Three-dimensional OCT based guinea pig eye model: relating morphology and optics

Postoperative intraocular lens tilt from preoperative full crystalline lens geometry using machine learning

In cataract surgery, the opacified crystalline lens is replaced by an artificial intraocular lens (IOL), requiring precise preoperative selection of parameters to optimize postoperative visual quality. Three-dimensional customized eye models, which can be constructed using quantitative data from anterior segment optical coherence tomography, provide a robust platform for virtual surgery. These models enable simulations and predictions of the optical outcomes for specific patients and selected IOLs. A critical step in building these models is estimating the IOL's tilt and position preoperatively based on the available preoperative geometrical information (ocular parameters). In this study, we present a machine learning model that, for the first time, incorporates the full shape geometry of the crystalline lens as candidate input features to predict the postoperative IOL tilt. Furthermore, we identify the most relevant features for this prediction task. Our model demonstrates statistically significantly lower estimation errors compared to a simple linear correlation method, reducing the estimation error by approximately 6%. These findings highlight the potential of this approach to enhance the accuracy of postoperative predictions. Further work is needed to examine the potential for such postoperative predictions to improve visual outcomes in cataract patients.

Comparative analysis of ocular biometrics using spectral domain optical coherence tomography with Purkinje image and optic nerve head alignments in mice

BACKGROUND

Mice are an emerging model for experimental myopia. Due to their small eye size, non-invasive optical coherence tomography is essential for evaluating ocular biometrics. There is currently no universally accepted protocol for those measurements. This study aims to compare ocular biometric measurements using two methods: Purkinje image-based alignment and optic nerve head alignment, utilizing spectral domain optical coherence tomography. Gaining an understanding of the implications of these methods in determining axial elongation in the normal growing eyes of wild-type C57BL/6J mice would offer valuable insight into their relevance for the experimental myopia model.

METHODS

Ocular dimensions and refractive development were measured on postnatal days P21 (n = 10), P28 (n = 15), and P35 (n = 8). The Purkinje image-based alignment (P1) was determined using a photorefractor and aligned perpendicular to the corneal apex using SD-OCT. In comparison, due to the absence of a fovea in the mouse retina, the optic nerve head (ONH) alignment was used. Variance analysis, regression analysis, and Bland-Altman analysis were performed to compare the differences between alignment methods as well as the replication by another operator.

RESULTS

Mice developed hyperopic ametropia under normal visual conditions. The photorefractor measured a technical variation of 3.9 D (95% CI, n = 170, triplicates). Bland-Altman analysis revealed a shorter (mean ± SD) axial length (- 26.4 ± 18.1 μm) and vitreous chamber depth (- 39.9 ± 25.4 μm) in the Purkinje image-based alignment. There was a significant difference in the relative growth trend in VCD (linear regression, p = 0.02), which was relatively stable and showed shortening when measured with ONH alignment from postnatal age 21 to 35 days.

CONCLUSIONS

SD-OCT allowed precise in-vivo measurement and segmentation of ocular dimensions, regardless of the methods adopted. P1 alignment consistently resulted in significantly shorter VCD and AL compared to ONH alignment at most time points. When considering temporal changes from P21 to P35, both methods showed similar results, with significant elongation of ACD, LT, and AL as expected. However, our findings revealed a significant shortening of VCD over time with the adoption of ONH alignment, while the change in P1 alignment was relatively stable. Therefore, AL provides a better measure for evaluating ocular growth in mice using optical coherence tomography than VCD for myopia research.

Estimation of the full shape of the crystalline lens from OCT: validation using stretched donor lenses

Quantifying human crystalline lens geometry as a function of age and accommodation is important for improved cataract and presbyopia treatments. In previous works we presented eigenlenses as a basis of 3-D functions to represent the full shape of the crystalline lens ex vivo. Also, we presented the application of eigenlenses to estimate the full shape of the lens in vivo from 3-D optical coherence tomography (OCT) images, where only the central part of the lens -visible through the pupil- is available. The current work presents a validation of the use of eigenlenses to estimate in vivo the full shape of dis-accommodated lenses. We used 14 ex vivo crystalline lenses from donor eyes (11-54 y/o) mounted in a lens stretcher, and measured the geometry and the power of the lenses using a combined OCT and ray tracing aberrometry system. Ex vivo, the full extent of the lens is accessible from OCT because the incident light is not blocked by the iris. We measured in non-stretched (fully accommodated) and stretched (mimicking in vivo dis-accommodated lenses) conditions. Then, we simulated computationally in vivo conditions on the obtained ex vivo lenses geometry (assuming that just the portion of the lens within a given pupil is available), and estimated the full shape using eigenlenses. The mean absolute error (MAE) between estimated and measured lens' diameters and volumes were MAE = 0.26 ± 0.18 mm and MAE = 7.0 ± 4.5 mm3, respectively. Furthermore, we concluded that the estimation error between measured and estimated lenses did not depend on the accommodative state (change in power due to stretching), and thus eigenlenses are also useful for the full shape estimation of in vivo dis-accommodated lenses.

Estimation of the full shape of the crystalline lens in-vivo from OCT images using eigenlenses

Quantifying the full 3-D shape of the human crystalline lens is important for improving intraocular lens power or sizing calculations in treatments of cataract and presbyopia. In a previous work we described a novel method for the representation of the full shape of the ex vivo crystalline lens called eigenlenses, which proved more compact and accurate than compared state-of-the art methods of crystalline lens shape quantification. Here we demonstrate the use of eigenlenses to estimate the full shape of the crystalline lens in vivo from optical coherence tomography images, where only the information visible through the pupil is available. We compare the performance of eigenlenses with previous methods of full crystalline lens shape estimation, and demonstrate an improvement in repeatability, robustness and use of computational resources. We found that eigenlenses can be used to describe efficiently the crystalline lens full shape changes with accommodation and refractive error.

Biometric measurement with a commercially available swept-source optical coherence tomography in myopia model species

Background

Biometric parameters play an important role in studies on myopia. This study aimed to explore the application of a commercially available two-dimensional visualized swept-source optical coherence tomography (OCT) system, for in vivo biometric measurement in multiple myopia model species.

Methods

In this study, chickens, guinea pigs, and C57BL/6 mice underwent eye imaging with the commercially available OCT (CASIA2), and the original images were used to calculate the central corneal thickness, anterior chamber depth (ACD), lens thickness (LT), vitreous chamber depth (VCD), and axial length (AL). The retinal thickness and choroidal thickness were also calculated in chicken eyes. The repeatability of the biometric measurement outcomes was analyzed.

Results

Excellent repeatable AL measurements were obtained for all three species, with an intraclass correlation coefficient (ICC) of ≥0.941 and a within-subject standard deviation of ≤0.055. Excellent repeatability was found in chicken eyes for ACD, LT, and VCD, with an ICC of ≥0.932; in guinea pig eyes for ACD and VCD, with an ICC of ≥0.934; and in mouse eyes for LT, with an ICC of ≥0.941.

Conclusions

It is effective to use commercially available OCT to measure biometric parameters in chickens, guinea pigs, and C57BL/6 mice. This methodology could potentially increase the accuracy and efficiency of future myopia animal experiments.

Scleral Cross-Linking in Form-Deprivation Myopic Guinea Pig Eyes Leads to Glaucomatous Changes

Purpose

To investigate the potential glaucomatous changes caused by scleral cross-linking (CXL) in a guinea pig form-deprivation (FD) myopia model.

Methods

Eighty 4-week-old tricolor guinea pigs were divided into four groups: FD only, genipin CXL only, FD plus CXL, and control. Refractive error, axial length (AL), intraocular pressure (IOP), and structural and vasculature optic disc changes in optical coherence tomography (OCT) and OCT angiography (OCTA) were measured at baseline and day 21. CXL efficacy was evaluated by scleral rigidity Young's modulus values. Histological and molecular changes in the anterior chamber angle, retina, and sclera were assessed.

Results

Baseline parameters were similar among groups (P > 0.05). The FD plus CXL group at day 21 had the least increase of AL (0.14 ± 0.08 mm) and highest IOP elevation (31.5 ± 3.6 mmHg) compared with the FD-only group (AL: 0.68 ± 0.17 mm; IOP: 22.2 ± 2.6 mmHg) and the control group (AL: 0.24 ± 0.09 mm; IOP: 17.4 ± 1.8 mmHg) (all P < 0.001). OCT and OCTA parameters of the optic disc in the FD plus CXL group at day 21 showed glaucomatous changes and decreased blood flow signals. Sclera rigidity increased in the CXL and FD plus CXL groups. Advanced glycation end products deposited extensively in the retina, choroid, and sclera of FD plus CXL eyes.

Conclusions

CXL causes increased IOP and subsequent optic disc, anterior segment, and scleral changes while inhibiting myopic progression and axial elongation in FD guinea pig eyes. Therefore, applying CXL to control myopia raises safety concerns.

Nonlinear distortion correction for posterior eye segment optical coherence tomography with application to tree shrews

We propose an empirical distortion correction approach for optical coherence tomography (OCT) devices that use a fan-scanning pattern to image the posterior eye segment. Two types of reference markers were used to empirically estimate the distortion correction approach in tree shrew eyes: retinal curvature from MRI images and implanted glass beads of known diameter. Performance was tested by correcting distorted images of the optic nerve head. In small animal eyes, our purposed method effectively reduced nonlinear distortions compared to a linear scaling method. No commercial posterior segment OCT provides anatomically correct images, which may bias the 3D interpretation of these scans. Our method can effectively reduce such bias.

Crystalline lens gradient refractive index distribution in the guinea pig

PURPOSE

The crystalline lens undergoes morphological and functional changes with age and may also play a role in eye emmetropisation. Both the geometry and the gradient index of refraction (GRIN) distribution contribute to the lens optical properties. We studied the lens GRIN in the guinea pig, a common animal model to study myopia.

METHODS

Lenses were extracted from guinea pigs (Cavia porcellus) at 18 days of age (n = 4, three monolaterally treated with negative lenses and one untreated) and 39 days of age (n = 4, all untreated). Treated eyes were myopic (-2.07 D on average) and untreated eyes hyperopic (+3.3 D), as revealed using streak retinoscopy in the live and cyclopeged animals. A custom 3D spectral domain optical coherence tomography (OCT) system (λ = 840 nm, Δλ = 50 nm) was used to image the enucleated crystalline lens at two orientations. Custom algorithms were used to estimate the lens shape and GRIN was modelled with four variables that were reconstructed using the OCT data and a minimisation algorithm. Ray tracing was used to calculate the optical power and spherical aberration assuming a homogeneous refractive index or the estimated GRIN.

RESULTS

Guinea pig lenses exhibited nearly parabolic GRIN profiles. When comparing the two age groups (18- and 39 day-old) there was a significant increase in the central thickness (from 3.61 to 3.74 mm), and in the refractive index of the surface (from 1.362 to 1.366) and the nucleus (from 1.443 to 1.454). The presence of GRIN shifted the spherical aberration (-4.1 µm on average) of the lens towards negative values.

CONCLUSIONS

The guinea pig lens exhibits a GRIN profile with surface and nucleus refractive indices that increase slightly during the first days of life. GRIN plays a major role in the lens optical properties and should be incorporated into computational guinea pig eye models to study emmetropisation, myopia development and ageing.

Simulating Outcomes of Cataract Surgery: Important Advances in Ophthalmology

As the human eye ages, the crystalline lens stiffens (presbyopia) and opacifies (cataract), requiring its replacement with an artificial lens [intraocular lens (IOL)]. Cataract surgery is the most frequently performed surgical procedure in the world. The increase in IOL designs has not been paralleled in practice by a sophistication in IOL selection methods, which rely on limited anatomical measurements of the eye and the surgeon's interpretation of the patient's needs and expectations. We propose that the future of IOL selection will be guided by 3D quantitative imaging of the crystalline lens to map lens opacities, anticipate IOL position, and develop fully customized eye models for ray-tracing-based IOL selection. Conversely, visual simulators (in which IOL designs are programmed in active elements) allow patients to experience prospective vision before surgery and to make more informed decisions about which IOL to choose. Quantitative imaging and optical and visual simulations of postsurgery outcomes will allow optimal treatments to be selected for a patient undergoing modern cataract surgery.

Optical Aberrations of Guinea Pig Eyes

Purpose

The guinea pig is widely used in studies of refractive error development and myopia which often involve experimental optical manipulations. The study described here investigated the optical quality of the guinea pig eye, for which there are limited data, despite its fundamental importance to understanding visually guided eye growth.

Methods

The ocular aberrations of eight adolescent New Zealand pigmented guinea pigs (6–11 weeks old) were measured after cycloplegia using a custom-built Shack–Hartmann aberrometer and fit with a Zernike polynomial function to the 10th order (65 terms). The optical quality of their eyes was assessed in terms of individual Zernike coefficients, and data were further analyzed to derive root-mean-square (RMS) wavefront errors, modulation transfer functions (MTFs), point spread functions (PSFs), Strehl ratios, and depth of focus. A 4-mm pupil was used in all computations. The derived data are compared with equivalent data from normal young adult human eyes.

Results

The guinea pigs exhibited low hyperopia and a small amount of positive spherical aberration, with other aberration terms decreasing with increasing order. Their average depth of focus, estimated from through-focus modulation, was 3.75 diopters. The RMS wavefront error of the guinea pig eye was found to be larger than that of the human eye for the same pupil size, reflecting a higher degree of aberrations, although the PSF (area) on the retina was smaller and sharper due to its shorter focal length. The radial average best-focus MTF derived for the guinea pig eye showed good performance at very low spatial frequencies, with a steeper decline with increasing frequency than for the human eye, dropping below 0.3 at 9 cpd. When converted to linear units (cycles/mm), the guinea pig eye had a higher spatial frequency cutoff and a slight contrast advantage for low spatial frequencies compared to the human eye.

Conclusions

The optical quality of the guinea pig eye is far superior to their reported behavioral visual acuity. This implies a neuroanatomical limit to their vision, which contrasts with the close match of optical and neural limits to spatial resolution in human eyes. The significance for eye growth regulation of the relative optical advantages exhibited by guinea pig eyes, when optical quality is expressed in linear rather than angular retinal units, warrants further consideration.

Morphological changes of human crystalline lens in myopia

Ocular biometric parameters, including full shape crystalline lens, were assessed in myopes and emmetropes using 3-D optical coherence tomography. The anterior chamber depth, the radius of the curvature of the anterior cornea, anterior lens, and posterior lens, lens thickness, lens equatorial diameter, surface area, equatorial position, volume, and power, were evaluated as functions of refractive errors and axial lengths while controlling for age effects. The crystalline lens appears to change with myopia consistent with lens thinning, equatorial, and capsular stretching while keeping constant volume. Axial elongation appears counteracted by a crystalline lens power reduction, while corneal power remains unaffected.

Estimation of intraocular lens position from full crystalline lens geometry: towards a new generation of intraocular lens power calculation formulas

In a cataract surgery, the opacified crystalline lens is replaced by an artificial intraocular lens (IOL). To optimize the visual quality after surgery, the intraocular lens to be implanted must be selected preoperatively for every individual patient. Different generations of formulas have been proposed for selecting the intraocular lens dioptric power as a function of its estimated postoperative position. However, very few formulas include crystalline lens information, in most cases only one-dimensional. The present study proposes a new formula to preoperatively estimate the postoperative IOL position (ELP) based on information of the 3-dimensional full shape of the crystalline lens, obtained from quantitative eye anterior segment optical coherence tomography imaging. Real patients were measured before and after cataract surgery (IOL implantation). The IOL position and the postoperative refraction estimation errors were calculated by subtracting the preoperative estimations from the actual values measured after surgery. The proposed ELP formula produced lower estimation errors for both parameters -ELP and refraction- than the predictions obtained with standard state-of-the-art methods, and opens new avenues to the development of new generation IOL power calculation formulas that improve refractive and visual outcomes.