Introduction to optical coherence elastography: tutorial

Convolutional Neural Networks Enable Direct Strain Estimation in Quasistatic Optical Coherence Elastography

Assessing the biomechanical properties of tissues can provide important information for disease diagnosis and therapeutic monitoring. Optical coherence elastography (OCE) is an emerging technology for measuring the biomechanical properties of tissues. Clinical translation of this technology is underway, and steps are being implemented to streamline data collection and processing. OCE data can be noisy, data processing can require significant manual tuning, and a single acquisition may contain gigabytes of data. In this work, we introduce a convolutional neural network-based method to translate raw OCE phase data to strain for quasistatic OCE that is ~40X faster than the conventional least squares approach by bypassing many intermediate data processing steps. The results suggest that a machine learning approach may be a valuable tool for fast, efficient, and accurate extraction of biomechanical information from raw OCE data.

Assessing UVA and Laser-Induced Crosslinking via Brillouin Microscopy

Keratoconus and other corneal ectatic disorders involve the degradation of collagen fibers, which compromises the corneal biomechanical properties. Ultraviolet-A (UVA) crosslinking has emerged as the primary treatment to slow down collagen degradation. This treatment is limited in both penetration depth and spatial precision, potentially leading to unwanted side effects. This study compares the changes in biomechanical properties of corneas crosslinked with UVA irradiation and a near-infrared femtosecond laser, using Brillouin microscopy. The biomechanical properties of the crosslinked regions were mapped in terms of Brillouin frequency shift in three dimensions. UVA crosslinking showed an average increase in Brillouin frequency shift of ~100 MHz. We demonstrate targeted spatial and axial corneal femtosecond crosslinking, with similar Brillouin frequency shift values to UVA in crosslinked regions.

Assessment of skin fibrosis in a murine model of systemic sclerosis with multifunctional optical coherence tomography

Significance

Systemic sclerosis (SSc) is a chronic idiopathic disease that causes immune dysregulation, vasculopathy, and organ fibrosis that affects more than 3 million people in the US alone. The modified Rodnan skin score (mRSS) is the current gold standard for diagnosing and staging skin fibrosis in SSc. However, mRSS is subjective, requires extensive training, and has high observer variability.

Aim

We aim to provide a quantitative method for the assessment of fibrosis.

Approach

We utilized optical coherence tomography (OCT), its extensions, optical coherence elastography (OCE), and OCT angiography (OCTA) to evaluate SSc-like fibrosis and therapy response in a mouse model.

Results

We showed stiffness differences between fibrotic and normal mouse skin by week 4 ( p = 0.02 ) during the longitudinal study. In the treatment response study, OCE recorded higher elastic wave velocity in untreated fibrotic skin ( p = 0.04 ). Treated fibrotic skin stiffness was between normal and fibrotic levels. OCTA indicated significantly dilated microvasculature in fibrotic skin versus control ( p ≪ 0.01 ), with more dilation in the treatment group ( p ≪ 0.01 ) than in normal skin.

Conclusions

Our results indicate that OCT and its extensions effectively analyze dermal fibrosis. OCE revealed increased stiffness in fibrotic skin, OCTA showed vessel dilation, and OCT noted morphological changes in fibrosis tissue.

Design and characterization of an optical phantom for mesoscopic multimodal fluorescence lifetime imaging and optical coherence elastography

We developed a novel methodology for manufacturing multimodal, tissue-mimicking phantoms that exhibit both molecular and biomechanical contrast. This methodology leverages the immiscibility of silicone and hydrogels to create solid mesoscale phantoms with localized regions of precisely controlled fluorescence, including fluorescence lifetime properties, and adjustable stiffness, without requiring physical barriers. Mechanical, fluorescent, and optical characterization confirmed the tunability of the phantoms across a range of values relevant to biomedical applications. A macroscale 3D phantom was fabricated, and its properties were validated through fluorescence lifetime imaging (FLI) and optical coherence elastography (OCE). Validation demonstrated the successful tuning of both mechanical and fluorescence lifetime contrasts within a 3D structure, highlighting the feasibility of multimodal FLI-OCE. This new phantom manufacturing process is expected to support the development and validation of new multimodal imaging approaches to study molecular and biomechanical properties of the tumor microenvironment (TME), as well as their impact on therapeutic efficacy, and to enhance targeted therapies.

Clinical evaluation of breast cancer tissue with optical coherence tomography: key findings from a large-scale study

PURPOSE

Breast cancer patients undergoing breast-conserving surgery may require a second operation if positive margins persist but current intraoperative methodologies often lack real-time and comprehensive assessments of tissue margins. This study addresses this critical gap by introducing a novel approach to enhance margin assessment in breast surgery.

METHODS

A total of 252 fresh tissue blocks from 199 patients with different types of breast lesions were scanned with a customized swept-source optical coherence tomography (SS-OCT) system, and the OCT features of normal, benign, and malignant breast tissues, were systematically analyzed.

RESULTS

The qualitative analysis results revealed that adipose tissue has high penetration depth and a typical honeycomb pattern, whereas fibrous tissue has the brightest grayscale values and a bundle-like structure. The lobular area appears as a dark region, and dilated ducts present a distinct tubular structure on B-scan images. Adenosis results in bright areas, fibroadenoma results in typical contour structures, phyllodes tumors present lobular structures, invasive carcinomas present a stellate pattern and low penetration depth, and mucinous carcinoma cancer cells are clearly visible within the low-scattering mucin.

CONCLUSIONS

Importantly, we provide comparative OCT and hematoxylin and eosin (H&E) histology images for less common conditions, such as phyllodes tumors, intraductal papillomas, and mucinous carcinoma. For the first time, we established an 3D OCT-histopathology library with a large field of view and systematically analyzed the multidimensional features. This work strongly supports the feasibility of using OCT technology intraoperatively in surgery. Additionally, the OCT-histopathology library can help pathologists better understand and identify tissue features, thereby enhancing diagnostic efficiency.

Phenotypic analysis of complex bioengineered 3D models

With advances in underlying technologies such as complex multicellular systems, synthetic materials, and bioengineering techniques, we can now generate in vitro miniaturized human tissues that recapitulate the organotypic features of normal or diseased tissues. Importantly, these 3D culture models have increasingly provided experimental access to diverse and complex tissues architectures and their morphogenic assembly in vitro. This review presents an analytical toolbox for biological researchers using 3D modeling technologies through which they can find a collation of currently available methods to phenotypically assess their 3D models in their normal state as well as their response to therapeutic or pathological agents.

Determinants of Human Corneal Mechanical Wave Dispersion for In Vivo Optical Coherence Elastography

Purpose

To characterize frequency-dependent wave speed dispersion in the human cornea using microliter air-pulse optical coherence elastography (OCE), and to evaluate the applicability of Lamb wave theory for determining corneal elastic modulus using high-frequency symmetric (S0) and anti-symmetric (A0) guided waves in cornea.

Methods

Wave speed dispersion analysis for transient (0.5 ms) microliter air-pulse stimulation was performed in four rabbit eyes ex vivo and compared to air-coupled ultrasound excitation. The effects of stimulation angle and sample geometry on the dispersion were evaluated in corneal phantoms. Corneal wave speed dispersion was measured in 36 healthy human eyes in vivo.

Results

Air-pulse-induced dispersion was comparable to ultrasound-induced dispersion between 0.7 and 5 kHz (mean-difference ± 1.96 × SD: 0.006 ± 0.5 m/s) in ex vivo rabbit corneas. Stimulation 0° relative to the surface normal generated A0 Lamb waves in corneal tissue phantoms, while oblique stimulation (35° and 65°) generated S0 waves. Stimulating normal to the human corneal apex in vivo (0°) induced A0 waves, plateauing at 10.87 to 13.63 m/s at 4 kHz, and when obliquely stimulated at the periphery (65°), produced S0 waves, plateauing at 13.10 to 15.98 m/s at 4 kHz.

Conclusions

Air-pulse OCE can be used to measure human corneal Lamb wave dispersion of A0 and S0 propagation modes in vivo. These modes are selectively excited by changing the stimulation angle. Accounting for wave speed dispersion enables reliable estimation of corneal elastic modulus in vivo.

Translational Relevance

This work demonstrates the feasibility of air-pulse stimulation for robust OCE measurements of corneal stiffness in vivo for disease detection and therapy evaluation.

Photothermal optical coherence microscopy for studying lipid architecture in human carotid arteries

Photothermal optical coherence microscopy (PT-OCM) combines the high-resolution, label-free morphological imaging of OCM with the ability to discriminate tissue composition through phase-sensitive photothermal imaging. In this study, we perform 2D imaging of human carotid endarterectomies to spectrally determine lipid distribution, with verification via histologically stained samples. The structural information from OCM is combined with the spectral information gained from measuring the resulting sample surface displacement from thermoelastic expansion, following light irradiation. PT-OCM is thus demonstrated as a potential tool in the investigation of atherosclerotic plaque lipids, contributing towards the understanding of plaque instability.

Geophysics-Inspired Nonlinear Stress-Strain Law for Biological Tissues and Its Applications in Compression Optical Coherence Elastography

We propose a nonlinear stress-strain law to describe nonlinear elastic properties of biological tissues using an analogy with the derivation of nonlinear constitutive laws for cracked rocks. The derivation of such a constitutive equation has been stimulated by the recently developed experimental technique-quasistatic Compression Optical Coherence Elastography (C-OCE). C-OCE enables obtaining nonlinear stress-strain dependences relating the applied uniaxial compressive stress and the axial component of the resultant strain in the tissue. To adequately describe nonlinear stress-strain dependences obtained with C-OCE for various tissues, the central idea is that, by analogy with geophysics, nonlinear elastic response of tissues is mostly determined by the histologically confirmed presence of interstitial gaps/pores resembling cracks in rocks. For the latter, the nonlinear elastic response is mostly determined by elastic properties of narrow cracks that are highly compliant and can easily be closed by applied compressing stress. The smaller the aspect ratio of such a gap/crack, the smaller the stress required to close it. Upon reaching sufficiently high compressive stress, almost all such gaps become closed, so that with further increase in the compressive stress, the elastic response of the tissue becomes nearly linear and is determined by the Young's modulus of the host tissue. The form of such a nonlinear dependence is determined by the distribution of the cracks/gaps over closing pressures; for describing this process, an analogy with geophysics is also used. After presenting the derivation of the proposed nonlinear law, we demonstrate that it enables surprisingly good fitting of experimental stress-strain curves obtained with C-OCE for a broad range of various tissues. Unlike empirical fitting, each of the fitting parameters in the proposed law has a clear physical meaning. The linear and nonlinear elastic parameters extracted using this law have already demonstrated high diagnostic value, e.g., for differentiating various types of cancerous and noncancerous tissues.

Asynchronous, semi-reverberant elastography

Optical coherence elastography measures elasticity-a property correlated with pathologies such as tumors due to fibrosis, atherosclerosis due to heterogeneous plaque composition, and ocular diseases such as keratoconus and glaucoma. Wave-based elastography, including reverberant elastography, leverages the properties of shear waves traveling through tissue primarily to infer shear modulus. These methods have already seen significant development over the past decade. However, existing implementations in OCT require robust synchronization of shear wave excitation with imaging, complicating widespread clinical adoption. We present a method for complete recovery of the harmonic shear wave field in an asynchronous, conventional frame-rate, raster-scanning OCT system by modeling raster-scanning as an amplitude modulation of the displacement field. This technique recovers the entire spatially and temporally coherent complex valued shear wave field from just two B-scans, while reducing the time scale for sensitivity to motion from minutes to tens of milliseconds. To the best of our knowledge, this work represents the first successful demonstration of reverberant elastography on a human subject in vivo with a conventional frame-rate, raster-scanning OCT system, greatly expanding opportunity for widespread translation.

Dual optical elastography detects TGF - β -induced alterations in the biomechanical properties of skin scaffolds

Significance

The skin's mechanical properties are tightly regulated. Various pathologies can affect skin stiffness, and understanding these changes is a focus in tissue engineering. Ex vivo skin scaffolds are a robust platform for evaluating the effects of various genetic and molecular interactions on the skin. Transforming growth factor-beta ( TGF - β ) is a critical signaling molecule in the skin that can regulate the amount of collagen and elastin in the skin and, consequently, its mechanical properties.

Aim

This study investigates the biomechanical properties of bio-engineered skin scaffolds, focusing on the influence of TGF - β , a signaling molecule with diverse cellular functions.

Approach

The TGF - β receptor I inhibitor, galunisertib, was employed to assess the mechanical changes resulting from dysregulation of TGF - β . Skin scaffold samples, grouped into three categories (control, TGF - β -treated, and TGF - β + galunisertib-treated), were prepared in two distinct culture media-one with aprotinin (AP) and another without. Two optical elastography techniques, namely wave-based optical coherence elastography (OCE) and Brillouin microscopy, were utilized to quantify the biomechanical properties of the tissues.

Results

Results showed significantly higher wave speed (with AP, p < 0.001 ; without AP, p < 0.001 ) and Brillouin frequency shift (with AP, p < 0.001 ; without AP, p = 0.01 ) in TGF - β -treated group compared with the control group. The difference in wave speed between the control and TGF - β + galunisertib with ( p = 0.10 ) and without AP ( p = 0.36 ) was not significant. Moreover, the TGF - β + galunisertib-treated group exhibited lower wave speed without and with AP and reduced Brillouin frequency shift than the TGF - β -treated group without AP, further strengthening the potential role of TGF - β in regulating the mechanical properties of the samples.

Conclusions

These findings offer valuable insights into TGF - β -induced biomechanical alterations in bio-engineered skin scaffolds, highlighting the potential of OCE and Brillouin microscopy in the development of targeted therapies in conditions involving abnormal tissue remodeling and fibrosis.

Non-contact elasticity contrast imaging using photon counting

Significance

Tissues' biomechanical properties, such as elasticity, are related to tissue health. Optical coherence elastography produces images of tissues based on their elasticity, but its performance is constrained by the laser power used, working distance, and excitation methods.

Aim

We develop a new method to reconstruct the elasticity contrast image over a long working distance, with only low-intensity illumination, and by non-contact acoustic wave excitation.

Approach

We combine single-photon vibrometry and quantum parametric mode sorting (QPMS) to measure the oscillating backscattered signals at a single-photon level and derive the phantoms' relative elasticity.

Results

We test our system on tissue-mimicking phantoms consisting of contrast sections with different concentrations and thus stiffness. Our results show that as the driving acoustic frequency is swept, the phantoms' vibrational responses are mapped onto the photon-counting histograms from which their mechanical properties-including elasticity-can be derived. Through lateral and longitudinal laser scanning at a fixed frequency, a contrast image based on samples' elasticity can be reliably reconstructed upon photon level signals.

Conclusions

We demonstrated the reliability of QPMS-based elasticity contrast imaging of agar phantoms in a long working distance, low-intensity environment. This technique has the potential for in-depth images of real biological tissue and provides a new approach to elastography research and applications.

Phase unwrapping for MHz optical coherence elastography and application to brain tumor tissue

During neuro-oncologic surgery, phase-sensitive optical coherence elastography (OCE) can be valuable for distinguishing between healthy and diseased tissue. However, the phase unwrapping process required to retrieve the original phase signal is a challenging and critical task. To address this issue, we demonstrate a one-dimensional unwrapping algorithm that recovers the phase signal from a 3.2 MHz OCE system. With a processing time of approximately 0.11 s per frame on the GPU, multiple 2π wraps are detected and corrected. By utilizing this approach, exact and reproducible information on tissue deformation can be obtained with pixel accuracy over the entire acquisition time. Measurements of brain tumor-mimicking phantoms and human ex vivo brain tumor samples verified the algorithm's reliability. The tissue samples were subjected to a 200 ms short air pulse. A correlation with histological findings confirmed the algorithm's dependability.

Machine Learning-Assisted Short-Wave InfraRed (SWIR) Techniques for Biomedical Applications: Towards Personalized Medicine

Personalized medicine transforms healthcare by adapting interventions to individuals' unique genetic, molecular, and clinical profiles. To maximize diagnostic and/or therapeutic efficacy, personalized medicine requires advanced imaging devices and sensors for accurate assessment and monitoring of individual patient conditions or responses to therapeutics. In the field of biomedical optics, short-wave infrared (SWIR) techniques offer an array of capabilities that hold promise to significantly enhance diagnostics, imaging, and therapeutic interventions. SWIR techniques provide in vivo information, which was previously inaccessible, by making use of its capacity to penetrate biological tissues with reduced attenuation and enable researchers and clinicians to delve deeper into anatomical structures, physiological processes, and molecular interactions. Combining SWIR techniques with machine learning (ML), which is a powerful tool for analyzing information, holds the potential to provide unprecedented accuracy for disease detection, precision in treatment guidance, and correlations of complex biological features, opening the way for the data-driven personalized medicine field. Despite numerous biomedical demonstrations that utilize cutting-edge SWIR techniques, the clinical potential of this approach has remained significantly underexplored. This paper demonstrates how the synergy between SWIR imaging and ML is reshaping biomedical research and clinical applications. As the paper showcases the growing significance of SWIR imaging techniques that are empowered by ML, it calls for continued collaboration between researchers, engineers, and clinicians to boost the translation of this technology into clinics, ultimately bridging the gap between cutting-edge technology and its potential for personalized medicine.

Methods for objective assessment of skin involvement in systemic sclerosis

PURPOSE OF REVIEW

Skin fibrosis is the most prominent disease manifestation of systemic sclerosis (SSc). Although the treatment for other SSc manifestations has expanded over the years, there is limited progress in identifying effective treatment options for SSc skin involvement. This is in part due to limitations in the utilized outcome measures for assessment of skin fibrosis. This review focuses on different emerging assessment tools for SSc skin involvement and their potential use for clinical care and multicenter trials.

RECENT FINDINGS

Durometer and other device-based methodologies requiring application of direct pressure to the affected skin have been studied in SSc. However, there are concerns that the required application of pressure might be a source of variability. Ultrasound-based methods have been compared with modified Rodnan Skin Score in several studies, indicating acceptable construct validity. However, few studies have examined their criterion validity by providing comparisons to skin histology. Optical coherence-based methods show promising preliminary results for simultaneous assessment of skin fibrosis and vasculopathy. Further standardization and validation (including comparison to skin histology) of these promising novel assessment tools in large, longitudinal SSc cohort studies are needed to establish them as clinically useful outcome measures with acceptable sensitivity to change.

SUMMARY

Recent advances in imaging techniques provide a promising opportunity for development of a valid and reliable assessment tool for quantification of SSc skin fibrosis, which can pave the way for approval of effective treatment options for this high burden disease manifestation.

Nanobomb optical coherence elastography in multilayered phantoms

Many tissues are composed of layered structures, and a better understanding of the changes in the layered tissue biomechanics can enable advanced guidance and monitoring of therapy. The advent of elastography using longitudinally propagating shear waves (LSWs) has created the prospect of a high-resolution assessment of depth-dependent tissue elasticity. Laser activation of liquid-to-gas phase transition of dye-loaded perfluorocarbon (PFC) nanodroplets (a.k.a., nanobombs) can produce highly localized LSWs. This study aims to leverage the potential of photoactivation of nanobombs to incudce LSWs with very high-frequency content in wave-based optical coherence elastography (OCE) to estimate the elasticity gradient with high resolution. In this work, we used multilayered tissue-mimicking phantoms to demonstrate that highly localized nanobomb (NB)-induced LSWs can discriminate depth-wise tissue elasticity gradients. The results show that the NB-induced LSWs rapidly change speed when transitioning between layers with different mechanical properties, resulting in an elasticity resolution of ∼65 µm. These results show promise for characterizing the elasticity of multilayer tissue with a fine resolution.

Reverberant optical coherence elastography using multifocal acoustic radiation force

In this study, we introduce a multifocal acoustic radiation force source that combines an ultrasound transducer and a 3D-printed acoustic lens for application in reverberant optical coherence elastography (Rev-OCE). An array of plano-concave acoustic lenses, each with an 11.8 mm aperture diameter, were used to spatially distribute the acoustic energy generated by a 1 MHz planar ultrasound transducer, producing multiple focal spots on a target plane. These focal spots generate reverberant shear wave fields detected by the optical coherence tomography (OCT) system. The effectiveness of the multifocal Rev-OCE system in probing mechanical properties with high resolution is demonstrated in layered gelatin phantoms.

The lens capsule significantly affects the viscoelastic properties of the lens as quantified by optical coherence elastography

The crystalline lens is a transparent, biconvex structure that has its curvature and refractive power modulated to focus light onto the retina. This intrinsic morphological adjustment of the lens to fulfill changing visual demands is achieved by the coordinated interaction between the lens and its suspension system, which includes the lens capsule. Thus, characterizing the influence of the lens capsule on the whole lens’s biomechanical properties is important for understanding the physiological process of accommodation and early diagnosis and treatment of lenticular diseases. In this study, we assessed the viscoelastic properties of the lens using phase-sensitive optical coherence elastography (PhS-OCE) coupled with acoustic radiation force (ARF) excitation. The elastic wave propagation induced by ARF excitation, which was focused on the surface of the lens, was tracked with phase-sensitive optical coherence tomography. Experiments were conducted on eight freshly excised porcine lenses before and after the capsular bag was dissected away. Results showed that the group velocity of the surface elastic wave, V, in the lens with the capsule intact (V=2.55±0.23 m/s) was significantly higher (p &lt; 0.001) than after the capsule was removed (V=1.19±0.25 m/s). Similarly, the viscoelastic assessment using a model that utilizes the dispersion of a surface wave showed that both Young’s modulus, E, and shear viscosity coefficient, η, of the encapsulated lens (E=8.14±1.10 kPa,η=0.89±0.093 Pa∙s) were significantly higher than that of the decapsulated lens (E=3.10±0.43 kPa,η=0.28±0.021 Pa∙s). These findings, together with the geometrical change upon removal of the capsule, indicate that the capsule plays a critical role in determining the viscoelastic properties of the crystalline lens.

Application of compression optical coherence elastography for characterization of human pericardium: A pilot study

The recent impressive progress in Compression Optical Coherence Elastography (C-OCE) demonstrated diverse biomedical applications, comprising ophthalmology, oncology, etc. High resolution of C-OCE enables spatially resolved characterization of elasticity of rather thin (thickness < 1 mm) samples, which previously was impossible. Besides Young's modulus, C-OCE enables obtaining of nonlinear stress-strain dependences for various tissues. Here, we report the first application of C-OCE to nondestructively characterize biomechanics of human pericardium, for which data of conventional tensile tests are very limited and controversial. C-OCE revealed pronounced differences among differently prepared pericardium samples. Ample understanding of the influence of chemo-mechanical treatment on pericardium biomechanics is very important because of rapidly growing usage of own patients' pericardium for replacement of aortic valve leaflets in cardio-surgery. The figure demonstrates differences in the tangent Young's modulus after glutaraldehyde-induced cross-linking for two pericardium samples. One sample was over-stretched during the preparation, which caused some damage to the tissue.

Hyaluronan Modulates the Biomechanical Properties of the Cornea

Purpose

Hyaluronan (HA) is a major constituent of the extracellular matrix (ECM) that has high viscosity and is essential for maintaining tissue hydration. In the cornea, HA is enriched in the limbal region and is a key component of the limbal epithelial stem cell niche. HA is upregulated after injury participating in the formation of the provisional matrix, and has a key role in regulating the wound healing process. This study investigated whether changes in the distribution of HA before and after injury affects the biomechanical properties of the cornea in vivo.

Methods

Corneas of wild-type (wt) mice and mice lacking enzymes involved in the biosynthesis of HA were analyzed before, immediately after, and 7 and 14 days after a corneal alkali burn (AB). The corneas were evaluated using both a ring light and fluorescein stain by in vivo confocal microscopy, optical coherence elastography (OCE), and immunostaining of corneal whole mounts.

Results

Our results show that wt mice and mice lacking HA synthase (Has)1 and 3 present an increase in corneal stiffness 7 and 14 days after AB without a significant increase in HA expression and absence of scarring at 14 days after AB. In contrast, mice lacking Has2 present a significant decrease in corneal stiffness, with a significant increase in HA expression and scarring at 14 days after AB.

Conclusions

Our findings show that the mechanical properties of the cornea are significantly modulated by changes in HA distribution following alkali burn.

Multiple Optical Elastography Techniques Reveal the Regulation of Corneal Stiffness by Collagen XII

Purpose

Collagen XII plays a role in regulating the structure and mechanical properties of the cornea. In this work, several optical elastography techniques were used to investigate the effect of collagen XII deficiency on the stiffness of the murine cornea.

Methods

A three-prong optical elastography approach was used to investigate the mechanical properties of the cornea. Brillouin microscopy, air-coupled ultrasonic optical coherence elastography (OCE) and heartbeat OCE were used to assess the mechanical properties of wild type (WT) and collagen XII-deficient (Col12a1-/-) murine corneas. The Brillouin frequency shift, elastic wave speed, and compressive strain were all measured as a function of intraocular pressure (IOP).

Results

All three optical elastography modalities measured a significantly decreased stiffness in the Col12a1-/- compared to the WT (P < 0.01 for all three modalities). The optical coherence elastography techniques showed that mean stiffness increased as a function of IOP; however, Brillouin microscopy showed no discernable trend in Brillouin frequency shift as a function of IOP.

Conclusions

Our approach suggests that the absence of collagen XII significantly softens the cornea. Although both optical coherence elastography techniques showed an expected increase in corneal stiffness as a function of IOP, Brillouin microscopy did not show such a relationship, suggesting that the Brillouin longitudinal modulus may not be affected by changes in IOP. Future work will focus on multimodal biomechanical models, evaluating the effects of other collagen types on corneal stiffness, and in vivo measurements.