and stress and strain outcomes are investigated to identify the most effective FEA components to use in modelling. METHODS The current study utilises fully anonymised records of 249 eyes, 132 right eyes, and 117 left eyes from subjects aged 14.1 ± 4.0 years on average (range 9 to 38 years), which were selected for secondary analysis processing. A set of custom-built MATLAB codes was built to automate the process from reading Medmont E300 height and distance files to processing and displaying FEA stress and strain outcomes. Measurements from before and after contact lens wear were handled to obtain the corneal surface change in shape and power. Tangential refractive power maps were constructed from which changes in refractive power pre- and post-Ortho-K wear were determined as the refractive power change (RPC). A total of 249 patient-specific FEA with innovative eyelid boundary detection and 3D construction analyses were automatically built and run for every anterior eye and lens combination while the lens was located in its clinically detected position. Maps of four stress components: contact pressure, Mises stress, pressure, and maximum principal stress were created in addition to maximum principal logarithmic strain maps. Stress and strain components were compared to the clinical RPC maps using the two-dimensional (2D) normalised cross-correlation and structural similarity (SSIM) index measure. RESULTS On the one hand, the maximum principal logarithmic strain recorded the highest moderate 2D cross-correlation area of 8.6 ± 10.3%, and contact pressure recorded the lowest area of 6.6 ± 9%. Mises stress recorded the second highest moderate 2D cross-correlation area with 8.3 ± 10.4%. On the other hand, when the SSIM index was used to compare the areas that were most similar to the clinical RPC, maximum principal stress was the most similar, with an average strong similarity percentage area of 26.5 ± 3.3%, and contact pressure was the least strong similarity area of 10.3 ± 7.3%. Regarding the moderate similarity areas, all components were recorded at around 34.4% similarity area except the contact pressure, which was down to 32.7 ± 5.8%. CONCLUSIONS FEA is an increasingly effective tool in being able to predict the refractive outcome of Ortho-K treatment. Its accuracy depends on identifying which clinical and modelling metrics contribute to the most accurate prediction of RPC with minimal ocular complications. In terms of clinical metrics, age, Intra-ocular pressure (IOP), central corneal thickness (CCT), surface topography, lens decentration and the 3D eyelid effect are all important for effective modelling. In terms of FEA components, maximum principal stress was found to be the best FEA barometer that can be used to predict the performance of Ortho-K lenses. In contrast, contact pressure provided the worst stress performance. In terms of strain, the maximum principal logarithmic strain was an effective strain barometer.
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Affiliation(s)
- Lo-Yu Wu
- Department of Power Mechanical Engineering, Nation Tsing Hua University, Hsinchu 300, Taiwan
- Research and Development Center, Brighten Optix Corporation, Taipei 111, Taiwan
| | - Wen-Pin Lin
- Research and Development Center, Brighten Optix Corporation, Taipei 111, Taiwan
- Department of Optometry, University of Kang Ning, Taipei 114, Taiwan
| | - Richard Wu
- Research and Development Center, Brighten Optix Corporation, Taipei 111, Taiwan
- College of Optometry, Pacific University, Forest Grove, OR 97116, USA
| | - Lynn White
- Research and Development Department, LWVision, Leicester LE18 1DF, UK
| | - Ahmed Abass
- Department of Materials, Design and Manufacturing Engineering, School of Engineering, University of Liverpool, Liverpool L69 3GH, UK
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Martinez-Sánchez MI, Bolívar G, Dastiridou A, Escámez P, Teus MA. Predictive Value of Dynamic Corneal Response Parameters Evaluated with Scheimpflug High-Speed Video (Corvis ST) on the Visual Field Progression in Prostaglandin Treated Ocular Hypertension and Open-Angle Glaucoma Patients. Ophthalmol Ther 2023; 12:3177-3186. [PMID: 37733223 PMCID: PMC10640486 DOI: 10.1007/s40123-023-00810-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/31/2023] [Indexed: 09/22/2023] Open
Abstract
INTRODUCTION The aim of this work is to compare the Corvis ST stress-strain index (SSI) and highest concavity (HC) parameters at baseline and 1 month after initiating monotherapy with prostaglandin analogues (PGs) in eyes showing visual field (VF) progression or stability. METHODS In this prospective, single-center, observational study, newly diagnosed and treatment-naïve OAG patients were examined at baseline and 1 month after beginning monotherapy with topical PGs monotherapy. Goldmann applanation tonometry pressure readings, Corneal Hysteresis (ORA-CH), and the Corvis ST measurements were obtained at both visits. VF progression (Humphrey) was evaluated based on data from 6 years of follow-up after the baseline visit. Stress-strain index (SSI) and HC parameters in progressing (P) and non-progressing (NP) eyes were the main outcome measures. RESULTS Sixty-three eyes were analyzed; mean age was 64.63 ± 11.26 years; 47 eyes were NP and 16 eyes were P according to the event analysis performed by the Humphrey device. There were no significant differences in IOP, CCT, or Corvis parameters between NP and P groups at baseline. Nevertheless, at 1 month, the SSI index was 1.60 ± 0.34 vs. 1.80 ± 0.34 (p = 0.003) in NP vs. P eyes, respectively. HC parameters were different between the groups at 1 month (p < 0.05) suggesting an increased scleral rigidity in the P group. There was no significant difference in IOP between groups at 1 month. CONCLUSIONS The Corvis ST provides a corneal rigidity index (SSI) that seems to be related to VF progression when measured 1 month after initiating PGs monotherapy. Differences in HC parameters, indicative of increased scleral stiffness, are also evident at 1 month on latanoprost in the P eyes.
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Affiliation(s)
- Marta I Martinez-Sánchez
- Hospital Universitario "Principe de Asturias", Alcalá de Henares, Madrid, Spain
- Hospital Universitario "Infanta Leonor", Madrid, Spain
| | - Gema Bolívar
- Hospital Universitario "Principe de Asturias", Alcalá de Henares, Madrid, Spain
- Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - Anna Dastiridou
- Ophthalmology Department, University of Thessaly, Larissa, Greece.
| | | | - Miguel A Teus
- Hospital Universitario "Principe de Asturias", Alcalá de Henares, Madrid, Spain
- Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
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Liu M, Li N, Chen T, Tian G, Lin Y, Gao H, Shi W. Comparison of Corneal Biomechanics Treated With Femtosecond Laser-Assisted In Situ Keratomileusis and Small-Incision Lenticule Extraction by New Corneal Biomechanical Parameters of Corvis ST II. Cornea 2023; 42:1384-1390. [PMID: 36729642 DOI: 10.1097/ico.0000000000003191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 09/27/2022] [Indexed: 02/03/2023]
Abstract
PURPOSE The aim of this study was to compare corneal biomechanics treated with femtosecond laser-assisted in situ keratomileusis (FS-LASIK) and small-incision lenticule extraction (SMILE) for myopia and astigmatism using the new corneal biomechanical parameters of Corvis ST II. METHODS This was a prospective nonrandomized controlled study. Patients treated with FS-LASIK or SMILE between January 2018 and July 2018 were included. Corvis ST II was performed to measure corneal biomechanical parameters, including deformation amplitude ratio 2.0 mm (DA ratio 2.0 mm), integrated inverse radius (Integr Radius), stiffness parameter at first applanation (SP-A1), and Ambrosio relational thickness through the horizontal meridian (ARTh), preoperatively, 1 month postoperatively, and 6 months postoperatively. Pentacam pachymetry was used to assess the reduction in pachymetry. RESULTS Forty-five eyes underwent FS-LASIK, and 45 eyes underwent SMILE. The new parameters obtained by Corvis ST II between preoperative and postoperative measurements showed significant changes after FS-LASIK or SMILE (all P < 0.001). Postoperative SP-A1 significantly decreased in the 2 groups (108.88 ± 14.47-73.32 ± 13.2 in FS-LASIK and 105.79 ± 17.68-73.91 ± 14.81 in SMILE). Eyes with equal preoperative pachymetry, intraocular pressure, and spherical equivalents showed no significant differences in these new parameters measured using Corvis ST II ( all P > 0.05) between the 2 groups. The prediction of the laser platform overestimated the measured pachymetry reduction in the SMILE group (111.93 ± 15.18 μm vs. 87.16 ± 15.47 μm). CONCLUSIONS New corneal biomechanical parameters measured using Corvis ST II showed no significant differences between FS-LASIK and SMILE in eyes with homogeneous preoperative parameters. The laser software platform may have overestimated the actual corneal reduction in the eyes treated with SMILE.
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Affiliation(s)
- Mingna Liu
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China ; and
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Na Li
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China ; and
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Tong Chen
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China ; and
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Ge Tian
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China ; and
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Yue Lin
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China ; and
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Hua Gao
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China ; and
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Weiyun Shi
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China ; and
- School of Ophthalmology, Shandong First Medical University, Jinan, China
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Elhusseiny AM, Scarcelli G, Saeedi OJ. Corneal Biomechanical Measures for Glaucoma: A Clinical Approach. Bioengineering (Basel) 2023; 10:1108. [PMID: 37892838 PMCID: PMC10604716 DOI: 10.3390/bioengineering10101108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/11/2023] [Accepted: 09/14/2023] [Indexed: 10/29/2023] Open
Abstract
Over the last two decades, there has been growing interest in assessing corneal biomechanics in different diseases, such as keratoconus, glaucoma, and corneal disorders. Given the interaction and structural continuity between the cornea and sclera, evaluating corneal biomechanics may give us further insights into the pathogenesis, diagnosis, progression, and management of glaucoma. Therefore, some authorities have recommended baseline evaluations of corneal biomechanics in all glaucoma and glaucoma suspects patients. Currently, two devices (Ocular Response Analyzer and Corneal Visualization Schiempflug Technology) are commercially available for evaluating corneal biomechanics; however, each device reports different parameters, and there is a weak to moderate agreement between the reported parameters. Studies are further limited by the inclusion of glaucoma subjects taking topical prostaglandin analogues, which may alter corneal biomechanics and contribute to contradicting results, lack of proper stratification of patients, and misinterpretation of the results based on factors that are confounded by intraocular pressure changes. This review aims to summarize the recent evidence on corneal biomechanics in glaucoma patients and insights for future studies to address the current limitations of the literature studying corneal biomechanics.
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Affiliation(s)
- Abdelrahman M. Elhusseiny
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA;
- Department of Ophthalmology, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Giuliano Scarcelli
- Fischell Department of Bioengineering, University of Maryland, College Park, MD 20742, USA;
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Osamah J. Saeedi
- Fischell Department of Bioengineering, University of Maryland, College Park, MD 20742, USA;
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA
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Vinciguerra R, Ambrosio R, Wang Y, Zhang F, Zhou X, Bai J, Yu K, Chen S, Fang X, Vinciguerra P. Detection of Keratoconus With a New Corvis Biomechanical Index Optimized for Chinese Populations. Am J Ophthalmol 2023; 252:182-187. [PMID: 37059320 DOI: 10.1016/j.ajo.2023.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 04/01/2023] [Accepted: 04/05/2023] [Indexed: 04/16/2023]
Abstract
PURPOSE The aim of this study was to introduce an optimized version of the Corvis Biomechanical Index for Chinese populations (cCBI). DESIGN Retrospective, multicenter clinical validity enhancement study. METHODS Patients were included from 7 clinics in Beijing, Shenyang, Guangzhou, Shanghai, Wenzhou, Chongqing, and Tianjin, China. Logistic regression was used to optimize the values of the constants of the CBI, based on database 1 as the development dataset (6 of 7 clinics), to create a new version of the index named cCBI. The factors of the CBI (A1Velocity, ARTh, Stiffness Parameter-A, DARatio2mm, and Inverse Integrated Radius) and the cutoff value were kept the same (0.5). With the formation of cCBI determined, it was validated on database 2 (1 of the 7 clinics). RESULTS Two thousand four hundred seventy-three patients (healthy and keratoconus) were included. In database 2, the area under the curve of the cCBI was 0.985 with 93.4% specificity and 95.5% sensitivity. In the same dataset, the original CBI produced an area under the curve of 0.978 with 68.1% specificity and 97.7% sensitivity. There was a statistically significant difference between the receiver operating characteristic curve of cCBI and CBI (De Long P = .0009) CONCLUSION: The new cCBI for Chinese patients was shown to be statistically significantly better when compared with CBI to separate healthy from keratoconic eyes. The presence of an external validation dataset confirms this finding and suggests the use of cCBI in everyday clinical practice to aid in the diagnosis of keratoconus in patients who are of Chinese ethnicity.
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Affiliation(s)
| | - Renato Ambrosio
- Department of Ophthalmology (R.A.), the Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Yan Wang
- Tianjin Eye Hospital (Y.W.), Tianjin Key Laboratory of Ophthalmology and Visual Science, Nankai University Affiliated Eye Hospital; Clinical College of Ophthalmology (Y.W.), Tianjin Medical University, Tianjin, China
| | - Fengju Zhang
- Beijing Tongren Eye Center (F.Z.), Beijing Tongren Hospital, Beijing Ophthalmology and Visual Sciences Key Lab, Capital Medical University, Beijing, China
| | - Xingtao Zhou
- Eye and ENT Hospital of Fudan University (X.Z.), Shanghai, China
| | - Ji Bai
- BAI JI Ophthalmology (J.B.), Chongqing, China
| | - Keming Yu
- Zhongshan Ophthalmic Center (K.Y.), Sun Yat-Sen University, Guangzhou, China
| | - Shihao Chen
- Eye Hospital (S.C.), Wenzhou Medical University, Zhejiang, China
| | - Xuejun Fang
- Shenyang Aier Eye Hospital (X.F.), Shenyang, China
| | - Paolo Vinciguerra
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy
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Brazuna R, Alonso RS, Salomão MQ, Fernandes BF, Ambrósio R. Ocular Biomechanics and Glaucoma. Vision (Basel) 2023; 7:vision7020036. [PMID: 37218954 DOI: 10.3390/vision7020036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/11/2023] [Accepted: 04/21/2023] [Indexed: 05/24/2023] Open
Abstract
Biomechanics is a branch of biophysics that deals with mechanics applied to biology. Corneal biomechanics have an important role in managing patients with glaucoma. While evidence suggests that patients with thin and stiffer corneas have a higher risk of developing glaucoma, it also influences the accurate measurement of intraocular pressure. We reviewed the pertinent literature to help increase our understanding of the biomechanics of the cornea and other ocular structures and how they can help optimize clinical and surgical treatments, taking into consideration individual variabilities, improve the diagnosis of suspected patients, and help monitor the response to treatment.
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Affiliation(s)
- Rodrigo Brazuna
- Department of Ophthalmology, Federal University of the State of Rio de Janeiro, Rio de Janeiro 22290-240, RJ, Brazil
| | - Ruiz S Alonso
- Department of Ophthalmology, Antonio Pedro University Hospital, Fluminense Federal University, Niterói 24033-900, RJ, Brazil
| | - Marcella Q Salomão
- Department of Ophthalmology, Federal University of São Paulo, São Paulo 04023-062, SP, Brazil
| | | | - Renato Ambrósio
- Department of Ophthalmology, Federal University of the State of Rio de Janeiro, Rio de Janeiro 22290-240, RJ, Brazil
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Towler J, Consejo A, Zhou D, Romano V, Levis H, Boote C, Elsheikh A, Geraghty B, Abass A. Typical localised element-specific finite element anterior eye model. Heliyon 2023; 9:e13944. [PMID: 37101628 PMCID: PMC10123217 DOI: 10.1016/j.heliyon.2023.e13944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 11/19/2022] [Accepted: 02/15/2023] [Indexed: 03/07/2023] Open
Abstract
Purpose The study presents an averaged anterior eye geometry model combined with a localised material model that is straightforward, appropriate and amenable for implementation in finite element (FE) modelling. Methods Both right and left eye profile data of 118 subjects (63 females and 55 males) aged 22-67 years (38.5 ± 7.6) were used to build an averaged geometry model. Parametric representation of the averaged geometry model was achieved through two polynomials dividing the eye into three smoothly connected volumes. This study utilised the collagen microstructure x-ray data of 6 ex-vivo healthy human eyes, 3 right eyes and 3 left eyes in pairs from 3 donors, 1 male and 2 females aged between 60 and 80 years, to build a localised element-specific material model for the eye. Results Fitting the cornea and the posterior sclera sections to a 5th-order Zernike polynomial resulted in 21 coefficients. The averaged anterior eye geometry model recorded a limbus tangent angle of 37° at a radius of 6.6 mm from the corneal apex. In terms of material models, the difference between the stresses generated in the inflation simulation up to 15 mmHg in the ring-segmented material model and localised element-specific material model were significantly different (p < 0.001) with the ring-segmented material model recording average Von-Mises stress 0.0168 ± 0.0046 MPa and the localised element-specific material model recording average Von-Mises stress 0.0144 ± 0.0025 MPa. Conclusions The study illustrates an averaged geometry model of the anterior human eye that is easy to generate through two parametric equations. This model is combined with a localised material model that can be used either parametrically through a Zernike fitted polynomial or non-parametrically as a function of the azimuth angle and the elevation angle of the eye globe. Both averaged geometry and localised material models were built in a way that makes them easy to implement in FE analysis without additional computation cost compared to the limbal discontinuity so-called idealised eye geometry model or ring-segmented material model.
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Affiliation(s)
- Joseph Towler
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | | | - Dong Zhou
- Department of Civil Engineering and Industrial Design, School of Engineering, University of Liverpool, Liverpool, UK
| | - Vito Romano
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- Department of Medical and Surgical Specialities, Radiological Sciences, And Public Health, Ophthalmology Clinic, University of Brescia, Italy
| | - Hannah Levis
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Craig Boote
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK
| | - Ahmed Elsheikh
- Department of Civil Engineering and Industrial Design, School of Engineering, University of Liverpool, Liverpool, UK
- Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Beijing, China
- NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Brendan Geraghty
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Ahmed Abass
- Department of Mechanical, Materials and Aerospace Engineering, School of Engineering, University of Liverpool, Liverpool, UK
- Department of Production Engineering and Mechanical Design, Faculty of Engineering, Port Said University, Egypt
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Assessment of the corneal biomechanical features of granular corneal dystrophy type 2 using dynamic ultra-high-speed Scheimpflug imaging. Graefes Arch Clin Exp Ophthalmol 2023; 261:761-767. [PMID: 36178505 DOI: 10.1007/s00417-022-05847-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 11/04/2022] Open
Abstract
PURPOSE To evaluate the corneal biomechanical features of eyes with granular corneal dystrophy type 2 (GCD2) by analyzing corneal biomechanical indices obtained using a Corvis ST (CST) dynamic ultra-high-speed Scheimpflug imaging device. METHODS In this retrospective case-control study, 35 CST parameters were compared in normal eyes (control) and eyes of patients with GCD2 treated at Osaka University Hospital, Osaka, Japan. The parameters included the Corvis Biomechanical Index (CBI), which is important in differentiating eyes with keratoconus from normal eyes. We measured the deposition rates of lesions in the central 7-mm region of the eye and assessed the correlation between the deposition rate and the CBI. RESULTS Twenty-one eyes with GCD2 and 23 control eyes were analyzed. Eyes with GCD2 showed significantly less corneal stiffness in 15 CST parameters than did control eyes. In particular, the CBI was remarkably higher in eyes with GCD2 than in control eyes (P = 0.000006). Additionally, the deposition rate and the CBI were positively correlated. CONCLUSIONS GCD2 eyes had softer corneas than did control eyes in most biomechanical CST parameters, and one of the parameters (the CBI) was linked to the rate of deposited lesions. Since IOP may be underestimated in GCD2 eyes, management should be especially careful in GCD2 cases complicated by glaucoma.
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12
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Liu MX, Zhou M, Li DL, Dong XX, Liang G, Pan CW. Corneal Biomechanics in Primary Open Angle Glaucoma and Ocular Hypertension: A Systematic Review and Meta-analysis. J Glaucoma 2023; 32:e24-e32. [PMID: 36583701 DOI: 10.1097/ijg.0000000000002170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 12/07/2022] [Indexed: 12/31/2022]
Abstract
PRCIS Normal tension glaucoma patients had softer corneas than normal controls, whereas high-tension glaucoma and ocular hypertension patients had stiffer corneas. PURPOSE To comprehensively identify the corneal biomechanical differences of patients with primary open angle glaucoma (POAG) and ocular hypertension (OHT) using the Ocular Response Analyzer or the Corvis ST. METHODS The electronic databases PubMed, Embase, and Web of Science were comprehensively searched for studies comparing corneal biomechanical differences between POAG and OHT patients with normal controls by Ocular Response Analyzer or Corvis ST. The weighted mean differences and 95% confidence intervals (CIs) were calculated. Subgroup analyses were performed according to the subtypes of POAG, including high-tension glaucoma (HTG) and normal tension glaucoma (NTG). RESULTS Thirty-one case-control studies were ultimately included, with 2462 POAG patients, 345 OHT patients, and 3281 normal controls. The corneal hysteresis (CH), corneal resistance factor (CRF), and highest concavity time (HC-t) were all lower in POAG patients than in normal controls. The CH, time at the second applanation (A2t), HC-t, highest concavity radius (HC-R), and deformation amplitude at the highest concavity (HC-DA) were lower in OHT patients, while the CRF, time at the first applanation (A1t), and stiffness parameter at the first applanation (SP-A1) were greater in OHT patients than in normal controls. The subgroup analyses showed that the CH, A2t, length at the second applanation (A2L), and HC-DA were lower in HTG, and the CH, CRF, A1t, and HC-t were lower in NTG patients than in normal controls. CONCLUSION The corneas of NTG patients are more deformable than normal controls, whereas the corneas of HTG and OHT patients are stiffer.
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Affiliation(s)
- Min-Xin Liu
- School of Public Health, Medical College of Soochow University, Suzhou
| | - Miao Zhou
- Department of Ophthalmology, Peking University People's Hospital, Beijing
| | - Dan-Lin Li
- School of Public Health, Medical College of Soochow University, Suzhou
| | - Xing-Xuan Dong
- School of Public Health, Medical College of Soochow University, Suzhou
| | - Gang Liang
- Department of Ophthalmology, The Affiliated Hospital of Yunnan University, Kunming
- Department of Ophthalmology, The Second People's Hospital of Yunnan Province, Kunming, China
| | - Chen-Wei Pan
- School of Public Health, Medical College of Soochow University, Suzhou
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13
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Yaïci R, Geerling G. [Tonometry: Review and Perspectives]. Klin Monbl Augenheilkd 2023. [PMID: 36827998 DOI: 10.1055/a-2022-0624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
Reliable and repeated IOP measurement are essential in the diagnosis and treatment of glaucoma. In this second part, the other contact tonometry and non-contact tonometry are presented. The clinical value of the different methods and the value of multimodality in tonometry will be discussed based on a review of the literature, and the latest innovations with telemetric IOP sensors will be introduced.
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14
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Catania F, Morenghi E, Rosetta P, Paolo V, Vinciguerra R. Corneal Biomechanics Assessment with Ultra High Speed Scheimpflug Camera in Primary Open Angle Glaucoma Compared with Healthy Subjects: A meta-analysis of the Literature. Curr Eye Res 2023; 48:161-171. [PMID: 35385343 DOI: 10.1080/02713683.2022.2059809] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE The aim of this meta-analysis of the literature is to provide a comprehensive analysis of the differences in Corvis ST dynamic corneal response (DCR) parameters between primary open-angle glaucoma (POAG) patients and healthy controls. METHODS A quantitative meta-analysis was conducted on articles published before September 10, 2021 identified by searching PubMed, EMBASE, and Web of Science. Prospective studies comparing DCR Corvis ST parameter in high tension POAG and healthy controls were included. The random-effects model was conducted. Assessment of heterogeneity was based on the calculation of I2. Funnel plots evaluation and meta-regression were performed in case of detection of high heterogeneity. RESULTS The selection process resulted in the inclusion of six articles. Pooled analysis revealed that POAG corneas respond to mechanical stimulus with a smaller concavity, showing lower deformation amplitude (DA) (CI95% -0.991 to -0.578; p < .001; I2 = 0%), higher highest concavity radius (HCR; confidence interval [CI]95% -0.01 to 0.34; p = .058; I2 = 6.7%), and lower peak distance (PD; CI95% -1.06 to -0.024; p = .040; I2 = 86.5%). They also show a slower loading phase, with lower highest concavity time (HCT; CI95% -0.39 to -0.02; p = .029; I2 = 3.3%) and lower applanation velocity-1 (CI95% -0.641 to -0.127; p = .003; I2 = 34.6%), and a faster restoration to the original form, shown by lower applanation time-2 (CI95% -1.123 to -0.544; p = .001; I2 = 44.8%) compared to healthy subjects. CONCLUSIONS High tension POAG patients are characterized by stiffer corneas compared to healthy controls. These differences are valid also after removing the effect of age, corneal thickness, and intraocular pressure (IOP).
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Affiliation(s)
- Fiammetta Catania
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.,Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy
| | - Emanuela Morenghi
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.,Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy
| | | | - Vinciguerra Paolo
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.,Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy
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Abstract
ZusammenfassungIn 2. Teil des Beitrags werden die sonstigen Kontakttonometer und die Nonkontakttonometrie präsentiert. Es wird anhand einer Revue der Literatur über den klinischen Wert der verschiedenen Methoden und den Wert der Multimodalität in der Tonometrie diskutiert; ferner werden die letzten Innovationen mit den telemetrischen IOD-Sensoren eingeführt.
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16
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Esporcatte LPG, Salomão MQ, Lopes BT, Sena N, Ferreira É, Filho JBRF, Machado AP, Ambrósio R. Biomechanics in Keratoconus Diagnosis. Curr Eye Res 2023; 48:130-136. [PMID: 35184637 DOI: 10.1080/02713683.2022.2041042] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Purpose: To prospectively review the importance of biomechanical assessment in the screening, diagnosis, prognosis, individualized planning, and clinical follow-up for ectatic corneal diseases.Methods: We demonstrate two commercially available devices to assess the corneal biomechanics in vivo, the Ocular Response Analyzer (ORA, Reichester, NY, USA) and the Corvis ST (Oculus, Wetzlar, Germany). Novel devices have been demonstrated to provide in vivo biomechanical measurements, including Brillouin optical microscopy and OCT elastography. Conclusion: The integration of biomechanical data and other data from multimodal refractive imaging using artificial intelligence demonstrated the ability to enhance accuracy in diagnosing ectatic corneal diseases.
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Affiliation(s)
- Louise Pellegrino G Esporcatte
- Rio de Janeiro Corneal Tomography and Biomechanics Study Group, Rio de Janeiro, Brazil.,Instituto de Olhos Renato Ambrósio, Rio de Janeiro, Brazil.,Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil
| | - Marcella Q Salomão
- Rio de Janeiro Corneal Tomography and Biomechanics Study Group, Rio de Janeiro, Brazil.,Instituto de Olhos Renato Ambrósio, Rio de Janeiro, Brazil.,Brazilian Artificial Intelligence Networking in Medicine - BrAIN, Rio de Janeiro and Maceió, Brazil.,Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil.,Instituto Benjamin Constant, Rio de Janeiro, Brazil
| | - Bernardo T Lopes
- Rio de Janeiro Corneal Tomography and Biomechanics Study Group, Rio de Janeiro, Brazil.,School of Engineering, University of Liverpool, Liverpool, UK
| | - Nelson Sena
- Department of Ophthalmology, Federal University the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Érica Ferreira
- Department of Ophthalmology, Federal University the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Joao Batista R F Filho
- Department of Ophthalmology, Federal University the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Aydano P Machado
- Brazilian Artificial Intelligence Networking in Medicine - BrAIN, Rio de Janeiro and Maceió, Brazil.,Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil.,Computing Institute, Federal University of Alagoas, Maceió, Brazil
| | - Renato Ambrósio
- Rio de Janeiro Corneal Tomography and Biomechanics Study Group, Rio de Janeiro, Brazil.,Instituto de Olhos Renato Ambrósio, Rio de Janeiro, Brazil.,Brazilian Artificial Intelligence Networking in Medicine - BrAIN, Rio de Janeiro and Maceió, Brazil.,Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil.,Department of Ophthalmology, Federal University the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
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Yuhas PT, Roberts CJ. Clinical Ocular Biomechanics: Where Are We after 20 Years of Progress? Curr Eye Res 2023; 48:89-104. [PMID: 36239188 DOI: 10.1080/02713683.2022.2125530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Purpose: Ocular biomechanics is an assessment of the response of the structures of the eye to forces that may lead to disease development and progression, or influence the response to surgical intervention. The goals of this review are (1) to introduce basic biomechanical principles and terminology, (2) to provide perspective on the progress made in the clinical study and assessment of ocular biomechanics, and (3) to highlight critical studies conducted in keratoconus, laser refractive surgery, and glaucoma in order to aid interpretation of biomechanical parameters in the laboratory and in the clinic.Methods: A literature review was first conducted of basic biomechanical studies related to ocular tissue. The subsequent review of ocular biomechanical studies was limited to those focusing on keratoconus, laser refractive surgery, or glaucoma using the only two commercially available devices that allow rapid assessment of biomechanical response in the clinic.Results: Foundational studies on ocular biomechanics used a combination of computer modeling and destructive forces on ex-vivo tissues. The knowledge gained from these studies could not be directly translated to clinical research and practice until the introduction of non-contact tonometers that quantified the deformation response of the cornea to an air puff, which represents a non-destructive, clinically appropriate load. The corneal response includes a contribution from the sclera which may limit corneal deformation. Two commercial devices are available, the Ocular Response Analyzer which produces viscoelastic parameters with a customized load for each eye, and the Corvis ST which produces elastic parameters with a consistent load for every eye. Neither device produces the classic biomechanical properties reported in basic studies, but rather biomechanical deformation response parameters which require careful interpretation.Conclusions: Research using clinical tools has enriched our understanding of how ocular disease alters ocular biomechanics, as well as how ocular biomechanics may influence the pathophysiology of ocular disease and response to surgical intervention.
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Affiliation(s)
- Phillip T Yuhas
- College of Optometry, The Ohio State University, Columbus, OH, USA
| | - Cynthia J Roberts
- Department of Ophthalmology and Visual Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA.,Department of Biomedical Engineering, College of Engineering, The Ohio State University, Columbus, OH, USA
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Chou CC, Shih PJ, Jou TS, Hsu MY, Chen JP, Hsu RH, Lee NC, Chien YH, Hwu WL, Wang IJ. Corneal Biomechanical Characteristics in Osteogenesis Imperfecta With Collagen Defect. Transl Vis Sci Technol 2023; 12:14. [PMID: 36622688 PMCID: PMC9838590 DOI: 10.1167/tvst.12.1.14] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Purpose To identify the characteristic corneal biomechanical properties of osteogenesis imperfecta (OI), and to compare the corneal biomechanical properties between OI and keratoconus. Methods We included 46 eyes of 23 patients with OI, 188 eyes of 99 keratoconus patients, and 174 eyes of 92 normal controls to compare corneal biomechanical parameters between OI corneas, keratoconus, and normal controls by using Corneal Visualization Scheimpflug Technology (Corvis ST). Results Patients with OI had significantly higher Corvis biomechanical index (CBI) (P < 0.001), higher tomographic and biomechanical index (TBI) (P = 0.040), lower Corvis Biomechanical Factor (CBiF) (P = 0.034), and lower stiffness parameter at first applanation (SP-A1) (P < 0.001) compared with normal controls. In contrast, OI group showed lower CBI (P < 0.001), lower TBI (P < 0.001), higher CBiF (P < 0.001), and higher SP-A1 (P = 0.020) than keratoconus group. Notably, the stress-strain index (SSI) was not significantly different between the OI and normal controls (P = 1.000), whereas keratoconus showed the lowest SSI compared with OI group (P = 0.025) and normal controls (P < 0.001). Conclusions Although the corneal structures of OI patients are less stable and easier to deform as compared to those of the control group, there is no significant difference in material stiffness observed between the OI and normal controls. In contrast, the corneas of keratoconus showed not only lower structural stability and higher deformability but also lower material stiffness compared with those of OI cornea and normal controls. Translational Relevance The biomechanical alterations are different between OI corneas and keratoconus.
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Affiliation(s)
- Chien-Chih Chou
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan,Department of Ophthalmology, Taichung Veterans General Hospital, Taichung, Taiwan,Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Po-Jen Shih
- Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Tzuu-Shuh Jou
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan,Center of Precision Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Min-Yen Hsu
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan,Department of Ophthalmology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Jun-Peng Chen
- Biostatistics Task Force of Taichung Veterans General Hospital, Taichung, Taiwan
| | - Rai-Hseng Hsu
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan,Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Ni-Chung Lee
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan,Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Yin-Hsiu Chien
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan,Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Wuh-Liang Hwu
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan,Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - I-Jong Wang
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan,Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan,Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
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Ramm L, Herber R, Lorenz G, Jasper CS, Pillunat LE, Pillunat KR. Evaluation of corneal biomechanical properties using the ocular response analyzer and the dynamic Scheimpflug-Analyzer Corvis ST in high pressure and normal pressure open-angle glaucoma patients. PLoS One 2023; 18:e0281017. [PMID: 36701409 PMCID: PMC9879466 DOI: 10.1371/journal.pone.0281017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 01/12/2023] [Indexed: 01/27/2023] Open
Abstract
PURPOSE To characterize differences in corneal biomechanics in high (HPG) and normal pressure (NPG) primary open-angle glaucoma, and its association to disease severity. METHODS Corneal biomechanical properties were measured using the Ocular Response Analyzer (ORA) and the dynamic Scheimpflug-Analyzer Corvis ST (CST). Disease severity was functionally assessed by automated perimetry (Humphrey field analyzer) and structurally with the Heidelberg Retina Tomograph. To avoid a possible falsification by intraocular pressure, central corneal thickness and age, which strongly influence ORA and CST measurements, group matching was performed. Linear mixed models and generalized estimating equations were used to consider inter-eye correlation. RESULTS Following group matching, 60 eyes of 38 HPG and 103 eyes of 60 NPG patients were included. ORA measurement revealed a higher CRF in HPG than in NPG (P < 0.001). Additionally, the CST parameter integrated radius (P < 0.001) was significantly different between HPG and NPG. The parameter SSI (P < 0.001) representing corneal stiffness was higher in HPG than in NPG. Furthermore, regression analysis revealed associations between biomechanical parameters and indicators of disease severity. In HPG, SSI correlated to RNFL thickness. In NPG, dependencies between biomechanical readings and rim area, MD, and PSD were shown. CONCLUSION Significant differences in corneal biomechanical properties were detectable between HPG and NPG patients which might indicate different pathophysiological mechanisms underlying in both entities. Moreover, biomechanical parameters correlated to functional and structural indices of diseases severity. A reduced corneal deformation measured by dynamic methods was associated to advanced glaucomatous damage.
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Affiliation(s)
- Lisa Ramm
- Department of Ophthalmology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Robert Herber
- Faculty of Medicine Carl Gustav Carus, Department of Ophthalmology, TU Dresden, Dresden, Germany
- * E-mail:
| | - Georg Lorenz
- Department of Ophthalmology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Carolin S. Jasper
- Department of Ophthalmology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Lutz E. Pillunat
- Department of Ophthalmology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Karin R. Pillunat
- Department of Ophthalmology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
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Correlations among Corneal Biomechanical Parameters, Stiffness, and Thickness Measured Using Corvis ST and Pentacam in Patients with Ocular Hypertension. J Ophthalmol 2022; 2022:7387581. [PMID: 36510627 PMCID: PMC9741532 DOI: 10.1155/2022/7387581] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 11/15/2022] [Accepted: 11/23/2022] [Indexed: 12/05/2022] Open
Abstract
Background To preliminary explore the correlations among corneal biomechanical parameters, stiffness, and thickness in patients with ocular hypertension (OHT) before and after treatment with topical antiglaucoma medications. Methods This was a retrospective study that included 35 eyes with newly diagnosed OHT. Axial length (AL), apical corneal thickness, and minimum corneal thickness were measured using Pentacam. The lengths, velocities, and times of the first and second corneal applanations (A1L, A1V, A1T, A2L, A2V, and A2T, respectively); the highest concavity radius; highest concavity peak distance (PDHC); highest concavity deformation amplitude (DAHC); highest concavity time (HCT); pachymetry (PACH); stress-strain index (SSI); stiffness parameter-A1 (SP-A1); deformation amplitude ratio (DA ratio); integrated radius (IR); Ambrosio's relational thickness horizontal (ARTh); corneal biomechanical index; noncorrected intraocular pressure (IOPnct); and biomechanically corrected IOP (bIOP) values were measured using the corneal visualization Scheimpflug technology (Corvis ST/CST). Results After 5 weeks of treatment, Goldman applanation tonometer-IOP, IOPnct, bIOP, PACH, A1T, A2V, SSI, SP-A1, and ARTh decreased, but A1V, A2T, PDHC, DAHC, DA ratio, and IR increased significantly (all p < 0.05). SP-A1 and A1T were positively associated with premedication IOP and IOP changes, whereas A1V, A2T, PDHC, and IR were negatively associated (all p < 0.05). DAHC and DA ratio had significantly negative correlations with IOP variations. PDHC was found to be positively correlated with AL (p < 0.05). A positive relationship was noted between SP-A1 and HCT before medication (p < 0.05). Conclusions SP-A1 was significantly and consistently associated with IOP. HCT might be correlated with SP-A1. SP-A1 and CST parameters could serve as potential biomarkers for evaluating OHT treatment efficacy.
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Zhao Y, Hu G, Yan Y, Wang Z, Liu X, Shi H. Biomechanical analysis of ocular diseases and its in vitro study methods. Biomed Eng Online 2022; 21:49. [PMID: 35870978 PMCID: PMC9308301 DOI: 10.1186/s12938-022-01019-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 07/13/2022] [Indexed: 12/25/2022] Open
Abstract
Ocular diseases are closely related to the physiological changes in the eye sphere and its contents. Using biomechanical methods to explore the relationship between the structure and function of ocular tissue is beneficial to reveal the pathological processes. Studying the pathogenesis of various ocular diseases will be helpful for the diagnosis and treatment of ocular diseases. We provide a critical review of recent biomechanical analysis of ocular diseases including glaucoma, high myopia, and diabetes. And try to summarize the research about the biomechanical changes in ocular tissues (e.g., optic nerve head, sclera, cornea, etc.) associated with those diseases. The methods of ocular biomechanics research in vitro in recent years are also reviewed, including the measurement of biomechanics by ophthalmic equipment, finite element modeling, and biomechanical analysis methods. And the preparation and application of microfluidic eye chips that emerged in recent years were summarized. It provides new inspiration and opportunity for the pathogenesis of eye diseases and personalized and precise treatment.
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Zarei R, Zamani MH, Eslami Y, Fakhraei GH, Tabatabaei M, Esfandiari AR. Comparing corneal biomechanics and intraocular pressure between healthy individuals and glaucoma subtypes: A cross-sectional study. Ann Med Surg (Lond) 2022; 82:104677. [PMID: 36268371 PMCID: PMC9577659 DOI: 10.1016/j.amsu.2022.104677] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/08/2022] [Accepted: 09/10/2022] [Indexed: 10/27/2022] Open
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Effect of prostaglandin analogues on the biomechanical corneal properties in patients with open-angle glaucoma and ocular hypertension measured with dynamic scheimpflug analyzer. Graefes Arch Clin Exp Ophthalmol 2022; 260:3927-3933. [PMID: 35841397 DOI: 10.1007/s00417-022-05752-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/18/2022] [Accepted: 06/29/2022] [Indexed: 11/04/2022] Open
Abstract
PURPOSE The aim of the study is to evaluate the effect of topical prostaglandin (PG) treatment on the corneal biomechanical properties in treatment-naïve patients with either primary open-angle glaucoma (POAG) or ocular hypertension (OHT) using the Corvis ST device. METHODS This is an observational study. We analyzed the Corvis ST dynamic corneal response parameters of our database using the newest software available. Thirty-four eyes of 34 patients were included. They were all newly diagnosed and treatment-naïve. Patients were evaluated at baseline and after 6 months of treatment with prostaglandin analogues. Ultrasound pachymetry, Optical Coherence Tomography (OCT) and a 24-2 visual field test were performed in baseline visit. Goldman Applanation Tonometry (GAT-IOP) and Corvis ST dynamic corneal response parameters were registered at baseline and at the 6-month visit. RESULTS After 6 months of treatment, the IOP decrease (Δ) values obtained with the different tonometers were ΔGAT -6.5 ± 3.7, ΔIOPnct -4.4 ± 5.7 and ΔbIOP -3.8 ± 5.4. The differences between ΔGAT vs ΔIOPnct, ΔGAT vs ΔbIOP, and ΔIOPnct vs ΔbIOP, were statistically significant (p < 0.05 for all comparisons). Statistically significant lower values of the stress-strain index (SSI) (1.77 ± 0.3 at baseline vs 1.54 ± 0.27 at the 6-month visit) were found (p = 0.0002). CONCLUSION The SSI provided by the Corvis ST seems to decrease significantly after topical prostaglandin therapy. We believe that our results support the hypothesis that topical PG therapy does decrease the corneal stiffness and thus, that the ocular hypotensive effect of these drugs is overestimated if GAT is used for IOP measurement.
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Esporcatte LPG, Salomão MQ, Junior NS, Machado AP, Ferreira É, Loureiro T, Junior RA. Corneal biomechanics for corneal ectasia: Update. Saudi J Ophthalmol 2022; 36:17-24. [PMID: 35971484 PMCID: PMC9375464 DOI: 10.4103/sjopt.sjopt_192_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/23/2021] [Accepted: 11/18/2021] [Indexed: 11/09/2022] Open
Abstract
Knowledge of biomechanical principles has been applied in several clinical conditions, including correcting intraocular pressure measurements, planning and following corneal treatments, and even allowing an enhanced ectasia risk evaluation in refractive procedures. The investigation of corneal biomechanics in keratoconus (KC) and other ectatic diseases takes place in several steps, including screening ectasia susceptibility, the diagnostic confirmation and staging of the disease, and also clinical characterization. More recently, investigators have found that the integration of biomechanical and tomographic data through artificial intelligence algorithms helps to elucidate the etiology of KC and ectatic corneal diseases, which may open the door for individualized or personalized medical treatments in the near future. The aim of this article is to provide an update on corneal biomechanics in the screening, diagnosis, staging, prognosis, and treatment of KC.
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Affiliation(s)
- Louise P. G. Esporcatte
- Rio de Janeiro Corneal Tomography and Biomechanics Study Group, Brazil,Renato Ambrosio Eye Institute, Rio de Janeiro, Brazil,Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil
| | - Marcella Q. Salomão
- Rio de Janeiro Corneal Tomography and Biomechanics Study Group, Brazil,Renato Ambrosio Eye Institute, Rio de Janeiro, Brazil,Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil,Brazilian Study Group of Artificial Intelligence and Corneal Analysis - BrAIN, Rio de Janeiro and Maceió, Brazil,Benjamin Constant Institute, Rio de Janeiro, Brazil
| | - Nelson S. Junior
- Department of Ophthalmology, Federal University the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Aydano P. Machado
- Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil,Brazilian Study Group of Artificial Intelligence and Corneal Analysis - BrAIN, Rio de Janeiro and Maceió, Brazil,Department of Computer Sciences, Federal University of Alagoas, Maceió, Brazil
| | - Érica Ferreira
- Rio de Janeiro Corneal Tomography and Biomechanics Study Group, Brazil,Department of Ophthalmology, Federal University the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Tomás Loureiro
- Department of Ophthalmology, Garcia de Orta Hospital, Almada, Portugal
| | - Renato A. Junior
- Rio de Janeiro Corneal Tomography and Biomechanics Study Group, Brazil,Renato Ambrosio Eye Institute, Rio de Janeiro, Brazil,Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil,Brazilian Study Group of Artificial Intelligence and Corneal Analysis - BrAIN, Rio de Janeiro and Maceió, Brazil,Department of Ophthalmology, Federal University the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil,Address for correspondence: Dr. Renato A. Junior, Rua Conde de Bonfim, 211/712, 20520-050, Rio de Janeiro, RJ, Brazil. E-mail:
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Xu Y, Ye Y, Chen Z, Xu J, Yang Y, Fan Y, Liu P, Chong IT, Yu K, Lam DC, Yu M. Corneal Stiffness and Modulus of Normal-Tension Glaucoma in Chinese. Am J Ophthalmol 2022; 242:131-138. [DOI: 10.1016/j.ajo.2022.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 11/01/2022]
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Wu N, Chen Y, Sun X. Association Between Ocular Biomechanics Measured With Corvis ST and Glaucoma Severity in Patients With Untreated Primary Open Angle Glaucoma. Transl Vis Sci Technol 2022; 11:10. [PMID: 35679036 PMCID: PMC9187943 DOI: 10.1167/tvst.11.6.10] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To compare the ocular biomechanical differences between normal controls and patients with untreated primary open angle glaucoma, including normal-tension glaucoma (NTG) and high-tension glaucoma (HTG), and to investigate the association between ocular biomechanics and glaucoma severity in each group. Methods One hundred fifty-three eyes of 153 subjects, including 51 controls, 47 NTG, and 55 HTG cases, were enrolled in this cross-sectional study. Each participant underwent biomechanical measurements by using the Corneal Visualization Scheimpflug Technology. Glaucoma severity was evaluated by mean deviation (MD), pattern standard deviation (PSD), ganglion cell complex (GCC), and retinal nerve fiber layer (RNFL) thickness. Results Deformation amplitude (P = 0.001) significantly increased, whereas first applanation time (P < 0.0001), highest concavity time (P = 0.001), stiffness parameter at first applanation (P = 0.009), and time of whole eye movement (WEM, P = 0.008) decreased significantly in NTG eyes compared with controls. Besides, NTG had the highest first applanation velocity than controls (P < 0.0001) and HTG (P = 0.044). Shorter time of WEM was independently correlated with worse MD (P = 0.02) and higher values of PSD (P = 0.03) in NTG. Axial length was positively related to PSD (P = 0.02) and negatively related to GCC (P < 0.0001) and RNFL (P < 0.0001) thickness in HTG. Conclusions NTG corneas are more deformable than healthy ones and HTG. Time of WEM, which relates to orbital compliance, is significantly associated with glaucomatous visual field defect in NTG, whereas axial length is correlated with glaucoma severity in HTG. Translational Relevance Ocular biomechanics may partly account for the differences of pathogenic mechanisms between NTG and HTG.
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Affiliation(s)
- Na Wu
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China
| | - Yuhong Chen
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China
| | - Xinghuai Sun
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China.,State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, China
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Brazuna R, Salomão M, Esporcatte B, Macedo M, Esporcatte L, Colombini GNUI, Ambrósio R. Corneal biomechanics and glaucoma beyond the bidirectional impact of intraocular pressure and corneal deformation response. REVISTA BRASILEIRA DE OFTALMOLOGIA 2022. [DOI: 10.37039/1982.8551.20220036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Wang Y, Cao H. Corneal and Scleral Biomechanics in Ophthalmic Diseases: An Updated Review. MEDICINE IN NOVEL TECHNOLOGY AND DEVICES 2022. [DOI: 10.1016/j.medntd.2022.100140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Akkara JD, Kuriakose A. Commentary: Water, water everywhere; alters eye when you drink. Indian J Ophthalmol 2022; 70:1230-1231. [PMID: 35326022 PMCID: PMC9240575 DOI: 10.4103/ijo.ijo_3041_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Affiliation(s)
- John D Akkara
- Department of Ophthalmology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu; Department of Glaucoma, Westend Eye Hospital, Cochin, Kerala, India
| | - Anju Kuriakose
- Department of Retina, Aravind Eye Hospital, Chennai, Tamil Nadu, India
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Vinciguerra R, Herber R, Wang Y, Zhang F, Zhou X, Bai J, Yu K, Chen S, Fang X, Raiskup F, Vinciguerra P. Corneal Biomechanics Differences Between Chinese and Caucasian Healthy Subjects. Front Med (Lausanne) 2022; 9:834663. [PMID: 35280913 PMCID: PMC8914014 DOI: 10.3389/fmed.2022.834663] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 01/31/2022] [Indexed: 11/16/2022] Open
Abstract
Purpose The aim of this study was to evaluate the difference between Caucasian and Chinese healthy subjects with regards to Corvis ST dynamic corneal response parameters (DCRs). Methods Two thousand eight hundred and eighty-nine healthy Caucasian and Chinese subjects were included in this multicenter retrospective study. Subsequently, Chinese eyes were matched to Caucasians by age, intraocular pressure (IOP), and Corneal Thickness (CCT) using a case-control matching algorithm. The DCRs assessed were Deformation Amplitude (DA) Applanation 1 velocity (A1v), integrated radius (1/R), deformation amplitude ratio (DAratio), stiffness parameter at applanation 1 (SPA1), ARTh (Ambrósio's Relational Thickness to the horizontal profile), and the novel Stress Strain Index (SSI). Results After age-, CCT-, and IOP- matching, 503 Chinese were assigned to 452 Caucasians participants. Statistical analysis showed a statistical significant difference between Chinese and Caucasian Healthy subjects in the values of SPA1 (p = 0.008), Arth (p = 0.008), and SSI (p < 0.001). Conversely, DA, A1v, DAratio, and 1/R were not significantly different between the two ethnical groups (p > 0.05). Conclusion We found significant differences in the values of the DCRs provided by the Corvis ST between Chinese and Caucasian healthy subjects.
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Affiliation(s)
| | - Robert Herber
- Department of Ophthalmology, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Yan Wang
- Tianjin Eye Hospital, Tianjin Key Laboratory of Ophthalmology and Visual Science, Nankai University Affiliated Eye Hospital, Tianjin, China
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
| | - Fengju Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Sciences Key Lab, Capital Medical University, Beijing, China
| | - Xingtao Zhou
- EYE & ENT Hospital of Fudan University, Shanghai, China
| | - Ji Bai
- BAI JI Ophthalmology, Chongqing, China
| | - Keming Yu
- Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Shihao Chen
- Eye Hospital, Wenzhou Medical University, Zhejiang, China
| | | | - Frederik Raiskup
- Department of Ophthalmology, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Paolo Vinciguerra
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Humanitas Research Hospital, Rozzano, Italy
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31
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A Review on Damage and Rupture Modelling for Soft Tissues. Bioengineering (Basel) 2022; 9:bioengineering9010026. [PMID: 35049735 PMCID: PMC8773318 DOI: 10.3390/bioengineering9010026] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/04/2022] [Accepted: 01/05/2022] [Indexed: 11/16/2022] Open
Abstract
Computational modelling of damage and rupture of non-connective and connective soft tissues due to pathological and supra-physiological mechanisms is vital in the fundamental understanding of failures. Recent advancements in soft tissue damage models play an essential role in developing artificial tissues, medical devices/implants, and surgical intervention practices. The current article reviews the recently developed damage models and rupture models that considered the microstructure of the tissues. Earlier review works presented damage and rupture separately, wherein this work reviews both damage and rupture in soft tissues. Wherein the present article provides a detailed review of various models on the damage evolution and tear in soft tissues focusing on key conceptual ideas, advantages, limitations, and challenges. Some key challenges of damage and rupture models are outlined in the article, which helps extend the present damage and rupture models to various soft tissues.
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Silva N, Ferreira A, Baptista PM, Figueiredo A, Reis R, Sampaio I, Beirão J, Vinciguerra R, Menéres P, Menéres MJ. Corneal Biomechanics for Ocular Hypertension, Primary Open-Angle Glaucoma, and Amyloidotic Glaucoma: A Comparative Study by Corvis ST. Clin Ophthalmol 2022; 16:71-83. [PMID: 35035215 PMCID: PMC8754459 DOI: 10.2147/opth.s350029] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 12/21/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND To evaluate biomechanical parameters of the cornea provided by Corvis ST in patients with ocular hypertension, primary open-angle glaucoma, and amyloidotic glaucoma and to compare with healthy controls. METHODS This was a cross-sectional study of patients with ocular hypertension, primary open-angle glaucoma, and amyloidotic glaucoma that underwent Corvis ST imaging. Primary outcome was the comparison of corneal biomechanical parameters between study groups after adjusting for age, gender, Goldmann intraocular pressure (GAT-IOP), and prostaglandin analogues medication. Secondary outcome was the comparison of different IOP measurements in each group. RESULTS One hundred and eighty-three eyes from 115 patients were included: 61 with primary open-angle glaucoma, 32 with amyloidotic glaucoma, 37 with ocular hypertension and 53 were healthy controls. Amyloidotic glaucoma group had smaller radius (p=0.025), lower deflection amplitude at highest concavity (p=0.019), and higher integrated radius (p=0.014) than controls. Ocular hypertension group had higher stiffness parameter at first applanation (p=0.043) than those with primary open-angle glaucoma, and higher stress-strain index (p=0.049) than those with amyloidotic glaucoma. Biomechanically corrected intraocular pressure was significantly lower than Goldmann intraocular pressure in group with primary open-angle glaucoma (p=0.005) and control group (p=0.013), and Goldmann intraocular pressure adjusted for pachymetry in group with primary open-angle glaucoma (p=0.01). CONCLUSION Eyes with amyloidotic glaucoma have more deformable corneas, while eyes with ocular hypertension have less deformable corneas. These findings may be linked to the susceptibility to glaucomatous damage and progression. There were significant differences between Goldmann applanation tonometry and biomechanically corrected intraocular ocular pressure provided by Corvis ST.
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Affiliation(s)
- Nisa Silva
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, 4099-001, Portugal
| | - André Ferreira
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, 4099-001, Portugal
- Unit of Anatomy, Department of Biomedicine, Faculty of Medicine of University of Porto, Porto, 4200-319, Portugal
| | - Pedro Manuel Baptista
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, 4099-001, Portugal
| | - Ana Figueiredo
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, 4099-001, Portugal
| | - Rita Reis
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, 4099-001, Portugal
| | - Isabel Sampaio
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, 4099-001, Portugal
| | - João Beirão
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, 4099-001, Portugal
- Department of Ophthalmology, Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, 4050-313, Portugal
| | - Riccardo Vinciguerra
- Ophthalmology Department, Humanitas San Pio X Hospital, Milan, Italy
- The School of Engineering, University of Liverpool, Liverpool, UK
| | - Pedro Menéres
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, 4099-001, Portugal
- Department of Ophthalmology, Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, 4050-313, Portugal
| | - Maria João Menéres
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, 4099-001, Portugal
- Department of Ophthalmology, Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, 4050-313, Portugal
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Boszczyk A, Kasprzak H, Przeździecka-Dołyk J. Novel Method of Measuring Corneal Viscoelasticity Using the Corvis ST Tonometer. J Clin Med 2022; 11:jcm11010261. [PMID: 35012002 PMCID: PMC8745689 DOI: 10.3390/jcm11010261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 12/21/2021] [Accepted: 12/30/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The process of rapid propagation of the corneal deformation in air puff tonometer depends not only on intraocular pressure, but also on the biomechanical properties of the cornea and anterior eye. One of the biomechanical properties of the cornea is viscoelasticity, which is the most visible in its high-speed deformations. It seems reasonable to link the corneal viscoelasticity parameter to two moments of the highest speed of corneal deformations, when the cornea buckles. The aim of this work is to present a method of determining the time and place of occurrence of corneal buckling, examine spatial and temporal dependencies between two corneal applanations and bucklings in the Corvis ST tonometer, and correlate these dependencies with corneal viscoelastic properties. METHODS Images of the horizontal cross section of the Corvis ST deformed cornea from the air puff tonometer Corvis ST were used. 14 volunteers participated in the study, each of them had one eye measured eight times. Mutual changes in the profile slopes of the deformed corneas were numerically determined. They describe pure corneal deformation, eliminating the influence of rotation, and displacement of the entire eyeball. For each point in the central area of the corneal profile, the maximum velocities of mutual slope changes accompanying the applanations were estimated. The times of their occurrence were adopted as buckling times. RESULTS The propagation of buckling along the corneal profile is presented, as well as the repeatability and mutual correlations between the buckling parameters and intraocular pressure. Based on the relationship between them, a new parameter describing corneal hysteresis: Corvis Viscoelasticity (CVE) is introduced. It is characterized by high repeatability: ICC = 0.82 (0.69-0.93 CI) and low and insignificant correlation with intraocular pressure: r = 0.25 (p-value = 0.38). CONCLUSION The results show for the first time how to measure the corneal buckling and viscoelastic effects with Corvis ST. CVE is a new proposed biomechanical parameter related to the viscoelastic properties of the cornea, which has high repeatability for the examined subject. The distribution of its values is planned to be tested on different groups of patients in order to investigate its clinical applicability.
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Affiliation(s)
- Agnieszka Boszczyk
- Department of Optics and Photonics, Wroclaw University of Science and Technology, 50-370 Wrocław, Poland; (H.K.); (J.P.-D.)
- Correspondence:
| | - Henryk Kasprzak
- Department of Optics and Photonics, Wroclaw University of Science and Technology, 50-370 Wrocław, Poland; (H.K.); (J.P.-D.)
| | - Joanna Przeździecka-Dołyk
- Department of Optics and Photonics, Wroclaw University of Science and Technology, 50-370 Wrocław, Poland; (H.K.); (J.P.-D.)
- Department of Ophthalmology, Wroclaw Medical University, 50-556 Wrocław, Poland
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Hoffmann EM, Aghayeva F, Wagner FM, Fiess A, Nagler M, Münzel T, Wild PS, Beutel ME, Schmidtmann I, Lackner KJ, Pfeiffer N, Schuster AK. Intraocular Pressure and Its Relation to Ocular Geometry: Results From the Gutenberg Health Study. Invest Ophthalmol Vis Sci 2022; 63:40. [PMID: 35089330 PMCID: PMC8802016 DOI: 10.1167/iovs.63.1.40] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Purpose The purpose of this study was to investigate the association between intraocular pressure (IOP) and ocular geometry. Methods The Gutenberg Health Study is a population-based cohort study in Mainz, Germany. Study participants underwent a comprehensive ophthalmologic examination including noncontact tonometry, objective refraction, optical biometry, and Scheimpflug imaging of the anterior segment at the first 5-year follow-up examination (in 2012–2017). Multivariable linear regression analysis was carried out to determine associations of IOP and geometric parameter of the human phakic eye, namely central corneal thickness (CCT), corneal curvature, anterior chamber depth (ACD), lens thickness, and axial length. In addition, the relationship of IOP and the anterior chamber angle (ACA) width was analyzed. Results There were 6640 participants with phakia (age 57.3 ± 10.2 years, 49.1% women) that were included in this cross-sectional analysis. Mean IOP was 14.8 ± 2.9 mm Hg in the right eyes and 14.9 ± 2.9 mm Hg in the left eyes. IOP increased with higher CCT, greater posterior segment length, higher age (all P < 0.001), thicker lens (P = 0.003), and female sex (P = 0.05), whereas the ACD was not associated with higher IOP. The IOP increased with a narrower ACA in univariable analysis (P < 0.001), but not in adjusted analysis in subjects with an open angle. Conclusions IOP values are related to ocular geometry, as shown in this population-based study on Caucasian subjects. Thus, knowledge of the architecture of the eye is an important factor when measuring IOP. Longitudinal evaluation will analyze whether some of these parameters are also risk factors for the development of glaucoma.
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Affiliation(s)
- Esther M Hoffmann
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Fidan Aghayeva
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Felix M Wagner
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Achim Fiess
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Markus Nagler
- Preventive Cardiology and Preventive Medicine - Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
| | - Philipp S Wild
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany.,Preventive Cardiology and Preventive Medicine - Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Irene Schmidtmann
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Karl J Lackner
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany.,Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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Vieira MJ, Pereira J, Castro M, Arruda H, Martins J, Sousa JP. Efficacy of corneal shape index in the evaluation of ocular hypertension, primary open-angle glaucoma and exfoliative glaucoma. Eur J Ophthalmol 2022; 32:275-281. [DOI: 10.1177/1120672120972020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose: The aim of the present study is to calculate Concavity Shape Index (CSI) in patients with POAG and exfoliative glaucoma (XFG) and correlate CSI with the severity of glaucoma, comparing to control and ocular hypertension (OHT) patients. Methods: This was a cross‑sectional study with 146 eyes/146 subjects: 37 healthy eyes, 23 eyes with OHT and 86 glaucoma eyes (70 with POAG, 16 with XFG). The severity of glaucoma was scored with the Glaucoma Staging System 2 (GSS2). Corvis ST® was used to calculate CSI. Results: Central corneal thickness (CCT) was significantly thinner in POAG (526 ± 40.0 µm) and XFG (520 ± 38.2 µm) than control group (553 ± 28.8 µm). CSI had no significant differences between the groups. XFG had a higher mean of GSS 2 (2.42 ± 1.38) than POAG (1.87 ± 1.55) and OHT (1.87 ± 1.55). OHT had a significantly less deformable cornea than: control (higher A1 length, lower A1 velocity, higher A2 velocity), POAG (higher A1 length, lower A1 velocity, lower deflection amplitude at highest concavity), and XFG group (lower A1 velocity, lower deflection amplitude at highest concavity), which was independent of age and CCT. No significant correlation was found between GSS 2 and CSI. Discussion: OHT patients had stiffer corneas (less deformed by the air puff) when compared to control, POAG or XFG patients. A less deformable cornea could potentially be related to a more resistant LC/peripapillary sclera. As such, this would result in a lesser optic nerve susceptibility to IOP damage.
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Affiliation(s)
- Maria J Vieira
- Ophthalmology Department, Centro Hospitalar Leiria, Leiria, Portugal
| | - Joana Pereira
- Ophthalmology Department, Centro Hospitalar Leiria, Leiria, Portugal
| | - Miguel Castro
- Ophthalmology Department, Centro Hospitalar Leiria, Leiria, Portugal
| | - Henrique Arruda
- Ophthalmology Department, Centro Hospitalar Leiria, Leiria, Portugal
| | - Joana Martins
- Ophthalmology Department, Centro Hospitalar Leiria, Leiria, Portugal
| | - João Paulo Sousa
- Ophthalmology Department, Centro Hospitalar Leiria, Leiria, Portugal
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Sun MG, Son T, Crutison J, Guaiquil V, Lin S, Nammari L, Klatt D, Yao X, Rosenblatt MI, Royston TJ. Optical coherence elastography for assessing the influence of intraocular pressure on elastic wave dispersion in the cornea. J Mech Behav Biomed Mater 2022; 128:105100. [PMID: 35121423 PMCID: PMC8904295 DOI: 10.1016/j.jmbbm.2022.105100] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 01/17/2022] [Accepted: 01/21/2022] [Indexed: 10/19/2022]
Abstract
The cornea is a highly specialized organ that relies on its mechanical stiffness to maintain its aspheric geometry and refractive power, and corneal diseases such as keratoconus have been linked to abnormal tissue stiffness and biomechanics. Dynamic optical coherence elastography (OCE) is a clinically promising non-contact and non-destructive imaging technique that can provide measurements of corneal tissue stiffness directly in vivo. The method relies on the concepts of elastography where shear waves are generated and imaged within a tissue to obtain mechanical properties such as tissue stiffness. The accuracy of OCE-based measurements is ultimately dependent on the mathematical theories used to model wave behavior in the tissue of interest. In the cornea, elastic waves propagate as guided wave modes which are highly dispersive and can be mathematically complex to model. While recent groups have developed detailed theories for estimating corneal tissue properties from guided wave behavior, the effects of intraocular pressure (IOP)-induced prestress have not yet been considered. It is known that prestress alone can strongly influence wave behavior, in addition to the associated non-linear changes in tissue properties. This present study shows that failure to account for the effects of prestress may result in overestimations of the corneal shear moduli, particularly at high IOPs. We first examined the potential effects of IOP and IOP-induced prestress using a combination of approximate mathematical theories describing wave behavior in thin plates with observations made from data published in the OCE literature. Through wave dispersion analysis, we deduce that IOP introduces a tensile hoop stress and may also influence an elastic foundational effect that were observable in the low-frequency components of the dispersion curves. These effects were incorporated into recently developed models of wave behavior in nearly incompressible, transversely isotropic (NITI) materials. Fitting of the modified NITI model with ex vivo porcine corneal data demonstrated that incorporation of the effects of IOP resulted in reduced estimates of corneal shear moduli. We believe this demonstrates that overestimation of corneal stiffness occurs if IOP is not taken into consideration. Our work may be helpful in separating inherent corneal stiffness properties that are independent of IOP; changes in these properties and in IOP are distinct, clinically relevant issues that affect the cornea health.
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Karmiris E, Tsiripidis K, Gartaganis PS, Totou S, Vasilopoulou MG, Patelis A, Giannakis I, Chalkiadaki E. Comparison of intraocular pressure obtained by Goldmann applanation tonometer, Corvis ST and an airpuff tonometer in healthy adults. Eur J Ophthalmol 2021; 32:11206721211069227. [PMID: 34955039 DOI: 10.1177/11206721211069227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To assess the agreement among four types of intraocular pressure (IOP) measurements: IOP obtained by Goldmann applanation tonometer (IOP-GAT),IOP obtained by an air-puff tonometer (Nidek NT-510)(IOP-NCT), the non-corrected IOP obtained by the Corneal Visualization Scheimpflug Technology (IOP-Corvis) and the biomechanically corrected IOP obtained by the Corvis ST (bIOP-Corvis) in healthy patients with a broad spectrum of IOP values. Methods: This prospective, observational study recruited 113 healthy individuals. Each patient underwent IOP evaluation via GAT, Nidek NT-510 and Corvis ST. Difference in mean in IOP readings was assessed by one-way repeated-measures analysis of variance (ANOVA).Tonometer intermethod agreement was assessed by the Bland-Altman method. The difference between the four IOP measurements was correlated against corneal (CCT) and age with Pearson's correlation test. Results: IOP-Corvis showed the highest values (16.59 ± 3.08 mmHg),followed by IOP-NCT (16.05 ± 3.43 mmHg), IOP-GAT (15.62 ± 3.08 mmHg) and bIOP-Corvis (15.10 ± 2.67 mmHg).There were statistically significant differences in IOP measurements among all the ANOVA pairwise comparisons except between IOP-GAT and bIOP-Corvis (p = 0.07),as well as between IOP-GAT and IOP-NCT (p = 0.25). Bland Altman analysis revealed a notable bias (all p < 0.05) among IOP-GAT and bIOP-Corvis, IOP-GAT and IOP-Corvis, IOP-GAT and IOP-NCT, bIOP-Corvis and IOP-Corvis, bIOP-Corvis and IOP-NCT,IOP-Corvis and IOP-NCT of 0.51, -0.97, -0.43, -1.49, -0.95, 0.53 mmHg respectively. We observed a strong correlation of the difference between bIOP-Corvis and IOP-Corvis with CCT and patient age. Conclusion: Compared with GAT and Nidek NT-510, the Corvis-derived IOPs were recorded either the highest as IOP-Corvis or the lowest as bIOP-Corvis. Even if the differences among the tonometers were relatively small, the IOP values obtained with the Corvis ST, NCT and GAT were not interchangeable.
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Affiliation(s)
- Efthymios Karmiris
- Department of Ophthalmology, 251 Hellenic Airforce General Hospital, Athens, Greece
| | | | - Panos S Gartaganis
- Department of Ophthalmology, 251 Hellenic Airforce General Hospital, Athens, Greece
| | - Styliani Totou
- Department of Ophthalmology, 251 Hellenic Airforce General Hospital, Athens, Greece
| | | | - Andreas Patelis
- Department of Ophthalmology, 251 Hellenic Airforce General Hospital, Athens, Greece
| | - Ioannis Giannakis
- Department of Ophthalmology, 251 Hellenic Airforce General Hospital, Athens, Greece
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Yasukura Y, Miki A, Maeda N, Koh S, Nishida K. Effect of Prostaglandin Analogues on Corneal Biomechanical Parameters Measured With a Dynamic Scheimpflug Analyzer. J Glaucoma 2021; 30:996-1000. [PMID: 34086611 DOI: 10.1097/ijg.0000000000001895] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 04/19/2021] [Indexed: 11/26/2022]
Abstract
PRCIS Treatment with topical prostaglandin analogues (PGAs) induces increased corneal compliance in glaucoma eyes measured with a dynamic Scheimpflug analyzer. PURPOSE The purpose of this study was to evaluate the effect of topical PGAs on the corneal biomechanical properties. METHODS We retrospectively studied the biomechanical parameters of 31 eyes of 19 consecutive patients with glaucoma measured using a dynamic Scheimpflug analyzer (Corvis ST) before and after initiation of treatment with topical PGAs. No patients had a history of glaucoma treatment before the study and no other antiglaucoma medication was used during the study period. Nine biomechanical parameters were evaluated before and 61.6±28.5 days (range: 21 to 105 d) after initiation of the treatment. The changes in the corneal biomechanical parameters before and after treatment were analyzed using multivariable models adjusting for intraocular pressure and central corneal thickness. The Benjamini-Hochberg method was used to correct for multiple comparison. RESULTS In multivariable models, PGA treatment resulted in shorter inward applanation time (P=0.016, coefficient=-0.151) and larger deflection amplitude (P=0.023, coefficient=0.055), peak distance (P=0.042, coefficient=0.131), and deformation amplitude ratio at 1 mm (P=0.018, coefficient=0.028). These associations consistently indicated increased corneal compliance (deformability) after PGA treatment. CONCLUSION Topical PGAs resulted in greater corneal compliance, suggesting that the changes in the corneal biomechanical properties may lead to overestimation of the intraocular pressure-lowering effects.
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Affiliation(s)
| | - Atsuya Miki
- Departments of Ophthalmology
- Innovative Visual Science, Osaka University Graduate School of Medicine
| | | | - Shizuka Koh
- Departments of Ophthalmology
- Innovative Visual Science, Osaka University Graduate School of Medicine
| | - Kohji Nishida
- Departments of Ophthalmology
- Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Osaka Prefecture, Japan
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Wu Y, Szymanska M, Hu Y, Fazal MI, Jiang N, Yetisen AK, Cordeiro MF. Measures of disease activity in glaucoma. Biosens Bioelectron 2021; 196:113700. [PMID: 34653715 DOI: 10.1016/j.bios.2021.113700] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/01/2021] [Accepted: 10/08/2021] [Indexed: 12/13/2022]
Abstract
Glaucoma is the leading cause of irreversible blindness globally which significantly affects the quality of life and has a substantial economic impact. Effective detective methods are necessary to identify glaucoma as early as possible. Regular eye examinations are important for detecting the disease early and preventing deterioration of vision and quality of life. Current methods of measuring disease activity are powerful in describing the functional and structural changes in glaucomatous eyes. However, there is still a need for a novel tool to detect glaucoma earlier and more accurately. Tear fluid biomarker analysis and new imaging technology provide novel surrogate endpoints of glaucoma. Artificial intelligence is a post-diagnostic tool that can analyse ophthalmic test results. A detail review of currently used clinical tests in glaucoma include intraocular pressure test, visual field test and optical coherence tomography are presented. The advanced technologies for glaucoma measurement which can identify specific disease characteristics, as well as the mechanism, performance and future perspectives of these devices are highlighted. Applications of AI in diagnosis and prediction in glaucoma are mentioned. With the development in imaging tools, sensor technologies and artificial intelligence, diagnostic evaluation of glaucoma must assess more variables to facilitate earlier diagnosis and management in the future.
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Affiliation(s)
- Yue Wu
- Department of Surgery and Cancer, Imperial College London, South Kensington, London, United Kingdom; Department of Chemical Engineering, Imperial College London, South Kensington, London, United Kingdom
| | - Maja Szymanska
- The Imperial College Ophthalmic Research Group (ICORG), Imperial College London, London, United Kingdom
| | - Yubing Hu
- Department of Chemical Engineering, Imperial College London, South Kensington, London, United Kingdom.
| | - M Ihsan Fazal
- The Imperial College Ophthalmic Research Group (ICORG), Imperial College London, London, United Kingdom
| | - Nan Jiang
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041, China
| | - Ali K Yetisen
- Department of Chemical Engineering, Imperial College London, South Kensington, London, United Kingdom
| | - M Francesca Cordeiro
- The Imperial College Ophthalmic Research Group (ICORG), Imperial College London, London, United Kingdom; The Western Eye Hospital, Imperial College Healthcare NHS Trust (ICHNT), London, United Kingdom; Glaucoma and Retinal Neurodegeneration Group, Department of Visual Neuroscience, UCL Institute of Ophthalmology, London, United Kingdom.
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Lopes BT, Bao F, Wang J, Liu X, Wang L, Abass A, Eliasy A, Elsheikh A. Review of in-vivo characterisation of corneal biomechanics. MEDICINE IN NOVEL TECHNOLOGY AND DEVICES 2021. [DOI: 10.1016/j.medntd.2021.100073] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
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Chen YY, Wang TH, Huang JY, Su CC. Relationship of axial length and corneal biomechanical properties with susceptibility to unilateral normal-tension glaucoma. Graefes Arch Clin Exp Ophthalmol 2021; 260:255-264. [PMID: 34410485 DOI: 10.1007/s00417-021-05346-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 07/04/2021] [Accepted: 07/26/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Corneal biomechanics, reflecting structural vulnerabilities of the eyeball, may participate in the pathogenesis of unilateral normal-tension glaucoma. This study investigated the pathophysiology of unilateral normal-tension glaucoma using Corvis ST (OCULUS Optikgeräte GmbH) and other ocular characteristics. METHODS Eighty-three patients with normal-tension glaucoma with unilateral visual field loss and structurally unaffected fellow eyes and 111 healthy controls were included in this prospective study. Dynamic corneal response parameters, intraocular pressure measured by rebound tonometry, central corneal thickness, and axial length were assessed on the same day. Measurements were compared between affected eyes, unaffected fellow eyes, and control eyes. Risk factors for normal-tension glaucoma and unilateral involvement were the main outcome measures. RESULTS A shorter first applanation time (adjusted odds ratio, 0.061; 95% confidence interval, 0.018-0.215) and a larger peak distance (adjusted odds ratio, 4.935; 95% confidence interval, 1.547-15.739) were significant risk factors for normal-tension glaucoma and were associated with greater glaucoma severity (both P < 0.001). Axial length (adjusted odds ratio, 29.015; 95% confidence interval, 4.452-189.083) was the predominant risk factor for unilateral involvement in patients with normal-tension glaucoma. CONCLUSION The eyes with normal-tension glaucoma were more compliant than healthy eyes. Axial elongation-associated optic nerve strain may play an important role in unilateral normal-tension glaucoma with similar corneal and scleral biomechanics in both eyes.
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Affiliation(s)
- Ying-Yi Chen
- Department of Ophthalmology, National Taiwan University Hospital College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Ophthalmology, Cathay General Hospital, Taipei, Taiwan
| | - Tsing-Hong Wang
- Department of Ophthalmology, National Taiwan University Hospital College of Medicine, National Taiwan University, Taipei, Taiwan
- National Taiwan University College of Medicine, Taipei, Taiwan
| | - Jehn-Yu Huang
- Department of Ophthalmology, National Taiwan University Hospital College of Medicine, National Taiwan University, Taipei, Taiwan
- National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chien-Chia Su
- Department of Ophthalmology, National Taiwan University Hospital College of Medicine, National Taiwan University, Taipei, Taiwan.
- National Taiwan University College of Medicine, Taipei, Taiwan.
- National Taiwan University Hospital, No. 7, Chung-Shan S. Rd., Taipei, Taiwan.
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Association between visual field damage and corneal structural parameters. Sci Rep 2021; 11:10732. [PMID: 34031496 PMCID: PMC8144395 DOI: 10.1038/s41598-021-90298-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 05/07/2021] [Indexed: 12/03/2022] Open
Abstract
The main goal of this study is to identify the association between corneal shape, elevation, and thickness parameters and visual field damage using machine learning. A total of 676 eyes from 568 patients from the Jichi Medical University in Japan were included in this study. Corneal topography, pachymetry, and elevation images were obtained using anterior segment optical coherence tomography (OCT) and visual field tests were collected using standard automated perimetry with 24-2 Swedish Interactive Threshold Algorithm. The association between corneal structural parameters and visual field damage was investigated using machine learning and evaluated through tenfold cross-validation of the area under the receiver operating characteristic curves (AUC). The average mean deviation was − 8.0 dB and the average central corneal thickness (CCT) was 513.1 µm. Using ensemble machine learning bagged trees classifiers, we detected visual field abnormality from corneal parameters with an AUC of 0.83. Using a tree-based machine learning classifier, we detected four visual field severity levels from corneal parameters with an AUC of 0.74. Although CCT and corneal hysteresis have long been accepted as predictors of glaucoma development and future visual field loss, corneal shape and elevation parameters may also predict glaucoma-induced visual functional loss.
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Abstract
Glaucoma is the second cause of irreversible blindness in the world. Intraocular pressure (IOP) is a recognized major risk factor for the development and progression of glaucomatous damage. Goldmann applanation tonometry (GAT) is internationally accepted as the gold standard for the measurement of IOP. The purpose of this study was to search for correlations between Goldmann tonometry and corneal mechanical properties and thickness by means of in vitro tests. IOP was measured by the Goldmann applanation tonometer (GIOP), and by a pressure transducer inserted in the anterior chamber of the eye (TIOP), at increasing pressure levels by addition of saline solution in the anterior chamber of enucleated pig eyes (n = 49). Mechanical properties were also determined by inflation tests. The GAT underestimated the real measurements made by the pressure transducer, with most common differences in the range 15–28 mmHg. The difference between the two instruments, highlighted by the Bland–Altman test, was confirmed by ANOVA, normality tests, and Mann–Whitney’s tests, both on the data arranged for infusions and for the data organized by pressure ranges. Pearson correlation tests revealed a negative correlation between (TIOP-GIOP) and both corneal stiffness and corneal thickness. In conclusion, data obtained showed a discrepancy between GIOP and TIOP more evident for softer and thinner corneas, that is very important for glaucoma detection.
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Baptista PM, Ambrosio R, Oliveira L, Meneres P, Beirao JM. Corneal Biomechanical Assessment with Ultra-High-Speed Scheimpflug Imaging During Non-Contact Tonometry: A Prospective Review. Clin Ophthalmol 2021; 15:1409-1423. [PMID: 33854295 PMCID: PMC8039844 DOI: 10.2147/opth.s301179] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/05/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND In recent years, increasing interest has arisen in the application of data from corneal biomechanics in many areas of ophthalmology, particularly to assist in the detection of early corneal ectasia or ectasia susceptibility, to predict corneal response to surgical or therapeutic interventions and in glaucoma management. Technology has evolved and, recently, the Scheimpflug principle was associated with a non-contact air-puff tonometer, allowing a thorough analysis of corneal biomechanics and a biomechanically corrected intraocular pressure assessment, opening up new perspectives both in ophthalmology and in other medical areas. Data from corneal biomechanics assessment are being integrated in artificial intelligence models in order to increase its value in clinical practice. OBJECTIVE To review the state of the art in the field of corneal biomechanics assessment with special emphasis to the technology based on ultra-high-speed Scheimpflug imaging during non-contact tonometry. SUMMARY A meticulous literature review was performed until the present day. We used 136 published manuscripts as our references. Both information from healthy individuals and descriptions of possible associations with systemic diseases are described. Additionally, it exposed information regarding several fields of ocular pathology, from cornea and ocular surface through areas of refractive surgery and glaucoma until vascular and structural diseases of the chorioretinal unit.
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Affiliation(s)
- Pedro Manuel Baptista
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Porto, Portugal
| | - Renato Ambrosio
- Rio de Janeiro Corneal Tomography and Biomechanics Study Group, Rio de Janeiro, RJ, Brazil
- Department of Cornea and Refractive Surgery, Instituto de Olhos Renato Ambrósio, Rio de Janeiro, Brazil
- Department of Opthalmology, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
- Federal University of São Paulo (UNIFESP), São Paulo, Brazil
- Brazilian Study Group of Artificial Intelligence and Corneal Analysis - BrAIN, Rio de Janeiro & Maceió, Brazil
| | - Luis Oliveira
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Pedro Meneres
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Porto, Portugal
| | - Joao Melo Beirao
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Porto, Portugal
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Comparison of corneal biomechanics among primary open-angle glaucoma with normal tension or hypertension and controls. Chin Med J (Engl) 2021; 134:1087-1092. [PMID: 33813516 PMCID: PMC8116033 DOI: 10.1097/cm9.0000000000001399] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background: Normal tension glaucoma (NTG) is a less pressure-dependent type of glaucoma with characteristic optic neuropathy. Recently, the biomechanical mechanism has been thought to account for glaucomatous optic neuropathy to some degree. We intended to compare dynamic corneal response parameters (DCRs) among patients with primary open-angle glaucoma with normal tension or hypertension and controls. The correlations between DCRs and known risk factors for glaucoma were also analyzed. Methods: In this cross-sectional study, 49 NTG subjects, 45 hypertension glaucoma (HTG) subjects, and 50 control subjects were enrolled. We compared the differences in DCRs using corneal visualization Scheimpflug technology among the NTG, HTG, and control groups. We also analyzed the correlations between DCRs and known risk factors for glaucoma (eg, central corneal thickness [CCT], intraocular pressure [IOP], etc). Results: The maximum inverse concave radius (NTG: 0.18 [0.17, 0.20] mm−1; control: 0.17 [0.16, 0.18] mm−1; P = 0.033), deformation amplitude ratio of 2 mm (DAR 2 mm, NTG: 4.87 [4.33, 5.39]; control: 4.37 [4.07, 4.88]; P < 0.001), and DAR 1 mm (NTG: 1.62 [1.58, 1.65]; control: 1.58 [1.54, 1.61]; P < 0.001) were significantly higher in NTG than in the controls. The integrated radius (IR, NTG: 8.40 ± 1.07 mm−1; HTG: 7.64 ± 1.31 mm−1; P = 0.026) and DAR 2 mm (NTG: 4.87 [4.33, 5.39]; HTG: 4.44 [4.12, 5.02]; P < 0.007) were significantly higher, whereas the stiffness parameter at the first applanation (SP-A1, NTG: 91.23 [77.45, 107.45]; HTG: 102.36 [85.77, 125.12]; P = 0.007) was lower in NTG than in HTG. There were no significant differences in the DCRs between HTG and control groups (P > 0.05). In the univariate and multivariate analyses, some of the DCRs, such as IR, were negatively correlated with CCT and IOP, whereas SP-A1 was positively correlated with CCT and IOP. Conclusions: The cornea was more deformable in NTG than in HTG or controls. There were no significant differences in corneal deformability between HTG and controls. The cornea was more deformable with the thinner cornea and lower IOP.
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Chou CC, Shih PJ, Lin HC, Chen JP, Yen JY, Wang IJ. Changes in Intraocular Pressure after Transepithelial Photorefractive Keratectomy and Femtosecond Laser In Situ Keratomileusis. J Ophthalmol 2021; 2021:5592195. [PMID: 33777445 PMCID: PMC7972855 DOI: 10.1155/2021/5592195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/22/2021] [Accepted: 02/28/2021] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To investigate the changes in intraocular pressure (IOP) and biomechanically corrected IOP (bIOP) in patients undergoing transepithelial photorefractive keratectomy (TPRK) and femtosecond laser in situ keratomileusis (FS-LASIK) and to determine the effects of preoperative biomechanical factors on IOP and bIOP changes after FS-LASIK and TPRK. DESIGN A retrospective comparative study. METHODS We retrospectively investigated the IOP and corneal biomechanical changes in 93 eyes undergoing FS-LASIK and 104 eyes undergoing TPRK in a clinical setting. Preoperative and postoperative data on ophthalmic and Corvis ST examinations, in vivo Young's modulus, and noncontact tonometry were analyzed. Marginal linear regression models with generalized estimating equations were used for intragroup and intergroup comparisons of IOP and bIOP changes. RESULTS In the univariate model, IOP reduction after FS-LASIK was 2.49 mmHg higher than that after TPRK. In addition, bIOP reduction after FS-LASIK was 1.85 mmHg higher than that after TPRK. In the multiple regression model, we revealed that IOP reduction after FS-LASIK was 1.75 mmHg higher than that after TPRK. Additionally, bIOP reduction after FS-LASIK was 1.64 mmHg higher than that after TPRK. Postoperative changes in bIOP were less than those in IOP. In addition, Young's modulus and CBI had no significant effect on postoperative IOP and bIOP changes. We establish a biomechanically predictive model using the available data to predict postoperative IOP and bIOP changes after TPRK and FS-LASIK. CONCLUSIONS Reductions in IOP and bIOP after FS-LASIK were 1.75 mmHg and 1.64 mmHg, respectively, more than those after TPRK, after adjustment for confounders. We revealed that the type of refractive surgery and peak distance (PD) were significant predictors of postoperative IOP and bIOP changes. By contrast, depth of ablation showed a significant effect on only IOP changes.
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Affiliation(s)
- Chien-Chih Chou
- Department of Ophthalmology, Taichung Veterans General Hospital, Taichung, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Po-Jen Shih
- Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Hung-Chou Lin
- Dr. Lin's Eye Clinic and Laser Vision Correction Center, Taoyuan, Taiwan
| | - Jun-Peng Chen
- Biostatistics Task Force of Taichung Veterans General Hospital, Taichung, Taiwan
| | - Jia-Yush Yen
- Department of Mechanical Engineering, National Taiwan University, Taipei, Taiwan
| | - I-Jong Wang
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
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Wang X, McAlinden C, Zhang H, Yan J, Wang D, Wei W, Mi S. Assessment of corneal biomechanics, tonometry and pachymetry with the Corvis ST in myopia. Sci Rep 2021; 11:3041. [PMID: 33542296 PMCID: PMC7862660 DOI: 10.1038/s41598-020-80915-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 12/16/2020] [Indexed: 11/09/2022] Open
Abstract
To evaluate the repeatability of Corvis ST corneal biomechanical, tonometry and pachymetry measurements, and agreement of pachymetry measures with the Pentacam HR and RTVue OCT. Three consecutive measurements of the right eye of 238 myopic subjects were acquired with the Corvis ST, Pentacam HR, and RTVue OCT. Repeatability of Corvis ST was evaluated by within-subject standard deviation [Sw] and repeatability limit [r]. The agreement of central corneal thickness (CCT) measurements were compared among the three instruments using the Bland-Altman limits of agreement. Comparisons were further stratified by CCT (Corneathin ≤ 500 µm; Corneanormal = 500-550 µm; Corneathick > 550 µm). Sw was below 1 mmHg in Corneathin, Corneanormal, and Corneathick groups for IOP and bIOP. Sw for SP-A1 were 4.880, 6.128, 7.719 mmHg/mm respectively. Sw for CBI were 0.228, 0.157, 0.076, and correspondingly Sw for TBI and SSI were 0.094 and 0.056, 0.079 and 0.053, 0.070 and 0.053. The Bland-Altman plots for CCT implied poor agreement with mean differences of 29.49 µm between Corvis and OCT, 9.33 µm between Pentacam and OCT, and 20.16 µm between Corvis and Pentacam. The Corvis ST showed good repeatability with the exception of CBI in the various CCT groups. The CCT measured by Corvis ST was not interchangeable with Pentacam HR and RTVue OCT.
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Affiliation(s)
- Xiaorui Wang
- Department of Ophthalmology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277, West Yanta Road, Xi'an, Shaanxi, China.,Laser Vision Center, The First Affiliated Hospital of Northwestern University, No. 30, Fenxiang Alley, Xi'an, Shaanxi, China.,Shaanxi Institute of Ophthalmology, Xi'an, China
| | - Colm McAlinden
- Department of Ophthalmology, Singleton Hospital, Swansea Bay University Health Board, Swansea, UK
| | - Hongbing Zhang
- Laser Vision Center, The First Affiliated Hospital of Northwestern University, No. 30, Fenxiang Alley, Xi'an, Shaanxi, China.,Shaanxi Institute of Ophthalmology, Xi'an, China
| | - Jie Yan
- Department of Ophthalmology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277, West Yanta Road, Xi'an, Shaanxi, China
| | - Dan Wang
- Department of Ophthalmology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277, West Yanta Road, Xi'an, Shaanxi, China
| | - Wei Wei
- Laser Vision Center, The First Affiliated Hospital of Northwestern University, No. 30, Fenxiang Alley, Xi'an, Shaanxi, China. .,Shaanxi Institute of Ophthalmology, Xi'an, China.
| | - Shengjian Mi
- Department of Ophthalmology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277, West Yanta Road, Xi'an, Shaanxi, China.
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Özkan Aksoy N, Çakır B, Aksoy YE, Demir Boncukçu K, Özmen S, Çelik E, Alagöz G. Effects of glaucoma and central corneal thickness on optic nerve head biomechanics. Int Ophthalmol 2021; 41:1283-1289. [PMID: 33387111 DOI: 10.1007/s10792-020-01686-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 12/19/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate effects of glaucoma and central corneal thickness (CCT) on optic nerve head biomechanics. METHODS Four groups were formed according to CCT measurements and the presence of glaucoma. Glaucomatous patients with thin (< 510 µ) and thick (> 570 µ) corneas composed groups 1 and 3, respectively. Nonglaucomatous patients with thin and thick corneas composed groups 2 and 4, respectively. Real-time elastography (RTE) was performed on all groups, and optic nerve strain rate (ONSR), orbital fat strain rate (OFSR), and strain ratio of orbital fat to the optic nerve and medial and lateral parts of the optic nerve (SROFON, SROFMON, SROFLON, respectively) were obtained and compared between groups. The correlations between CCT and these parameters were also investigated. RESULTS Statistically significant difference was not found between groups in terms of strain rate of optic nerve and orbital fat, SRFON, SROFMON and SROFLON. There was a positive correlation between ONSR and OFSR and mean CCT in patients with CCT thinner than 510 µ (p: 0.03 r: 0.26, p: 0.01 r: 0.32 respectively). CONCLUSION SROFON, SROFLON and SROFMON values did not differ between glaucomatous and nonglaucomatous patients with thin or thick CCTs. The correlations between CCT and OFSR and ONSR were found to be statistically significant in patients with thin CCT.
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Affiliation(s)
- Nilgün Özkan Aksoy
- Department of Ophthalmology, Sakarya University Medical Education and Research Hospital, Sakarya, Turkey.
| | - Burçin Çakır
- Department of Ophthalmology, Sakarya University Medical Education and Research Hospital, Sakarya, Turkey
| | - Yakup Ersel Aksoy
- Department of Ophthalmology, Sakarya University Medical Education and Research Hospital, Sakarya, Turkey
| | - Kadriye Demir Boncukçu
- Department of Ophthalmology, Sakarya University Medical Education and Research Hospital, Sakarya, Turkey
| | - Sedat Özmen
- Department of Ophthalmology, Sakarya University Medical Education and Research Hospital, Sakarya, Turkey
| | - Erkan Çelik
- Department of Ophthalmology, Sakarya University Medical Education and Research Hospital, Sakarya, Turkey
| | - Gürsoy Alagöz
- Department of Ophthalmology, Sakarya University Medical Education and Research Hospital, Sakarya, Turkey
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Sun Y, Guo Y, Cao K, Zhang Y, Xie Y, Pang R, Shi Y, Wang H, Wang N. Relationship between corneal stiffness parameters and lamina cribrosa curvature in normal tension glaucoma. Eur J Ophthalmol 2020; 31:3049-3056. [PMID: 33334173 DOI: 10.1177/1120672120982521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To evaluate the relationship between corneal biomechanical parameters and lamina cribrosa (LC) curvature in normal tension glaucoma (NTG). METHODS 95 eyes of 56 NTG patients were enrolled in this prospective, observational study. Corneal biomechanical parameters, including stiffness parameters at applanation 1 (SP-A1), deformation amplitude ratio (DA ratio), inverse concave radius and biomechanically corrected intraocular pressure estimate (bIOP), were captured using the Corneal Visualization Scheimpflug Technology instrument (Corvis-ST). LC curvature was evaluated by mean adjusted LC curvature index (maLCCI) averaged by the measurements on 12 radial B-scan images obtained using swept-source optical coherence tomography (SS-OCT). Linear mixed models were constructed to assess the relationship between corneal biomechanical parameters and LC curvature. RESULTS The mean age of participants was 51.04 ± 13.74 years (range, 24-82 years). The SP-A1 and maLCCI were 93.50 ± 13.82 mm Hg/mm and 7.57 ± 1.58, respectively. In univariate and multivariate analysis, SP-A1 (p < 0.001 and p = 0.001) and age (p = 0.010 and p = 0.024) were both significantly associated with maLCCI. The LC curvature increased with softer cornea demonstrated by lower SP-A1 and younger eyes. There was no statistical significance interaction between SP-A1 and age (p = 0.194). CONCLUSIONS The greater posterior LC curvature was associated with lower corneal stiffness parameters and younger eyes in NTG patients. CLINICAL TRIAL REGISTRATION Chinese Clinical Trial Registry, ChiCTR1900021465.
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Affiliation(s)
- Yunxiao Sun
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China
| | - Yiqin Guo
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China
| | - Kai Cao
- Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China
| | - Yue Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China
| | - Yuan Xie
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ruiqi Pang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China
| | - Yan Shi
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Huaizhou Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China
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Association between Corneal Stiffness Parameter at the First Applanation and Keratoconus Severity. J Ophthalmol 2020; 2020:6667507. [PMID: 33343935 PMCID: PMC7726963 DOI: 10.1155/2020/6667507] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/10/2020] [Accepted: 11/10/2020] [Indexed: 02/07/2023] Open
Abstract
Objective The study aimed to evaluate the character of corneal stiffness parameter at the first applanation (SP-A1) in normal and keratoconus eyes and explore the association between SP-A1 and keratoconus severity indicators. Methods A total of 351 normal and 351 keratoconus eyes were included in the current study. Keratoconus was diagnosed according to the corneal topography map and slit-lamp examination. The severity of keratoconus was classified to mild (steep keratometry (Ks) < 48D), moderate (48 ≤ Ks < 55D), and severe (Ks ≥ 55D). The SP-A1 was measured using the Corvis ST software. The correlation analyses and receiver operating characteristic (ROC) curve were performed in the current analysis. Results The SP-A1 values of keratoconus were lower than that of normal eyes (72.11 (57.02, 83.08) mmHg/mm vs 110.89 (100.45, 122.47) mmHg/mm, P < 0.001). With the severity of keratoconus increasing, the SP-A1 decreased and the value of SP-A1 was 79.54 (70.30, 90.93) mmHg/mm, 65.11 (53.14, 77.46) mmHg/mm, and 47.59 (37.50, 62.14) mmHg/mm in mild, moderate, and severe keratoconus eyes, respectively (P < 0.001). The negative association between SP-A1 and Ks was found in mild, moderate, and severe keratoconus eyes (r mild = -0.171, r moderate = -0.317, r severe = -0.288, all P < 0.05). A positive association between SP-A1 and the thinnest corneal thickness (TCT) was found in all eyes (rnormal = 0.687, r mild = 0.519, r moderate = 0.488, r severe = 0.382, all P < 0.05). SP-A1 was found to be statistically positively associated with intraocular pressure (IOP), biomechanical corrected IOP (bIOP), time from the initiation of air puff until the first applanation (A1T), corneal velocity at the second applanation (A2V), and negatively associated with deformation amplitude (DA), peak distance (PD), corneal velocity at the first applanation (A1V), time from the initiation of air puff until the second applanation (A2T), and DA Ratio Max [2 mm] both in normal and keratoconus eyes (all P < 0.05). The ROC analysis indicated that the AUC (95% CI) of SP-A1 was 0.952 (0.934-0.967) and 0.930 (0.904-0.951) in detecting keratoconus eyes and mild keratoconus eyes from normal eyes, respectively. Conclusions The SP-A1 value decreased while the keratoconus severity increased. It was lower in keratoconus than that in normal eyes and could be helpful in identifying keratoconus eyes from normal eyes. Further researches would be warranted to expand the clinical utility of SP-A1.
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