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Liu X, Ye Y, Ge Y, Qu J, Liedberg B, Zhang Q, Wang Y. Smart Contact Lenses for Healthcare Monitoring and Therapy. ACS NANO 2024; 18:6817-6844. [PMID: 38407063 DOI: 10.1021/acsnano.3c12072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
The eye contains a wealth of physiological information and offers a suitable environment for noninvasive monitoring of diseases via smart contact lens sensors. Although extensive research efforts recently have been undertaken to develop smart contact lens sensors, they are still in an early stage of being utilized as an intelligent wearable sensing platform for monitoring various biophysical/chemical conditions. In this review, we provide a general introduction to smart contact lenses that have been developed for disease monitoring and therapy. First, different disease biomarkers available from the ocular environment are summarized, including both physical and chemical biomarkers, followed by the commonly used materials, manufacturing processes, and characteristics of contact lenses. Smart contact lenses for eye-drug delivery with advancing technologies to achieve more efficient treatments are then introduced as well as the latest developments for disease diagnosis. Finally, sensor communication technologies and smart contact lenses for antimicrobial and other emerging bioapplications are also discussed as well as the challenges and prospects of the future development of smart contact lenses.
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Affiliation(s)
- Xiaohu Liu
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou 325001, China
| | - Ying Ye
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou 325001, China
| | - Yuancai Ge
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou 325001, China
| | - Jia Qu
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou 325001, China
| | - Bo Liedberg
- School of Materials Science and Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore 639798, Singapore
| | - Qingwen Zhang
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou 325001, China
- Engineering Research Center of Clinical Functional Materials and Diagnosis & Treatment Devices of Zhejiang Province, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou 325001, China
| | - Yi Wang
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou 325001, China
- Engineering Research Center of Clinical Functional Materials and Diagnosis & Treatment Devices of Zhejiang Province, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou 325001, China
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2
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Shean R, Yu N, Guntipally S, Nguyen V, He X, Duan S, Gokoffski K, Zhu Y, Xu B. Advances and Challenges in Wearable Glaucoma Diagnostics and Therapeutics. Bioengineering (Basel) 2024; 11:138. [PMID: 38391624 PMCID: PMC10886103 DOI: 10.3390/bioengineering11020138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/24/2024] Open
Abstract
Glaucoma is a leading cause of irreversible blindness, and early detection and treatment are crucial for preventing vision loss. This review aims to provide an overview of current diagnostic and treatment standards, recent medical and technological advances, and current challenges and future outlook for wearable glaucoma diagnostics and therapeutics. Conventional diagnostic techniques, including the rebound tonometer and Goldmann Applanation Tonometer, provide reliable intraocular pressure (IOP) measurement data at single-interval visits. The Sensimed Triggerfish and other emerging contact lenses provide continuous IOP tracking, which can improve diagnostic IOP monitoring for glaucoma. Conventional therapeutic techniques include eye drops and laser therapies, while emerging drug-eluting contact lenses can solve patient noncompliance with eye medications. Theranostic platforms combine diagnostic and therapeutic capabilities into a single device. Advantages of these platforms include real-time monitoring and personalized medication dosing. While there are many challenges to the development of wearable glaucoma diagnostics and therapeutics, wearable technologies hold great potential for enhancing glaucoma management by providing continuous monitoring, improving medication adherence, and reducing the disease burden on patients and healthcare systems. Further research and development of these technologies will be essential to optimizing patient outcomes.
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Affiliation(s)
- Ryan Shean
- Keck School of Medicine, University of Southern California, 1975 Zonal Avenue, Los Angeles, CA 90033, USA
| | - Ning Yu
- Department of Chemical Engineering, Stanford University, Stanford, CA 94305, USA
| | - Sourish Guntipally
- Terasaki Institute for Biomedical Innovation, 21100 Erwin Street, Los Angeles, CA 90064, USA
| | - Van Nguyen
- Roski Eye Institute, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Los Angeles, CA 90033, USA
| | - Ximin He
- Department of Materials Science and Engineering, University of California, 410 Westwood Plaza, Los Angeles, CA 90095, USA
| | - Sidi Duan
- Department of Materials Science and Engineering, University of California, 410 Westwood Plaza, Los Angeles, CA 90095, USA
| | - Kimberly Gokoffski
- Roski Eye Institute, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Los Angeles, CA 90033, USA
| | - Yangzhi Zhu
- Terasaki Institute for Biomedical Innovation, 21100 Erwin Street, Los Angeles, CA 90064, USA
| | - Benjamin Xu
- Roski Eye Institute, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Los Angeles, CA 90033, USA
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Zhang H, Zhang Y. Rational Design of Flexible Mechanical Force Sensors for Healthcare and Diagnosis. MATERIALS (BASEL, SWITZERLAND) 2023; 17:123. [PMID: 38203977 PMCID: PMC10780056 DOI: 10.3390/ma17010123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/13/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024]
Abstract
Over the past decade, there has been a significant surge in interest in flexible mechanical force sensing devices and systems. Tremendous efforts have been devoted to the development of flexible mechanical force sensors for daily healthcare and medical diagnosis, driven by the increasing demand for wearable/portable devices in long-term healthcare and precision medicine. In this review, we summarize recent advances in diverse categories of flexible mechanical force sensors, covering piezoresistive, capacitive, piezoelectric, triboelectric, magnetoelastic, and other force sensors. This review focuses on their working principles, design strategies and applications in healthcare and diagnosis, with an emphasis on the interplay among the sensor architecture, performance, and application scenario. Finally, we provide perspectives on the remaining challenges and opportunities in this field, with particular discussions on problem-driven force sensor designs, as well as developments of novel sensor architectures and intelligent mechanical force sensing systems.
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Affiliation(s)
- Hang Zhang
- School of Materials Science and Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore 639798, Singapore;
| | - Yihui Zhang
- Applied Mechanics Laboratory, Department of Engineering Mechanics, Tsinghua University, Beijing 100084, China
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Wu KY, Mina M, Carbonneau M, Marchand M, Tran SD. Advancements in Wearable and Implantable Intraocular Pressure Biosensors for Ophthalmology: A Comprehensive Review. MICROMACHINES 2023; 14:1915. [PMID: 37893352 PMCID: PMC10609220 DOI: 10.3390/mi14101915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/27/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023]
Abstract
Glaucoma, marked by its intricate association with intraocular pressure (IOP), stands as a predominant cause of non-reversible vision loss. In this review, the physiological relevance of IOP is detailed, alongside its potential pathological consequences. The review further delves into innovative engineering solutions for IOP monitoring, highlighting the latest advancements in wearable and implantable sensors and their potential in enhancing glaucoma management. These technological innovations are interwoven with clinical practice, underscoring their real-world applications, patient-centered strategies, and the prospects for future development in IOP control. By synthesizing theoretical concepts, technological innovations, and practical clinical insights, this review contributes a cohesive and comprehensive perspective on the IOP biosensor's role in glaucoma, serving as a reference for ophthalmological researchers, clinicians, and professionals.
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Affiliation(s)
- Kevin Y. Wu
- Department of Surgery, Division of Ophthalmology, University of Sherbrooke, Sherbrooke, QC J1G 2E8, Canada; (K.Y.W.)
| | - Mina Mina
- Department of Mechanical and Manufacturing Engineering, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Marjorie Carbonneau
- Department of Surgery, Division of Ophthalmology, University of Sherbrooke, Sherbrooke, QC J1G 2E8, Canada; (K.Y.W.)
| | - Michael Marchand
- Department of Surgery, Division of Ophthalmology, University of Sherbrooke, Sherbrooke, QC J1G 2E8, Canada; (K.Y.W.)
| | - Simon D. Tran
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC H3A 1G1, Canada
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Jones L, Efron N, Bandamwar K, Barnett M, Jacobs DS, Jalbert I, Pult H, Rhee MK, Sheardown H, Shovlin JP, Stahl U, Stanila A, Tan J, Tavazzi S, Ucakhan OO, Willcox MDP, Downie LE. TFOS Lifestyle: Impact of contact lenses on the ocular surface. Ocul Surf 2023; 29:175-219. [PMID: 37149139 DOI: 10.1016/j.jtos.2023.04.010] [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: 04/07/2023] [Accepted: 04/10/2023] [Indexed: 05/08/2023]
Abstract
Several lifestyle choices made by contact lens wearers can have adverse consequences on ocular health. These include being non-adherent to contact lens care, sleeping in lenses, ill-advised purchasing options, not seeing an eyecare professional for regular aftercare visits, wearing lenses when feeling unwell, wearing lenses too soon after various forms of ophthalmic surgery, and wearing lenses when engaged in risky behaviors (e.g., when using tobacco, alcohol or recreational drugs). Those with a pre-existing compromised ocular surface may find that contact lens wear exacerbates ocular disease morbidity. Conversely, contact lenses may have various therapeutic benefits. The coronavirus disease-2019 (COVID-19) pandemic impinged upon the lifestyle of contact lens wearers, introducing challenges such as mask-associated dry eye, contact lens discomfort with increased use of digital devices, inadvertent exposure to hand sanitizers, and reduced use of lenses. Wearing contact lenses in challenging environments, such as in the presence of dust and noxious chemicals, or where there is the possibility of ocular trauma (e.g., sport or working with tools) can be problematic, although in some instances lenses can be protective. Contact lenses can be worn for sport, theatre, at high altitude, driving at night, in the military and in space, and special considerations are required when prescribing in such situations to ensure successful outcomes. A systematic review and meta-analysis, incorporated within the review, identified that the influence of lifestyle factors on soft contact lens dropout remains poorly understood, and is an area in need of further research. Overall, this report investigated lifestyle-related choices made by clinicians and contact lens wearers and discovered that when appropriate lifestyle choices are made, contact lens wear can enhance the quality of life of wearers.
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Affiliation(s)
- Lyndon Jones
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, Canada.
| | - Nathan Efron
- School of Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Kalika Bandamwar
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Melissa Barnett
- University of California, Davis Eye Center, Sacramento, CA, USA
| | - Deborah S Jacobs
- Massachusetts Eye & Ear, Harvard Medical School, Boston, MA, USA
| | - Isabelle Jalbert
- School of Optometry and Vision Science, UNSW Sydney, NSW, Australia
| | - Heiko Pult
- Dr Heiko Pult Optometry & Vision Research, Weinheim, Germany
| | | | - Heather Sheardown
- Department of Chemical Engineering, McMaster University, Hamilton, Ontario, Canada
| | | | - Ulli Stahl
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, Canada
| | | | - Jacqueline Tan
- School of Optometry and Vision Science, UNSW Sydney, NSW, Australia
| | - Silvia Tavazzi
- Department of Materials Science, University of Milano-Bicocca, Milan, Italy
| | | | - Mark D P Willcox
- School of Optometry and Vision Science, UNSW Sydney, NSW, Australia
| | - Laura E Downie
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
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Al-Qaysi ZK, Beadham IG, Schwikkard SL, Bear JC, Al-Kinani AA, Alany RG. Sustained release ocular drug delivery systems for glaucoma therapy. Expert Opin Drug Deliv 2023; 20:905-919. [PMID: 37249548 DOI: 10.1080/17425247.2023.2219053] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 05/24/2023] [Indexed: 05/31/2023]
Abstract
INTRODUCTION Glaucoma is a group of progressive optic neuropathies resulting in irreversible blindness. It is associated with an elevation of intraocular pressure (>21 mm Hg) and optic nerve damage. Reduction of the intraocular pressure (IOP) through the administration of ocular hypotensive eye drops is one of the most common therapeutic strategies. Patient adherence to conventional eye drops remains a major obstacle in preventing glaucoma progression. Additional problems emerge from inadequate patient education as well as local and systemic side effects associated with adminstering ocular hypotensive drugs. AREAS COVERED Sustained-release drug delivery systems for glaucoma treatment are classified into extraocular systems including wearable ocular surface devices or multi-use (immediate-release) eye formulations (such as aqueous solutions, gels; ocular inserts, contact lenses, periocular rings, or punctual plugs) and intraocular drug delivery systems (such as intraocular implants, and microspheres for supraciliary drug delivery). EXPERT OPINION Sustained release platforms for the delivery of ocular hypotensive drugs (small molecules and biologics) may improve patient adherence and prevent vision loss. Such innovations will only be widely adopted when efficacy and safety has been established through large-scale trials. Sustained release drug delivery can improve glaucoma treatment adherence and reverse/prevent vision deterioration. It is expected that these approaches will improve clinical management and prognosis of glaucoma.
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Affiliation(s)
- Zinah K Al-Qaysi
- Drug Discovery, Delivery and Patient Care (DDDPC) Theme, Department of Pharmacy, Kingston University London, Kingston Upon Thames, UK
| | - Ian G Beadham
- Drug Discovery, Delivery and Patient Care (DDDPC) Theme, Department of Pharmacy, Kingston University London, Kingston Upon Thames, UK
| | - Sianne L Schwikkard
- Department of Chemical and Pharmaceutical Sciences, Kingston University, Kingston Upon Thames, UK
| | - Joseph C Bear
- Department of Chemical and Pharmaceutical Sciences, Kingston University, Kingston Upon Thames, UK
| | - Ali A Al-Kinani
- Drug Discovery, Delivery and Patient Care (DDDPC) Theme, Department of Pharmacy, Kingston University London, Kingston Upon Thames, UK
| | - Raid G Alany
- Drug Discovery, Delivery and Patient Care (DDDPC) Theme, Department of Pharmacy, Kingston University London, Kingston Upon Thames, UK
- School of Pharmacy, The University of Auckland, Auckland, New Zealand
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Campigotto A, Campbell RJ, Lai Y. Correlation between corneal and contact lens deformation with changes in intraocular pressure for wearable monitoring systems. Eye (Lond) 2023; 37:2055-2060. [PMID: 36302975 PMCID: PMC10333185 DOI: 10.1038/s41433-022-02285-y] [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: 02/18/2022] [Revised: 09/11/2022] [Accepted: 10/07/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE The aim of this work is to evaluate the extent to which the eye's curvature deformation, due to changes in the intraocular pressure (IOP), can be directly tracked by an overlying contact lens. METHOD In this experimental study, using 12 cadaveric eyes, the IOP was increased from 10 to 36 mmHg, while video imaging was used to capture the three experimental variations. The deformation of the bare eye was used as a control, while the deformation of an overlying silicone grided contact lens and an overlying microfluidic IOP-sensing contact lens were examined and compared. RESULTS The relation between the slope of the radius of corneal curvature versus the IOP for both the bare eye and the marker contact lens yielded a linear relationship with a R2 value of 0.83. The microfluidic contact lens resulted in an average performance of 0.40 mm indicator movement/mmHg (SD 0.006). Comparing the slope of the marker contact lens deformation, to the performance of the microfluidic contact lens resulted in a R2 value of 0.78. The strain map of the overlaying grided contact lens showed most deformation occurring along the outer edge of the lens with increased deformation as increase IOP occurs; as well as with some negative, compressive movement near the central points. CONCLUSION The deformation from the curvature of the eye is significant enough from 10 to 36 mmHg that a silicone contact lens can capture and mimic those changes. The results show promise for optimization in contact lens-based IOP monitoring.
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Affiliation(s)
- Angelica Campigotto
- Department of Mechanical and Materials Engineering, Queen's University, Kingston, ON, Canada
| | - Robert J Campbell
- Department of Ophthalmology, Queen's University, Kingston, ON, Canada
- Department of Ophthalmology, Kingston Health Sciences Centre, Kingston, ON, Canada
| | - Yongjun Lai
- Department of Mechanical and Materials Engineering, Queen's University, Kingston, ON, Canada.
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Huang SK, Ishii M, Mizuki Y, Kawagoe T, Takeuchi M, Nomura E, Mizuki N. Circadian Fluctuation Changes in Intraocular Pressure Measured Using a Contact Lens Sensor in Patients with Glaucoma after the Adjunctive Administration of Ripasudil: A Prospective Study. J Pers Med 2023; 13:jpm13050800. [PMID: 37240970 DOI: 10.3390/jpm13050800] [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: 02/24/2023] [Revised: 04/23/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023] Open
Abstract
Nocturnal and circadian intraocular pressure (IOP) fluctuations are important issues in glaucoma treatment. Ripasudil 0.4% eye drops, a new glaucoma medication, lowers IOP by increasing aqueous humor outflow through the trabecular meshwork. We aimed to compare differences between circadian IOP fluctuations measured using a contact lens sensor (CLS) before and after administering 0.4% ripasudil eye drops adjunctively to patients with primary open-angle glaucoma (POAG) and normal tension glaucoma (NTG). Patients with POAG (n = 1) and NTG (n = 5) underwent 24 h IOP monitoring with a CLS before and after administering ripasudil eye drops every 12 h (8 a.m., 8 p.m.) for 2 weeks without discontinuing currently used glaucoma medications. No vision-threatening adverse event occurred. The reduction in IOP fluctuation and the reduction in the SD of IOP in 24 h, awake time and sleep time did not reach statistical significance. The baseline office-hour IOP, which was measured using Goldmann applanation tonometry (GAT), ranged in the low teens, and the reduction in office-hour IOP also did not show a significant difference. Further study is necessary to evaluate whether the low baseline IOP with less IOP reduction relates to attenuated IOP fluctuation reduction.
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Affiliation(s)
- Shih-Kung Huang
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Kanagawa, Japan
- Department of Ophthalmology, Yokohama Hodogaya Central Hospital, Yokohama 240-8585, Kanagawa, Japan
| | - Mai Ishii
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Kanagawa, Japan
| | - Yuki Mizuki
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Kanagawa, Japan
| | - Tatukata Kawagoe
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Kanagawa, Japan
| | - Masaki Takeuchi
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Kanagawa, Japan
| | - Eiichi Nomura
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Kanagawa, Japan
| | - Nobuhisa Mizuki
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Kanagawa, Japan
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Turner M, Ou Y. At-Home Glaucoma Monitoring: Is it Ready for Prime Time? Ophthalmol Glaucoma 2023; 6:117-120. [PMID: 36184483 DOI: 10.1016/j.ogla.2022.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/28/2022] [Accepted: 08/11/2022] [Indexed: 10/14/2022]
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Torun H, Fazla B, Arman S, Ozdalgic B, Yetisen AK, Tasoglu S. Microfluidic contact lenses for ocular diagnostics and drug delivery. NANO SELECT 2022. [DOI: 10.1002/nano.202200202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Hulya Torun
- Graduate School of Sciences and Engineering Koc University Istanbul Turkey
- Koc University Research Center for Translational Medicine Koc University Istanbul Turkey
| | - Bartu Fazla
- Graduate School of Sciences and Engineering Koc University Istanbul Turkey
| | - Samaneh Arman
- Graduate School of Sciences and Engineering Koc University Istanbul Turkey
| | - Berin Ozdalgic
- Koc University Research Center for Translational Medicine Koc University Istanbul Turkey
- Department of Mechanical Engineering, Engineering Faculty Koc University Istanbul Turkey
- Division of Opticianry, The School of Medical Services and Techniques Dogus University Istanbul Turkey
| | - Ali K. Yetisen
- Department of Chemical Engineering Imperial College London London UK
| | - Savas Tasoglu
- Koc University Research Center for Translational Medicine Koc University Istanbul Turkey
- Department of Mechanical Engineering, Engineering Faculty Koc University Istanbul Turkey
- Arcelik Research Center for Creative Industries (KUAR) Koc University Istanbul Turkey
- Institute of Biomedical Engineering Bogazici University Istanbul Turkey
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Abstract
ABSTRACT Contact lenses are a safe and effective method for correction of refractive error and worn by an estimated 45 million Americans. Because of the widespread availability and commercial popularity of contact lenses, it is not well appreciated by the public that contact lenses are U.S. Food and Drug Administration (FDA)-regulated medical devices. Contact lenses are marketed in numerous hard and soft materials that have been improved over decades, worn in daily or extended wear, and replaced in range of schedules from daily to yearly or longer. Lens materials and wear and care regimens have impact on the risks of contact lens-related corneal inflammatory events and microbial keratitis. This article reviews contact lens safety, with specific focus on the correction of refractive error in healthy eyes.
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Zhang J, Kim K, Kim HJ, Meyer D, Park W, Lee SA, Dai Y, Kim B, Moon H, Shah JV, Harris KE, Collar B, Liu K, Irazoqui P, Lee H, Park SA, Kollbaum PS, Boudouris BW, Lee CH. Smart soft contact lenses for continuous 24-hour monitoring of intraocular pressure in glaucoma care. Nat Commun 2022; 13:5518. [PMID: 36127347 PMCID: PMC9489713 DOI: 10.1038/s41467-022-33254-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 09/09/2022] [Indexed: 11/09/2022] Open
Abstract
Continuous monitoring of intraocular pressure, particularly during sleep, remains a grand challenge in glaucoma care. Here we introduce a class of smart soft contact lenses, enabling the continuous 24-hour monitoring of intraocular pressure, even during sleep. Uniquely, the smart soft contact lenses are built upon various commercial brands of soft contact lenses without altering their intrinsic properties such as lens power, biocompatibility, softness, transparency, wettability, oxygen transmissibility, and overnight wearability. We show that the smart soft contact lenses can seamlessly fit across different corneal curvatures and thicknesses in human eyes and therefore accurately measure absolute intraocular pressure under ambulatory conditions. We perform a comprehensive set of in vivo evaluations in rabbit, dog, and human eyes from normal to hypertension to confirm the superior measurement accuracy, within-subject repeatability, and user comfort of the smart soft contact lenses beyond current wearable ocular tonometers. We envision that the smart soft contact lenses will be effective in glaucoma care.
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Affiliation(s)
- Jinyuan Zhang
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Kyunghun Kim
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Ho Joong Kim
- Charles D. Davidson School of Chemical Engineering, Purdue University, West Lafayette, IN, USA
| | - Dawn Meyer
- School of Optometry, Indiana University, Bloomington, IN, USA
| | - Woohyun Park
- School of Mechanical Engineering, Purdue University, West Lafayette, IN, USA
| | - Seul Ah Lee
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Yumin Dai
- School of Materials Engineering, Purdue University, West Lafayette, IN, USA
| | - Bongjoong Kim
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA.,Department of Mechanical and System Design Engineering, Hongik University, Seoul, 04066, Republic of Korea
| | - Haesoo Moon
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Jay V Shah
- Elmore Family School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, USA
| | - Keely E Harris
- Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, IN, USA
| | - Brett Collar
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Kangying Liu
- Department of Chemistry, Purdue University, West Lafayette, IN, USA
| | - Pedro Irazoqui
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Hyowon Lee
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA.,Center for Implantable Devices, Purdue University, West Lafayette, IN, USA.,Birck Nanotechnology Center, Purdue University, West Lafayette, IN, USA
| | - Shin Ae Park
- Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, IN, USA.
| | - Pete S Kollbaum
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA. .,School of Optometry, Indiana University, Bloomington, IN, USA.
| | - Bryan W Boudouris
- Charles D. Davidson School of Chemical Engineering, Purdue University, West Lafayette, IN, USA. .,Department of Chemistry, Purdue University, West Lafayette, IN, USA. .,Birck Nanotechnology Center, Purdue University, West Lafayette, IN, USA.
| | - Chi Hwan Lee
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA. .,School of Optometry, Indiana University, Bloomington, IN, USA. .,School of Mechanical Engineering, Purdue University, West Lafayette, IN, USA. .,School of Materials Engineering, Purdue University, West Lafayette, IN, USA. .,Center for Implantable Devices, Purdue University, West Lafayette, IN, USA. .,Birck Nanotechnology Center, Purdue University, West Lafayette, IN, USA.
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13
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Zhu Y, Li S, Li J, Falcone N, Cui Q, Shah S, Hartel MC, Yu N, Young P, de Barros NR, Wu Z, Haghniaz R, Ermis M, Wang C, Kang H, Lee J, Karamikamkar S, Ahadian S, Jucaud V, Dokmeci MR, Kim HJ, Khademhosseini A. Lab-on-a-Contact Lens: Recent Advances and Future Opportunities in Diagnostics and Therapeutics. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2022; 34:e2108389. [PMID: 35130584 PMCID: PMC9233032 DOI: 10.1002/adma.202108389] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/27/2022] [Indexed: 05/09/2023]
Abstract
The eye is one of the most complex organs in the human body, containing rich and critical physiological information (e.g., intraocular pressure, corneal temperature, and pH) as well as a library of metabolite biomarkers (e.g., glucose, proteins, and specific ions). Smart contact lenses (SCLs) can serve as a wearable intelligent ocular prosthetic device capable of noninvasive and continuous monitoring of various essential physical/biochemical parameters and drug loading/delivery for the treatment of ocular diseases. Advances in SCL technologies and the growing public interest in personalized health are accelerating SCL research more than ever before. Here, the current status and potential of SCL development through a comprehensive review from fabrication to applications to commercialization are discussed. First, the material, fabrication, and platform designs of the SCLs for the diagnostic and therapeutic applications are discussed. Then, the latest advances in diagnostic and therapeutic SCLs for clinical translation are reviewed. Later, the established techniques for wearable power transfer and wireless data transmission applied to current SCL devices are summarized. An outlook, future opportunities, and challenges for developing next-generation SCL devices are also provided. With the rise in interest of SCL development, this comprehensive and essential review can serve as a new paradigm for the SCL devices.
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Affiliation(s)
- Yangzhi Zhu
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
| | - Shaopei Li
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
| | - Jinghang Li
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
- School of Engineering, Westlake University, Hangzhou, Zhejiang Province, 310024, China
- School of Materials Science and Engineering, Wuhan Institute of Technology, Wuhan, Hubei Province, 430205, China
| | - Natashya Falcone
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
| | - Qingyu Cui
- Department of Medicine, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, 90095, USA
| | - Shilp Shah
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
- Department of Bioengineering, University of California-Los Angeles, Los Angeles, CA, 90095, USA
| | - Martin C Hartel
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
- Department of Bioengineering, University of California-Los Angeles, Los Angeles, CA, 90095, USA
| | - Ning Yu
- Department of Chemical and Environmental Engineering, University of California-Riverside, Riverside, CA, 92521, USA
| | - Patric Young
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
| | | | - Zhuohong Wu
- Department of Nanoengineering, University of California-San Diego, San Diego, CA, 92093, USA
| | - Reihaneh Haghniaz
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
| | - Menekse Ermis
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
| | - Canran Wang
- Andrew and Peggy Cherng Department of Medical Engineering, Division of Engineering and Applied Science, California Institute of Technology, Pasadena, CA, 91125, USA
| | - Heemin Kang
- Department of Materials Science and Engineering, Korea University, Seoul, 02841, Republic of Korea
| | - Junmin Lee
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), Pohang, 37673, Republic of Korea
| | | | - Samad Ahadian
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
| | - Vadim Jucaud
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
| | - Mehmet R Dokmeci
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
| | - Han-Jun Kim
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
| | - Ali Khademhosseini
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
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14
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Yang M, Ye Z, Alsaab N, Farhat M, Chen PY. In-Vitro Demonstration of Ultra-Reliable, Wireless and Batteryless Implanted Intracranial Sensors Operated on Loci of Exceptional Points. IEEE TRANSACTIONS ON BIOMEDICAL CIRCUITS AND SYSTEMS 2022; 16:287-295. [PMID: 35380967 DOI: 10.1109/tbcas.2022.3164697] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Vital signal monitoring, such as pulse, respiration rate, intra-organ and intra-vascular pressure, can provide important information for determination of clinic diagnosis, treatments, and surgical protocols. Nowadays, micromachined bioimplants, equipped with antennas for converting bio-signals to modulated radio transmissions, may allow remote continuous monitoring of patients' vital signs. Yet, current passive biotelemetry techniques usually suffer from poor signal reproducibility and robustness in light of inevitable misalignment between transmitting and receiving antennas. Here, we seek to address this long-existing challenge and to robustly acquire information from a passive wireless intracranial pressure (or brain pressure) sensor by introducing a novel, high-performance biotelemetry system. In spite of variable inductive links, this biotelemetry system may have absolute accuracy by leveraging the uniqueness of loci of exceptional points (EPs) in non-Hermitian radio-frequency (RF) electronic systems with parity-time (PT) symmetry. Our in-vitro experimental demonstration shows that the proposed intracranial (ICP) monitoring system can provide a sub-mmHg resolution in the ICP range of 0-20 mmHg and ultra-robust wireless data acquisition against the misalignment-induced weakening of inductive link. Our results could provide a practical pathway toward reliable, real-time wireless monitoring of ICP, and other vital signals generated by bio-implants and wearables.
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15
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Ye Y, Ge Y, Zhang Q, Yuan M, Cai Y, Li K, Li Y, Xie R, Xu C, Jiang D, Qu J, Liu X, Wang Y. Smart Contact Lens with Dual-Sensing Platform for Monitoring Intraocular Pressure and Matrix Metalloproteinase-9. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2022; 9:e2104738. [PMID: 35195359 PMCID: PMC9036001 DOI: 10.1002/advs.202104738] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 01/06/2022] [Indexed: 05/09/2023]
Abstract
Contact lenses have become a popular health-monitoring wearable device due to their direct contact with the eyes. By integrating biosensors into contact lenses, real-time and noninvasive diagnoses of various diseases can be realized. However, current contact lens sensors often require complex electronics, which may obstruct the user's vision or even damage the cornea. Moreover, most of the reported contact lens sensors can only detect one analyte. Therefore, an optical-based dual-functional smart contact lens sensor has been introduced to monitor intraocular pressure (IOP) and detect matrix metalloproteinase-9 (MMP-9), both of which are key biomarkers in many eye-related diseases such as glaucoma. Specifically, the elevated IOP is continuously monitored by applying an antiopal structure through color changes, without any complex electronics. Together with the peptide modified gold nanobowls (AuNBs) surface-enhanced Raman scattering (SERS) substrate, the quantitative analysis of MMP-9 at a low nanomolar range is achieved in real tear samples. The dual-sensing functions are thus demonstrated, providing a convenient, noninvasive, and potentially multifunctional sensing platform for monitoring health and diagnostic biomarkers in human tears.
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Affiliation(s)
- Ying Ye
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical EngineeringWenzhou Medical UniversityWenzhou325027P. R. China
- Wenzhou InstituteUniversity of Chinese Academy of SciencesWenzhou325001P. R. China
| | - Yuancai Ge
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical EngineeringWenzhou Medical UniversityWenzhou325027P. R. China
- Wenzhou InstituteUniversity of Chinese Academy of SciencesWenzhou325001P. R. China
| | - Qingwen Zhang
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical EngineeringWenzhou Medical UniversityWenzhou325027P. R. China
- Wenzhou InstituteUniversity of Chinese Academy of SciencesWenzhou325001P. R. China
| | - Meiling Yuan
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical EngineeringWenzhou Medical UniversityWenzhou325027P. R. China
- Wenzhou InstituteUniversity of Chinese Academy of SciencesWenzhou325001P. R. China
| | - Yu Cai
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical EngineeringWenzhou Medical UniversityWenzhou325027P. R. China
- Wenzhou InstituteUniversity of Chinese Academy of SciencesWenzhou325001P. R. China
| | - Kang Li
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical EngineeringWenzhou Medical UniversityWenzhou325027P. R. China
- Wenzhou InstituteUniversity of Chinese Academy of SciencesWenzhou325001P. R. China
| | - Yang Li
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical EngineeringWenzhou Medical UniversityWenzhou325027P. R. China
- Wenzhou InstituteUniversity of Chinese Academy of SciencesWenzhou325001P. R. China
| | - Ruifeng Xie
- School of Opto‐Electronic EngineeringChangchun University of Science and TechnologyChangchun130022P. R. China
| | - Changshun Xu
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical EngineeringWenzhou Medical UniversityWenzhou325027P. R. China
- Wenzhou InstituteUniversity of Chinese Academy of SciencesWenzhou325001P. R. China
| | - Danfeng Jiang
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical EngineeringWenzhou Medical UniversityWenzhou325027P. R. China
- Wenzhou InstituteUniversity of Chinese Academy of SciencesWenzhou325001P. R. China
| | - Jia Qu
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical EngineeringWenzhou Medical UniversityWenzhou325027P. R. China
| | - Xiaohu Liu
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical EngineeringWenzhou Medical UniversityWenzhou325027P. R. China
- Wenzhou InstituteUniversity of Chinese Academy of SciencesWenzhou325001P. R. China
| | - Yi Wang
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical EngineeringWenzhou Medical UniversityWenzhou325027P. R. China
- Wenzhou InstituteUniversity of Chinese Academy of SciencesWenzhou325001P. R. China
- School of Opto‐Electronic EngineeringChangchun University of Science and TechnologyChangchun130022P. R. China
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16
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Recent Advancements in AI-Enabled Smart Electronics Packaging for Structural Health Monitoring. METALS 2021. [DOI: 10.3390/met11101537] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Real-time health monitoring of civil infrastructures is performed to maintain their structural integrity, sustainability, and serviceability for a longer time. With smart electronics and packaging technology, large amounts of complex monitoring data are generated, requiring sophisticated artificial intelligence (AI) techniques for their processing. With the advancement of technology, more complex AI models have been applied, from simple models to sophisticated deep learning (DL) models, for structural health monitoring (SHM). In this article, a comprehensive review is performed, primarily on the applications of AI models for SHM to maintain the sustainability of diverse civil infrastructures. Three smart data capturing methods of SHM, namely, camera-based, smartphone-based, and unmanned aerial vehicle (UAV)-based methods, are also discussed, having made the utilization of intelligent paradigms easier. UAV is found to be the most promising smart data acquisition technology, whereas convolution neural networks are the most impressive DL model reported for SHM. Furthermore, current challenges and future perspectives of AI-based SHM systems are also described separately. Moreover, the Internet of Things (IoT) and smart city concepts are explained to elaborate on the contributions of intelligent SHM systems. The integration of SHM with IoT and cloud-based computing is leading us towards the evolution of future smart cities.
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17
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Brusini P, Salvetat ML, Zeppieri M. How to Measure Intraocular Pressure: An Updated Review of Various Tonometers. J Clin Med 2021; 10:3860. [PMID: 34501306 PMCID: PMC8456330 DOI: 10.3390/jcm10173860] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 08/17/2021] [Accepted: 08/23/2021] [Indexed: 02/05/2023] Open
Abstract
Intraocular pressure (IOP) is an important measurement that needs to be taken during ophthalmic examinations, especially in ocular hypertension subjects, glaucoma patients and in patients with risk factors for developing glaucoma. The gold standard technique in measuring IOP is still Goldmann applanation tonometry (GAT); however, this procedure requires local anesthetics, can be difficult in patients with scarce compliance, surgical patients and children, and is influenced by several corneal parameters. Numerous tonometers have been proposed in the past to address the problems related to GAT. The authors review the various devices currently in use for the measurement of intraocular pressure (IOP), highlighting the main advantages and limits of the various tools. The continuous monitoring of IOP, which is still under evaluation, will be an important step for a more complete and reliable management of patients affected by glaucoma.
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Affiliation(s)
- Paolo Brusini
- Department of Ophthalmology, Policlinico “Città di Udine”, 33100 Udine, Italy;
| | - Maria Letizia Salvetat
- Department of Ophthalmology, Azienda Sanitaria Friuli Occidentale, 33170 Pordenone, Italy;
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
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18
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Triggerfish Recording of IOP Patterns in Combined HFDS Minimally Invasive Glaucoma and Cataract Surgery: A Prospective Study. J Clin Med 2021; 10:jcm10163472. [PMID: 34441768 PMCID: PMC8396965 DOI: 10.3390/jcm10163472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 07/30/2021] [Accepted: 08/04/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The aim of the study is to investigate whether the circadian IOP rhythm can be influenced by combined cataract surgery with high frequency deep sclerotomy (HFDS) and whether intraocular pressure (IOP) can be significantly reduced by HFDS. METHODS In our study 10 patients were included, in whom 24 h IOP monitoring was installed before and after HFDS/cataract surgery using a Triggerfish. HFDS is a minimally invasive glaucoma surgery (MIGS). RESULTS After performed HFDS combined with cataract surgery, the IOP was reduced from 27.7 ± 2.11 mmHg to 14.4 ± 2.59 mmHg, which is highly significant (p < 0.001). The contact lens sensor (CLS) cosinor analysis pre- and postoperatively showed that the circadian rhythm is not influenced by the surgery, i.e., the circadian IOP rhythm did not show significant differences before and after surgery. CONCLUSIONS HFDS combined with cataract surgery is a potent surgical method that can significantly reduce the IOP. However, the circadian rhythm cannot be changed by the surgery. The acrophase remained during the night in all patients.
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19
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A soft and transparent contact lens for the wireless quantitative monitoring of intraocular pressure. Nat Biomed Eng 2021; 5:772-782. [PMID: 33941897 DOI: 10.1038/s41551-021-00719-8] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 03/22/2021] [Indexed: 02/02/2023]
Abstract
Continuous detection of raised intraocular pressure (IOP) could benefit the monitoring of patients with glaucoma. Current contact lenses with embedded sensors for measuring IOP are rigid, bulky, partially block vision or are insufficiently sensitive. Here, we report the design and testing in volunteers of a soft and transparent contact lens for the quantitative monitoring of IOP in real time using a smartphone. The contact lens incorporates a strain sensor, a wireless antenna, capacitors, resistors, stretchable metal interconnects and an integrated circuit for wireless communication. In rabbits, the lens provided measurements that match those of a commercial tonometer. In ten human participants, the lens proved to be safe, and reliably provided accurate quantitative measurements of IOP without inducing inflammation.
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20
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Xu J, Li R, Xu H, Yang Y, Zhang S, Ren T. Recent progress of continuous intraocular pressure monitoring. NANO SELECT 2021. [DOI: 10.1002/nano.202100137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Jiandong Xu
- Institute of Microelectronics Tsinghua University Beijing 100084 China
- Beijing National Research Center for Information Science and Technology (BNRist) Tsinghua University Beijing 100084 China
| | - Ruisong Li
- Department of Electrical Engineering and Computer Science and Department of Bioengineering College of Engineering University of California Berkeley California 94720 USA
| | - Haokai Xu
- Institute of Microelectronics Tsinghua University Beijing 100084 China
- Beijing National Research Center for Information Science and Technology (BNRist) Tsinghua University Beijing 100084 China
| | - Yi Yang
- Institute of Microelectronics Tsinghua University Beijing 100084 China
- Beijing National Research Center for Information Science and Technology (BNRist) Tsinghua University Beijing 100084 China
| | - Sheng Zhang
- Shenzhen International Graduate School Tsinghua University Shenzhen 518055 China
| | - Tian‐Ling Ren
- Institute of Microelectronics Tsinghua University Beijing 100084 China
- Beijing National Research Center for Information Science and Technology (BNRist) Tsinghua University Beijing 100084 China
- Center for Flexible Electronics Technology Tsinghua University Beijing 100084 China
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21
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Kim TY, Shin S, Choi H, Jeong SH, Myung D, Hahn SK. Smart Contact Lenses with a Transparent Silver Nanowire Strain Sensor for Continuous Intraocular Pressure Monitoring. ACS APPLIED BIO MATERIALS 2021; 4:4532-4541. [PMID: 35006789 PMCID: PMC10867858 DOI: 10.1021/acsabm.1c00267] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Continuous intraocular pressure (IOP) monitoring can provide a paradigm shift in the management of patients with glaucoma as a facile alternative to conventional diagnostic methods. However, the low sensitivity and functional instability of current IOP sensors have limited their clinical utility in the management of glaucoma. Here, we have developed a smart contact lens integrated with a transparent silver nanowire IOP strain sensor and wireless circuits for noninvasive, continuous IOP monitoring. After confirming the robust stability of the IOP sensor within the smart contact lens in the presence of tears and repeated eyelid blink model cycles, we were able to monitor IOP changes on polydimethylsiloxane model eyes in vitro. In vivo tests demonstrated that our fully integrated wireless smart contact lens could successfully monitor the change in IOP in living rabbit eyes, which was clearly validated by the conventional invasive tonometer IOP test. Taken together, we could confirm the feasibility of our smart contact lens as a noninvasive platform for continuous IOP monitoring of glaucoma patients.
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Affiliation(s)
- Tae Yeon Kim
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk 37673, Korea
| | - Sangbaie Shin
- PHI BIOMED Co., 168 Yeoksam-ro, Gangnam-gu, Seoul 06248, South Korea
| | - Hyunsik Choi
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk 37673, Korea
| | - Sang Hoon Jeong
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk 37673, Korea
| | - David Myung
- Department of Ophthalmology and Chemical Engineering, Stanford University, 443 Via Ortega, Stanford, California 94305, United States
| | - Sei Kwang Hahn
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk 37673, Korea
- PHI BIOMED Co., 168 Yeoksam-ro, Gangnam-gu, Seoul 06248, South Korea
- Department of Ophthalmology and Chemical Engineering, Stanford University, 443 Via Ortega, Stanford, California 94305, United States
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22
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Abstract
The recent advances in bio-integratable electronics are creating new opportunities for investigating and directing biologically significant processes, yet their performance to date is still limited by the inherent physiochemical and signaling mismatches at the heterogeneous interfaces. Hydrogels represent a unique category of materials to bridge the gap between biological and electronic systems because of their structural/functional similarity to biological tissues and design versatility to accommodate cross-system communication. In this review, we discuss the latest progress in the engineering of hydrogel interfaces for bioelectronics development that promotes (1) structural compatibility, where the mechanical and chemical properties of hydrogels can be modulated to achieve coherent, chronically stable biotic-abiotic junctions; and (2) interfacial signal transduction, where the charge and mass transport within the hydrogel mediators can be rationally programmed to condition/amplify the bioderived signals and enhance the electrical/electrochemical coupling. We will further discuss the application of functional hydrogels in complex physiological environments for bioelectronic integration across different scales/biological levels. These ongoing research efforts have the potential to blur the distinction between living systems and artificial electronics, and ultimately decode and regulate biological functioning for both fundamental inquiries and biomedical applications.
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Affiliation(s)
- Richard Vo
- Department of Biomedical Engineering, Tufts University, Medford, MA 02155, USA.
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23
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Jones L, Hui A, Phan CM, Read ML, Azar D, Buch J, Ciolino JB, Naroo SA, Pall B, Romond K, Sankaridurg P, Schnider CM, Terry L, Willcox M. CLEAR - Contact lens technologies of the future. Cont Lens Anterior Eye 2021; 44:398-430. [PMID: 33775384 DOI: 10.1016/j.clae.2021.02.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 02/01/2021] [Indexed: 12/20/2022]
Abstract
Contact lenses in the future will likely have functions other than correction of refractive error. Lenses designed to control the development of myopia are already commercially available. Contact lenses as drug delivery devices and powered through advancements in nanotechnology will open up further opportunities for unique uses of contact lenses. This review examines the use, or potential use, of contact lenses aside from their role to correct refractive error. Contact lenses can be used to detect systemic and ocular surface diseases, treat and manage various ocular conditions and as devices that can correct presbyopia, control the development of myopia or be used for augmented vision. There is also discussion of new developments in contact lens packaging and storage cases. The use of contact lenses as devices to detect systemic disease has mostly focussed on detecting changes to glucose levels in tears for monitoring diabetic control. Glucose can be detected using changes in colour, fluorescence or generation of electric signals by embedded sensors such as boronic acid, concanavalin A or glucose oxidase. Contact lenses that have gained regulatory approval can measure changes in intraocular pressure to monitor glaucoma by measuring small changes in corneal shape. Challenges include integrating sensors into contact lenses and detecting the signals generated. Various techniques are used to optimise uptake and release of the drugs to the ocular surface to treat diseases such as dry eye, glaucoma, infection and allergy. Contact lenses that either mechanically or electronically change their shape are being investigated for the management of presbyopia. Contact lenses that slow the development of myopia are based upon incorporating concentric rings of plus power, peripheral optical zone(s) with add power or non-monotonic variations in power. Various forms of these lenses have shown a reduction in myopia in clinical trials and are available in various markets.
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Affiliation(s)
- Lyndon Jones
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada; Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong.
| | - Alex Hui
- School of Optometry and Vision Science, UNSW Sydney, Sydney, NSW, Australia
| | - Chau-Minh Phan
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada; Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong
| | - Michael L Read
- Eurolens Research, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Dimitri Azar
- Department of Ophthalmology and Visual Sciences, University of Illinois College of Medicine, Chicago, IL, USA; Verily Life Sciences, San Francisco, CA, USA
| | - John Buch
- Johnson & Johnson Vision Care, Jacksonville, FL, USA
| | - Joseph B Ciolino
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - Shehzad A Naroo
- College of Health and Life Sciences, Aston University, Birmingham B4 7ET, UK
| | - Brian Pall
- Johnson & Johnson Vision Care, Jacksonville, FL, USA
| | - Kathleen Romond
- Department of Ophthalmology and Visual Sciences, University of Illinois College of Medicine, Chicago, IL, USA
| | - Padmaja Sankaridurg
- School of Optometry and Vision Science, UNSW Sydney, Sydney, NSW, Australia; Brien Holden Vision Institute, Sydney, Australia
| | | | - Louise Terry
- School of Optometry and Vision Sciences, Cardiff University, UK
| | - Mark Willcox
- School of Optometry and Vision Science, UNSW Sydney, Sydney, NSW, Australia
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24
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Barnett M, Courey C, Fadel D, Lee K, Michaud L, Montani G, van der Worp E, Vincent SJ, Walker M, Bilkhu P, Morgan PB. CLEAR - Scleral lenses. Cont Lens Anterior Eye 2021; 44:270-288. [PMID: 33775380 DOI: 10.1016/j.clae.2021.02.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 02/01/2021] [Indexed: 12/25/2022]
Abstract
Scleral lenses were the first type of contact lens, developed in the late nineteenth century to restore vision and protect the ocular surface. With the advent of rigid corneal lenses in the middle of the twentieth century and soft lenses in the 1970's, the use of scleral lenses diminished; in recent times there has been a resurgence in their use driven by advances in manufacturing and ocular imaging technology. Scleral lenses are often the only viable form of contact lens wear across a range of clinical indications and can potentially delay the need for corneal surgery. This report provides a brief historical review of scleral lenses and a detailed account of contemporary scleral lens practice including common indications and recommended terminology. Recent research on ocular surface shape is presented, in addition to a comprehensive account of modern scleral lens fitting and on-eye evaluation. A range of optical and physiological challenges associated with scleral lenses are presented, including options for the clinical management of a range of ocular conditions. Future applications which take advantage of the stability of scleral lenses are also discussed. In summary, this report presents evidence-based recommendations to optimise patient outcomes in modern scleral lens practice.
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Affiliation(s)
- Melissa Barnett
- University of California, Davis Eye Center, Sacramento, CA, United States.
| | | | | | - Karen Lee
- University of Houston, College of Optometry, Houston, TX, United States
| | | | - Giancarlo Montani
- Università del Salento, Dipartimento di Matematica e Fisica CERCA, Lecce, Italy
| | - Eef van der Worp
- Eye-Contact-Lens Research & Education, Amsterdam, NL, Netherlands
| | - Stephen J Vincent
- Queensland University of Technology (QUT), Centre for Vision and Eye Research, School of Optometry and Vision Science, Contact Lens and Visual Optics Laboratory, Brisbane, Australia
| | - Maria Walker
- University of Houston, College of Optometry, Houston, TX, United States
| | - Paramdeep Bilkhu
- School of Optometry & Vision Science, Aston University, Birmingham, United Kingdom
| | - Philip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, University of Manchester, Manchester, United Kingdom
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25
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Gillmann K, Weinreb RN, Mansouri K. The effect of daily life activities on intraocular pressure related variations in open-angle glaucoma. Sci Rep 2021; 11:6598. [PMID: 33758276 PMCID: PMC7988182 DOI: 10.1038/s41598-021-85980-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 02/26/2021] [Indexed: 12/13/2022] Open
Abstract
The recent advent of continuous intraocular pressure (IOP) telemetry has led to an increased awareness of the importance of IOP fluctuations, and theories have emerged that IOP variations could play as much a role in glaucoma progression as the mean level of IOP. The aim of the present study was to evaluate the direct effect of common daily activities on IOP-related profiles. Primary open-angle glaucoma and glaucoma suspect patients were prospectively enrolled from specialist clinics at the University of California San Diego (UCSD), USA. Patients were fitted with a SENSIMED Triggerfish (TF) contact lens sensor (CLS) and were instructed to return to their usual daily activities for 24 h. They were asked to record each specific activity or event in a diary. The protocol was repeated twice. The following events were recorded: "walking/cycling", "resistance training", "yoga/meditation", and "emotional stress". CLS measurements recorded 60-to-30 min prior to each event were used as a baseline reference, and all IOP-related fluctuations for 120 min after the start of each event were reported in relation to this reference. Forty relevant events from 22 CLS recordings in 14 patients were retrieved from the diaries. Walking/cycling (n = 10) caused a small but statistically significant elevation of the IOP-related profile during the activity (p = 0.018). Resistance training (n = 11) caused a persistent elevation of the IOP-related profile from the onset of the activity (p = 0.005) through 120 min after the activity was stopped (p = 0.007). Yoga/meditation (n = 4) caused a sustained drop in the IOP-related profiles through to 120 min, although this was not statistically significant (p > 0.380). Emotional stress (n = 13) was associated with a gradual elevation of the IOP-related profile from the start of the stressful stimulus. Both early and late variations were statistically significant (p = 0.038 and p = 0.021, respectively). The present study suggests that emotional stress and resistance training may be associated with persistent IOP-related profile elevation.
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Affiliation(s)
- Kevin Gillmann
- Glaucoma Research Center, Montchoisi Clinic, Swiss Visio, Lausanne, Switzerland.,Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, USA
| | - Kaweh Mansouri
- Glaucoma Research Center, Montchoisi Clinic, Swiss Visio, Lausanne, Switzerland. .,Department of Ophthalmology, University of Colorado School of Medicine, Denver, CO, USA.
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Effect of variations of corneal physiology on novel non-invasive intraocular pressure monitoring soft contact lens. Biomed Microdevices 2021; 23:16. [PMID: 33725182 DOI: 10.1007/s10544-021-00555-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2021] [Indexed: 10/21/2022]
Abstract
Glaucoma is the leading cause of irreversible blindness around the world. With its slow asymptomatic progression, there is an emphasis on early detection and frequent monitoring. A novel microfluidic contact lens has been established as a potential way to track the fluctuations of the intraocular pressure (IOP) which is a key indicator for diagnosing and monitoring glaucoma progression. The purpose of this article is to determine the effect of physiological variations of the eye on the performance of the microfluidic contact lens. Ultrasound biomicroscopy (UBM) was used to measure the central corneal thickness (CCT) and radius of corneal curvature (RCC) for a series of 16 fresh enucleated porcine eyes. The effect of these corneal anatomic features on device performance was then assessed by systematically adjusting intraocular pressure from 10 to 34 mmHg and monitoring the device indicator response. The performance of the microfluidic contact lens was determined by finding the amount the indicator fluid shifted in position as a result of 1 mmHg IOP increase. The relationship between IOP and indicator fluid was found to be linear for all eyes. The slope of the indicator fluid movement as a result of the IOP was evaluated against the CCT and RCC of each porcine eye. This yielded low correlation coefficients, 0.057 for CCT and 0.024 for RCC, meaning that these physiological differences showed no systematic impact on the measurements made with the contact lens.
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Yang Z, Mansouri K, Moghimi S, Weinreb RN. Nocturnal Variability of Intraocular Pressure Monitored With Contact Lens Sensor Is Associated With Visual Field Loss in Glaucoma. J Glaucoma 2021; 30:e56-e60. [PMID: 33137021 PMCID: PMC7987586 DOI: 10.1097/ijg.0000000000001727] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 10/18/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim was to determine whether 24-hour recording of intraocular pressure (IOP)-related ocular dimensional changes with a contact lens sensor (CLS, Triggerfish) is associated with the rate of visual field (VF) progression in primary open-angle glaucoma (POAG) patients. DESIGN This was a retrospective, observational cohort study. PARTICIPANTS Patients with POAG were included from the Glaucoma Clinic and Diagnostic Innovations in Glaucoma Study at the Hamilton Glaucoma Center at University of California, San Diego. METHODS A session of 24-hour CLS recording was acquired for 1 eye from each patient. The mean follow-up time was 9.9±4.0 years. The association between CLS variables and rate of change of mean deviation was determined by univariate and multivariate mixed linear regression models. RESULTS Thirty-two patients, aged 69.8±13.6 years were included, 50% were female. An average of 11.6±5.6 standard automated perimetry examinations was available with a mean rate of mean deviation progression of -0.2±0.4 dB/year. Mean IOP was 17.8±4.2 mm Hg. The mean number of IOP-lowering medications were 1.2±1.0. Each 10-unit larger nocturnal variability of IOP-related ocular dimensional changes measured by CLS recording was significantly associated with -0.25±0.11 dB faster VF loss in POAG patients (P=0.035). CONCLUSIONS Twenty-four-hour CLS recording of IOP-related ocular dimensional change was associated with faster VF progression. Such CLS recordings are useful to assess the risk of in progression in POAG patients.
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Affiliation(s)
- Zhiyong Yang
- Viterbi Family Department of Ophthalmology and the Shiley Eye Institute, Hamilton Glaucoma Center, University of California, San Diego, La Jolla, CA
| | - Kaweh Mansouri
- Glaucoma Research Center, Montchoisi Clinic, Swiss Visio, Lausanne, Switzerland
- Department of Ophthalmology, University of Colorado School of Medicine, Denver, CO
| | - Sasan Moghimi
- Viterbi Family Department of Ophthalmology and the Shiley Eye Institute, Hamilton Glaucoma Center, University of California, San Diego, La Jolla, CA
| | - Robert N Weinreb
- Viterbi Family Department of Ophthalmology and the Shiley Eye Institute, Hamilton Glaucoma Center, University of California, San Diego, La Jolla, CA
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Naroo SA, Morgan PB, Shinde L, Lee C, Ewbank A. Contact lens education for the practitioners of the future. Ophthalmic Physiol Opt 2021; 41:603-609. [PMID: 33609327 DOI: 10.1111/opo.12791] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/11/2020] [Accepted: 11/11/2020] [Indexed: 12/18/2022]
Abstract
The World Health Organization has identified a shortage of trained human resources as one of the greatest challenges to increasing the availability of eye care services and reducing preventable visual impairment around the world. Increased prevalence of myopia and new strategies for myopia management have raised the prospect of various interventions, including contact lenses for therapeutic use as well as for refractive correction. More personnel skilled in contact lens fitting will be needed to address potential worldwide demand for these interventions. This review investigates the current status and future requirements of global contact lens education in light of these developments. The COVD-19 pandemic led educational institutions worldwide to move towards online delivery. An online survey among 546 educators, conducted in May 2020, investigated changes to contact lens education delivery before and after the onset of the pandemic. A total of 214 responses were received from 32 countries. Prior to COVID-19 restrictions, 23% of educators had conducted more than 50% of their total teaching online; however, 69% expected to conduct more than half of their teaching online by the end of 2020 and 12% anticipated 90% or more of their teaching would be online. Some 76% of educators expected to provide more online lectures after the pandemic and 63% anticipated new methods to deliver practical education. Around half were planning to introduce new teaching online platforms (54%) and more online assessment methods (53%). The global need for increasing numbers of skilled personnel points to a crucial role for educators in teaching the contact lens practitioners of the future. Contact lens education delivery was already evolving prior to COVID-19, and changes that are currently occurring may lead to permanent differences in the way contact lenses are taught in future. The International Association of Contact Lens Educators (IACLE) provides educators with a standardised global curriculum, online resources and teaching technology that could also serve as a model for wider ophthalmic education in future.
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Affiliation(s)
- Shehzad A Naroo
- International Association of Contact Lens Educators, Guelph, Ontario, Canada.,School of Optometry, College of Health and Life Science, Aston University, Birmingham, United Kingdom
| | - Philip B Morgan
- International Association of Contact Lens Educators, Guelph, Ontario, Canada.,Division of Pharmacy and Optometry, University of Manchester, Manchester, United Kingdom
| | - Lakshmi Shinde
- International Association of Contact Lens Educators, Guelph, Ontario, Canada.,Optometry Council of India, Bangalore, India
| | - Cheni Lee
- International Association of Contact Lens Educators, Guelph, Ontario, Canada.,Academy of Optometry Leprindo, Jakarta, Indonesia
| | - Alison Ewbank
- International Association of Contact Lens Educators, Guelph, Ontario, Canada
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Lin JB, Sheybani A, Santeford A, Apte RS. Longitudinal Growth Differentiation Factor 15 (GDF15) and Long-term Intraocular Pressure Fluctuation in Glaucoma: A Pilot Study. J Ophthalmic Vis Res 2021; 16:21-27. [PMID: 33520124 PMCID: PMC7841272 DOI: 10.18502/jovr.v16i1.8245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 11/16/2020] [Indexed: 12/01/2022] Open
Abstract
Purpose Growth Differentiation Factor 15 (GDF15) was previously identified as a molecular marker of retinal ganglion cell stress in rodent models of glaucoma and was elevated in the aqueous humor (AH) of patients with primary open-angle glaucoma as a possible risk factor for glaucoma progression. The purpose of this study was to determine whether changes in the AH GDF15 levels were associated with intraocular pressure (IOP) changes in eyes undergoing glaucoma surgery. Methods Here, we performed a prospective, longitudinal pilot study in nine patients to determine whether changes in AH GDF15 levels from surgery to post-surgery follow-up were associated with IOP fluctuation. An initial AH sample was taken from the peripheral corneal paracentesis during planned glaucoma surgery, and a second sample was taken during an outpatient follow-up visit, approximately six months later. Results There was a statistically significant correlation between GDF15 fold change and IOP standard deviation (r = 0.87, P = 0.003), IOP range (r = 0.87, P = 0.003), and maximum IOP (r = 0.86, P = 0.003). There was no correlation between the GDF15 fold change and baseline IOP (r = 0.50, P = 0.17), final IOP (r = 0.038, P = 0.92), or mean IOP (r = 0.40, P = 0.28). Conclusion Our findings in this pilot study suggest that longitudinal changes in AH GDF15 may be associated with IOP fluctuation during the postoperative period. Further studies are necessary to corroborate these findings in a larger patient population and to explore the possibility that AH GDF15 may be used not only to improve treatment algorithms but also as a surrogate endpoint in clinical trials.
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Affiliation(s)
- Jonathan B Lin
- Departments of Ophthalmology and Vision Science, Washington University, USA
| | - Arsham Sheybani
- Departments of Ophthalmology and Vision Science, Washington University, USA
| | - Andrea Santeford
- Departments of Ophthalmology and Vision Science, Washington University, USA
| | - Rajendra S Apte
- Departments of Ophthalmology and Vision Science, Washington University, USA.,Departments of Developmental Biology, Washington University, USA.,Departments of Medicine, Washington University, USA
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Mustfa SA, Maurizi E, McGrath J, Chiappini C. Nanomedicine Approaches to Negotiate Local Biobarriers for Topical Drug Delivery. ADVANCED THERAPEUTICS 2021. [DOI: 10.1002/adtp.202000160] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Salman Ahmad Mustfa
- Centre for Craniofacial and Regenerative Biology King's College London London SE1 9RT UK
| | - Eleonora Maurizi
- Dipartimento di Medicina e Chirurgia Università di Parma Parma 43121 Italy
| | - John McGrath
- St John's Institute of Dermatology King's College London London SE1 9RT UK
| | - Ciro Chiappini
- Centre for Craniofacial and Regenerative Biology King's College London London SE1 9RT UK
- London Centre for Nanotechnology King's College London London WC2R 2LS UK
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Sharifipour F, Malekahmadi M, Azimi M, Cheraghian B. Intraocular pressure and corneal biomechanical changes after water-drinking test in glaucoma patients. J Curr Ophthalmol 2021; 33:394-399. [PMID: 35128184 PMCID: PMC8772500 DOI: 10.4103/joco.joco_19_21] [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: 01/15/2021] [Revised: 09/27/2021] [Accepted: 09/27/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose: To evaluate intraocular pressure (IOP) and corneal biomechanical changes after water-drinking test (WDT) in glaucomatous and normal eyes using Ocular Response Analyzer (ORA). Methods: This prospective study included 30 medically controlled, 30 surgically treated glaucoma patients and 30 normal individuals. Baseline measurements included central corneal thickness (CCT), ORA-derived corneal hysteresis (CH), corneal resistance factor (CRF), corneal-compensated IOP (IOPcc), and Goldmann-correlated IOP (IOPg). Measurements were repeated 15, 30, and 60 min after drinking 1000 mL of water. Changes in ORA parameters were compared among the groups. Results: All groups showed a significant increase in IOPg and IOPcc at all test points. Peak IOP occurred at 15 min and decreased gradually over time but did not reach the baseline values at 60 min. The surgery group had significantly lower baseline IOPg and IOPcc (10.7 ± 3.1 and 12.8 ± 3.7 mmHg, P = 0.001 and 0.01), lower peak IOPg and IOPcc (14.4 ± 4.6 and 16.2 ± 4.6 mmHg, P = 0.003 and 0.034), and lower percent IOPg and IOPcc fluctuations (13 ± 5.6 and 15 ± 5.9, P = 0.0001 and 0.002), respectively, compared to the medical group. Baseline CH and its fluctuations were not significantly different among the groups. CH decreased to a trough corresponding to peak IOPcc. There was a significant negative correlation between IOPcc and CH (r = −0.609, P < 0.001). The medical group showed more CRF fluctuations compared to normal group.(P = 0.039). Conclusion: Surgically treated glaucomatous eyes show less IOP fluctuations and lower peak IOP after WDT compared to medically controlled and normal eyes.
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Dick HB, Gerste RD. Future Intraocular Lens Technologies. Ophthalmology 2020; 128:e206-e213. [PMID: 33373617 DOI: 10.1016/j.ophtha.2020.12.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 12/16/2020] [Accepted: 12/22/2020] [Indexed: 11/18/2022] Open
Abstract
The future of intraocular lens (IOL) technology has already begun with a number of recent innovations. The postoperative change of refractive power will lead to a customized fine-tuning that provides patients with the individual vision they expect and with as much spectacle independence as possible. The latest-generation (2.0) Light-Adjustable Lens (RxSight) was recently introduced into clinical practice, with the first results being very encouraging. Other methods of altering the power of an already implanted IOL are under development. The same can be said about the correction of presbyopia, the so-called last frontier in refractive surgery. Extended depth-of-focus IOLs have been introduced, as has the technology of the pinhole IOL. The latter has therapeutic potential beyond the refractive aspect and has already proven helpful in cases of iris defects and irregular corneas. Several technologies are currently being tested to achieve-finally-an accommodative IOL. One such concept uses the (remaining) strength of the ciliary muscle, whereas another is triggered by the pupil reaction when shifting focus from far to near. Not an IOL itself, but rather a high-tech innovation that so far has mostly been implanted during cataract surgery, is a microelectronic sensor that measures habitual intraocular pressure (IOP) at any given time and promises to revolutionize the management of glaucoma patients. The last generation of this device (Eyemate; Implandata Opthalmics Products GmbH) is implanted during small-incision cataract surgery; the latest development is an even smaller sensor that will be inserted suprachoroidally before, in the near future, such a device will be part of a capsular ring. These IOP sensors are a prime example that IOL technology will continue to be a driving force in ophthalmology, with a positive impact far beyond cataract surgery.
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Raber FP, Gerbutavicius R, Wolf A, Kortüm K. Smartphone-Based Data Collection in Ophthalmology. Klin Monbl Augenheilkd 2020; 237:1420-1428. [PMID: 33285587 DOI: 10.1055/a-1232-4250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Due to their widespread use among the population and their wide range of functions and sensors, smartphones are suitable for data collection for medical purposes. App-supported input masks, patient diaries, and patient information systems, mobile access to the patient file as well as telemedical services will continue to find their way into our field of expertise in the future. In addition, the use of smartphone sensors (GPS and motion sensors, touch display, microphone) and coupling possibilities with biosensors (for example with Continuous Glucose Monitoring [CGM] systems), advanced camera technology, the possibility of regular and appointment independent checking of the visual system (visual acuity/contrast vision) as well as real-time data transfer offer interesting possibilities for patient treatment and clinical research. The present review deals with the current status and future perspectives of smartphone-based data collection and possible applications in ophthalmology.
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Affiliation(s)
| | | | - Armin Wolf
- Augenklinik, Universitätsklinikum Ulm, Deutschland
| | - Karsten Kortüm
- Augenheilkunde, Augenarztpraxis Dres. Kortüm, Ludwigsburg, Deutschland.,Augenklinik, Ludwig-Maximilians-Universität München, Medizinische Fakultät, München, Deutschland
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34
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Shioya S, Higashide T, Tsuchiya S, Simon‐Zoula S, Varidel T, Cerboni S, Mansouri K, Sugiyama K. Using 24-hr ocular dimensional profile recorded with a sensing contact lens to identify primary open-angle glaucoma patients with intraocular pressure constantly below the diagnostic threshold. Acta Ophthalmol 2020; 98:e1017-e1023. [PMID: 32339402 DOI: 10.1111/aos.14453] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 04/03/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the use of a 24-hr ocular dimensional profile recorded with a contact lens sensor (CLS) combined with a single tonometric intraocular pressure (IOP) reading to indicate the potential for exceeding the diagnostic threshold for normal tension glaucoma (NTG) in Japanese patients. METHODS Intraocular pressure (IOP) of untreated Japanese NTG patients was measured with tonometry every 3 hr from 9:00 to 24:00. The subsequent day a 24-hr CLS (SENSIMED Triggerfish, Sensimed AG, Lausanne, Switzerland) profile was recorded on the same eye. Patients initially diagnosed as NTG were reclassified as NTG when the measured IOP values were consistently <20 mmHg or as primary open-angle glaucoma (POAG) when IOP was ≥20 mmHg in at least 1 measurement. For each patient and each IOP time-point, IOP values were combined with information provided by the CLS profile ('classifier') to indicate the potential for exceeding the diagnostic threshold value. Statistical analyses were performed for each classifier. RESULTS A total of 65 patients, 28 males and 37 females (mean ages: 50.8 ± 14.6 years and 52.6 ± 10.2 years, respectively), were analysed. Following IOP diurnal measurement, five patients (7.7%) were reclassified as POAG. Two classifiers (15:00 CLS and 18:00 CLS) showed high sensitivity and negative predictive value (100%), identifying all the POAG patients. CONCLUSION Contact lens sensor information can be used in conjunction with a single tonometric reading to determine patients' potential of having IOP levels exceeding the diagnostic threshold within a 24-hr period, without the need to perform a 24-hr tonometric curve. This would allow clinicians to identify POAG patients who may otherwise be eventually misclassified as NTG.
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Affiliation(s)
- Satomi Shioya
- Department of Ophthalmology and Visual Science Kanazawa University Graduate School of Medical Science Kanazawa Japan
| | - Tomomi Higashide
- Department of Ophthalmology and Visual Science Kanazawa University Graduate School of Medical Science Kanazawa Japan
| | - Shunsuke Tsuchiya
- Department of Ophthalmology and Visual Science Kanazawa University Graduate School of Medical Science Kanazawa Japan
| | | | | | | | - Kaweh Mansouri
- Glaucoma Research Center Montchoisi Clinic Swiss Vision Network Lausanne Switzerland
- Department of Ophthalmology University of Colorado Denver CO USA
| | - Kazuhisa Sugiyama
- Department of Ophthalmology and Visual Science Kanazawa University Graduate School of Medical Science Kanazawa Japan
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Relationship Between Contact Lens Sensor Output Parameters and Visual Field Progression in Open-angle Glaucoma: Assessment of a Practical Tool to Guide Clinical Risk-assessment. J Glaucoma 2020; 29:461-466. [PMID: 32224801 DOI: 10.1097/ijg.0000000000001502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE In recent years, new technologies have emerged to better analyze and interpret intraocular pressure (IOP) fluctuations. Among them is the progression report (PR), an algorithm based on continuous contact lens sensor (CLS) readings to estimate the likelihood of fast visual field (VF) glaucomatous progression. The objective of this study is to validate the PR. METHODS In this retrospective study, 30 open-angle glaucoma patients were enrolled. Twenty-four hours IOP-related variations were recorded using a CLS. Recordings were used to generate PR. The likelihood of fast VF progression (<-1 dB/y mean deviation) was estimated by 2 masked assessors based on clinical parameters. At least 3 VF were performed over the 2 years following the initial assessment, to determine actual progression. RESULTS Mean age was 65.9±10.45 years, with a mean baseline mean deviation of -5.4±5.1. After a mean follow-up of 29.5±12.9 months, 26.7% of eyes were assessed as fast progressors (-2.9±1.9 dBs/y). The average risk-score attributed by the PR was 42% [41% (slow) vs. 44% (fast); P=0.035]. Correlations between the 2 assessors were good (r=0.59), and identical to that between PR and the averaged assessors' gradings. Correlations between mean deviation progression rates and PR, Assessor 1 and Assessor 2's gradings were, r=0.57, 0.31, and 0.43, respectively. CONCLUSIONS PR provided comparable predictions of the risk of fast VF progression as did physician estimates based on all available clinical data. With their relationship to the eye's biomechanical properties and the ocular tissues' response to pressure variations, CLS recordings may offer new information that complements conventional examinations.
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Abstract
Currently, the level of intraocular pressure (IOP) can be assessed with a large number of tonometers, which differ in the principle of action, the place of application and the degree of invasiveness. All the methods in use - except for direct manometry - allow only indirect judgement of the level of ophthalmotonus. The quality of tonometric measurement is influenced by many factors, from the choice of tonometer to the analysis of the results obtained by the doctor. The use of complex methods for assessing the level of intraocular pressure provides additional information that increases its diagnostic value. This article summarizes current information about modern methods of tonometry, and describes their features.
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Affiliation(s)
- A A Antonov
- Research Institute of Eye Diseases, Moscow, Russia
| | - E V Karlova
- Samara Regional Clinical Ophthalmological Hospital named after T.I. Eroshevsky, Samara, Russia
| | | | - D A Dorofeev
- Chelyabinsk Regional Clinical Hospital No 3, Chelyabinsk, Russia
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Khaldi A, Daniel E, Massin L, Kärnfelt C, Ferranti F, Lahuec C, Seguin F, Nourrit V, de Bougrenet de la Tocnaye JL. A laser emitting contact lens for eye tracking. Sci Rep 2020; 10:14804. [PMID: 32908167 PMCID: PMC7481179 DOI: 10.1038/s41598-020-71233-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 07/31/2020] [Indexed: 12/23/2022] Open
Abstract
In this paper, we present the first realisation and experimentation of a new eye tracking system using an infrared (iR) laser pointer embedded into a wireless smart contact lens. We denote this contact lens prototype as the cyclops lens, in reference to the famous hero of the X-Men comics. The full eye tracker device combines the smart contact lens and its eyewear, which provides a primary source of energy and the beam detection system. We detail the assembling and encapsulation process of the main functionalities into the contact lens and present how a gaze tracking system is achieved, compared to existing conventional eye-tracking ones. Finally, we discuss future technical improvements.
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Affiliation(s)
- A Khaldi
- Optics Department, IMT Atlantique, CS 83818, 29238, Brest CEDEX 3, France.
| | - E Daniel
- Optics Department, IMT Atlantique, CS 83818, 29238, Brest CEDEX 3, France
| | - L Massin
- Optics Department, IMT Atlantique, CS 83818, 29238, Brest CEDEX 3, France
- Electronic Department, IMT Atlantique, CS 83818, 29238, Brest CEDEX 3, France
- Lab-Sticc, UMR6285, IMT Atlantique, CS 83818, 29238, Brest CEDEX 3, France
| | - C Kärnfelt
- Microwave Department, IMT Atlantique, CS 83818, 29238, Brest CEDEX 3, France
- Lab-Sticc, UMR6285, IMT Atlantique, CS 83818, 29238, Brest CEDEX 3, France
| | - F Ferranti
- Microwave Department, IMT Atlantique, CS 83818, 29238, Brest CEDEX 3, France
- Lab-Sticc, UMR6285, IMT Atlantique, CS 83818, 29238, Brest CEDEX 3, France
| | - C Lahuec
- Electronic Department, IMT Atlantique, CS 83818, 29238, Brest CEDEX 3, France
- Lab-Sticc, UMR6285, IMT Atlantique, CS 83818, 29238, Brest CEDEX 3, France
| | - F Seguin
- Electronic Department, IMT Atlantique, CS 83818, 29238, Brest CEDEX 3, France
- Lab-Sticc, UMR6285, IMT Atlantique, CS 83818, 29238, Brest CEDEX 3, France
| | - V Nourrit
- Optics Department, IMT Atlantique, CS 83818, 29238, Brest CEDEX 3, France
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Kwon S, Kim SH, Khang D, Lee JY. Potential Therapeutic Usage of Nanomedicine for Glaucoma Treatment. Int J Nanomedicine 2020; 15:5745-5765. [PMID: 32821099 PMCID: PMC7418176 DOI: 10.2147/ijn.s254792] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 06/05/2020] [Indexed: 12/20/2022] Open
Abstract
Glaucoma is a group of diseases characterized by progressive degeneration of retinal ganglion cells, leading to irreversible blindness. Currently, intraocular pressure reduction is the only established treatment available for glaucoma. With this treatment, the progression of the disease can only be delayed and there is no recovery. In addition, the commercially available eye drops have the disadvantage of low compliance and short therapeutic time, while glaucoma surgery always has the risk of failure due to wound fibrosis. Nanotechnology can overcome the limitations of the current treatment through the encapsulation and conjugation of drugs used for lowering intraocular pressure and antifibrotic agents using biodegradable or biocompatible nanoparticles for the sustained release of the drugs to protect the damaged ocular cells. Furthermore, using nanotechnology, treatment can be administered in various forms, including eye drops, contact lens, and ocular inserts, according to the convenience of the patients. Despite the promising results of delaying the progression of glaucoma, the regeneration of damaged ocular cells, including trabecular meshwork and retinal ganglion cells, is another critical hurdle to overcome. Bone marrow-derived mesenchymal stem cells and Müller glia cells can secrete neurogenic factors that trigger the regeneration of associated cells, including trabecular meshwork and retinal ganglion cells. In conclusion, this review highlights the potential therapeutic applications of nanotechnology- and stem cell-based methods that can be employed for the protection and regeneration of ocular cells.
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Affiliation(s)
- Song Kwon
- Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon 21999, South Korea
| | - Sung Hyun Kim
- Department of Ophthalmology, Gil Medical Center, Gachon University, College of Medicine, Incheon 21565, South Korea
| | - Dongwoo Khang
- Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon 21999, South Korea.,Department of Gachon Advanced Institute for Health Science & Technology (GAIHST), Gachon University, Incheon 21999, South Korea.,Department of Physiology, School of Medicine, Gachon University, Incheon 21999, South Korea
| | - Jong Yeon Lee
- Department of Ophthalmology, Gil Medical Center, Gachon University, College of Medicine, Incheon 21565, South Korea
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Ku M, Kim J, Won JE, Kang W, Park YG, Park J, Lee JH, Cheon J, Lee HH, Park JU. Smart, soft contact lens for wireless immunosensing of cortisol. SCIENCE ADVANCES 2020; 6:eabb2891. [PMID: 32923592 PMCID: PMC7455488 DOI: 10.1126/sciadv.abb2891] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 05/26/2020] [Indexed: 05/04/2023]
Abstract
Despite various approaches to immunoassay and chromatography for monitoring cortisol concentrations, conventional methods require bulky external equipment, which limits their use as mobile health care systems. Here, we describe a human pilot trial of a soft, smart contact lens for real-time detection of the cortisol concentration in tears using a smartphone. A cortisol sensor formed using a graphene field-effect transistor can measure cortisol concentration with a detection limit of 10 pg/ml, which is low enough to detect the cortisol concentration in human tears. In addition, this soft contact lens only requires the integration of this cortisol sensor with transparent antennas and wireless communication circuits to make a smartphone the only device needed to operate the lens remotely without obstructing the wearer's view. Furthermore, in vivo tests using live rabbits and the human pilot experiment confirmed the good biocompatibility and reliability of this lens as a noninvasive, mobile health care solution.
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Affiliation(s)
- Minjae Ku
- Nano Science Technology Institute, Department of Materials Science and Engineering, Yonsei University, Seoul 03722, Republic of Korea
- Center for Nanomedicine, Institute for Basic Science (IBS), Seoul 03722, Republic of Korea
| | - Joohee Kim
- Nano Science Technology Institute, Department of Materials Science and Engineering, Yonsei University, Seoul 03722, Republic of Korea
- Center for Nanomedicine, Institute for Basic Science (IBS), Seoul 03722, Republic of Korea
| | - Jong-Eun Won
- Center for Nanomedicine, Institute for Basic Science (IBS), Seoul 03722, Republic of Korea
| | - Wonkyu Kang
- Department of Chemical Engineering, Myongji University, Yongin 17058, Republic of Korea
| | - Young-Geun Park
- Nano Science Technology Institute, Department of Materials Science and Engineering, Yonsei University, Seoul 03722, Republic of Korea
- Center for Nanomedicine, Institute for Basic Science (IBS), Seoul 03722, Republic of Korea
- School of Materials Science and Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan 44919, Republic of Korea
| | - Jihun Park
- Nano Science Technology Institute, Department of Materials Science and Engineering, Yonsei University, Seoul 03722, Republic of Korea
- Center for Nanomedicine, Institute for Basic Science (IBS), Seoul 03722, Republic of Korea
- School of Materials Science and Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan 44919, Republic of Korea
| | - Jae-Hyun Lee
- Center for Nanomedicine, Institute for Basic Science (IBS), Seoul 03722, Republic of Korea
- Advanced Science Institute, Yonsei University, Seoul 03722, Republic of Korea
| | - Jinwoo Cheon
- Center for Nanomedicine, Institute for Basic Science (IBS), Seoul 03722, Republic of Korea
- Advanced Science Institute, Yonsei University, Seoul 03722, Republic of Korea
- Department of Chemistry, Yonsei University, Seoul 03722, Republic of Korea
| | - Hyun Ho Lee
- Department of Chemical Engineering, Myongji University, Yongin 17058, Republic of Korea
| | - Jang-Ung Park
- Nano Science Technology Institute, Department of Materials Science and Engineering, Yonsei University, Seoul 03722, Republic of Korea
- Center for Nanomedicine, Institute for Basic Science (IBS), Seoul 03722, Republic of Korea
- Advanced Science Institute, Yonsei University, Seoul 03722, Republic of Korea
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Maeng B, Chang HK, Park J. Photonic crystal-based smart contact lens for continuous intraocular pressure monitoring. LAB ON A CHIP 2020; 20:1740-1750. [PMID: 32347844 DOI: 10.1039/c9lc01268k] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Glaucoma is a very common disease after cataracts and is dangerous enough to cause irreversible blindness. However, often the main symptom of glaucoma is difficult to recognize because it may be absent or appear late, so the risk of blindness is greater. Intraocular pressure (IOP) is a well-known primary factor indicating glaucoma. In this study, we demonstrate a smart IOP sensor embedded in a contact lens that works through visual color changes without an external power source such as a battery or RF-based wireless power transfer. A microhydraulic amplification mechanism is adopted to enhance the range of color change from a photonic crystal (PC)-based flexible membrane whose lattice distance between nanostructures varies according to the morphology changes of an eyeball caused by IOP. The performance of the sensor is quantitatively demonstrated using an artificial silicone eye model for in vitro evaluation and a porcine eyeball for ex vivo verification. It has a limit of detection (LOD) of 3.2 and 5.12 mmHg, which was measured and evaluated using a spectrometer and a smartphone camera, respectively. The results prove that our sensor embedded in the contact lens can continuously monitor the IOP change using color change, and a smartphone camera can be used as a quantitative IOP measurement system in a noninvasive manner without an expensive optical spectrometer.
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Affiliation(s)
- Bohee Maeng
- Department of Mechanical Engineering, Sogang University, 35 Baekbeom-ro, Mapo-gu, Seoul 04107, Republic of Korea.
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Enders P, Cursiefen C. Device profile of the EYEMATE-IO™ system for intraocular pressure monitoring: overview of its safety and efficacy. Expert Rev Med Devices 2020; 17:491-497. [DOI: 10.1080/17434440.2020.1761788] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Philip Enders
- Department of Ophthalmology, University Hospital of Cologne , Cologne, Germany
| | - Claus Cursiefen
- Department of Ophthalmology, University Hospital of Cologne , Cologne, Germany
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Campigotto A, Lai Y. A novel non‐invasive wearable sensor for intraocular pressure measurement. ACTA ACUST UNITED AC 2020. [DOI: 10.1002/mds3.10086] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Angelica Campigotto
- Department of Mechanical Engineering Queen’s University Kingston Ontario Canada
| | - Yongjun Lai
- Department of Mechanical Engineering Queen’s University Kingston Ontario Canada
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Lazkani N, Butler J, Rickard MJA, Truitt S, Kawaguchi NK, DeWolf AJ, Van Zant CA, Villegas JP, Hassel AR, Park JJ, Jones CF. Development of a Nanofabricated Sensor for Monitoring Intraocular Pressure via Ocular Tissue Strain. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:4363-4367. [PMID: 31946834 DOI: 10.1109/embc.2019.8857430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
As the number of individuals developing glaucoma is increasing, researchers and ophthalmologists are exploring new approaches to monitor intraocular pressure, which is a critical measurement for glaucoma detection. Current monitoring methods, such as implantable pressure sensors and wearable contact lenses with sensors, are being explored in eye research clinics. However, these systems currently lack in providing 24 hours data through a practical platform for large-scale use. This paper presents a novel method that provides constant measurements of the scleral strain, which is correlated with the change of intraocular pressure, using a nanofabricated discrete resistor array implant sensor. A preliminary bench-top test was performed using the sensor, and it showed that the nanofabricated 1.6 mm by 2.7 mm resistor array exhibits discrete sensing levels at increments of 41 ohms as a fixture needle traversed approximately half of the array. Though the nanosensor is in the prototype developing stage, it promises a new modality for constant, remote, and around the clock glaucoma monitoring.
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Yetisen AK, Jiang N, Castaneda Gonzalez CM, Erenoglu ZI, Dong J, Dong X, Stößer S, Brischwein M, Butt H, Cordeiro MF, Jakobi M, Hayden O, Koch AW. Scleral Lens Sensor for Ocular Electrolyte Analysis. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2020; 32:e1906762. [PMID: 31834667 DOI: 10.1002/adma.201906762] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/13/2019] [Indexed: 06/10/2023]
Abstract
The quantitative analysis of tear analytes in point-of-care settings can enable early diagnosis of ocular diseases. Here, a fluorescent scleral lens sensor is developed to quantitatively measure physiological levels of pH, Na+ , K+ , Ca2+ , Mg2+ , and Zn2+ ions. Benzenedicarboxylic acid, a pH probe, displays a sensitivity of 0.12 pH units within pH 7.0-8.0. Crown ether derivatives exhibit selectivity to Na+ and K+ ions within detection ranges of 0-100 and 0-50 mmol L-1 , and selectivities of 15.6 and 8.1 mmol L-1 , respectively. A 1,2 bis(o-aminophenoxy)ethane-N,N,-N',N'-tetraacetic-acid-based probe allows Ca2+ ion sensing with 0.02-0.05 mmol L-1 sensitivity within 0.50-1.25 mmol L-1 detection range. 5-Oxazolecarboxylic acid senses Mg2+ ions, exhibiting a sensitivity of 0.10-0.44 mmol L-1 within the range of 0.5-0.8 mmol L-1 . The N-(2-methoxyphenyl)iminodiacetate Zn2+ ion sensor has a sensitivity of 1 µmol L-1 within the range of 10-20 µmol L-1 . The fluorescent sensors are subsequently multiplexed in the concavities of an engraved scleral lens. A handheld ophthalmic readout device comprising light-emitting diodes (LEDs) and bandpass filters is fabricated to excite as well as read the scleral sensor. A smartphone camera application and an user interface are developed to deliver quantitative measurements with data deconvolution. The ophthalmic system enables the assessment of dry eye severity stages and the differentiation of its subtypes.
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Affiliation(s)
- Ali K Yetisen
- Institute for Measurement Systems and Sensor Technology, Technical University of Munich, Munich, D-80290, Germany
| | - Nan Jiang
- School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, 02138, USA
| | - Carmen M Castaneda Gonzalez
- Institute for Measurement Systems and Sensor Technology, Technical University of Munich, Munich, D-80290, Germany
| | - Zeynep Izlen Erenoglu
- Institute for Measurement Systems and Sensor Technology, Technical University of Munich, Munich, D-80290, Germany
| | - Jie Dong
- Institute for Measurement Systems and Sensor Technology, Technical University of Munich, Munich, D-80290, Germany
| | - Xingchen Dong
- Institute for Measurement Systems and Sensor Technology, Technical University of Munich, Munich, D-80290, Germany
| | - Simon Stößer
- Institute for Measurement Systems and Sensor Technology, Technical University of Munich, Munich, D-80290, Germany
| | - Martin Brischwein
- Department of Electrical and Computer Engineering, TranslaTUM Campus, Technical University of Munich, Munich, D-80290, Germany
| | - Haider Butt
- Department of Mechanical Engineering, Khalifa University, 127788, Abu Dhabi, United Arab Emirates
| | - Maria F Cordeiro
- The Western Eye Hospital, Imperial College Healthcare NHS Trust, London, NW1 5QH, UK
- The Imperial College Ophthalmic Research Group (ICORG), Imperial College, London, NW1 5QH, UK
- Glaucoma and Retinal Neurodegeneration Group, Department of Visual Neuroscience, UCL Institute of Ophthalmology, London, EC1V 9EL, UK
| | - Martin Jakobi
- Institute for Measurement Systems and Sensor Technology, Technical University of Munich, Munich, D-80290, Germany
| | - Oliver Hayden
- Department of Electrical and Computer Engineering, TranslaTUM Campus, Technical University of Munich, Munich, D-80290, Germany
| | - Alexander W Koch
- Institute for Measurement Systems and Sensor Technology, Technical University of Munich, Munich, D-80290, Germany
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Choritz L, Mansouri K, van den Bosch J, Weigel M, Dick HB, Wagner M, Thieme H, Thieme H, Rüfer F, Szurmann P, Wehner W, Spitzer M, Hesse L, Jünemann A, Plange N, Schmickler S, Dick B, Hakan K. Telemetric Measurement of Intraocular Pressure via an Implantable Pressure Sensor-12-Month Results from the ARGOS-02 Trial. Am J Ophthalmol 2020; 209:187-196. [PMID: 31545953 DOI: 10.1016/j.ajo.2019.09.011] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 09/11/2019] [Accepted: 09/12/2019] [Indexed: 11/27/2022]
Abstract
PURPOSE The aim of this study was to investigate the safety and performance of the second generation of an implantable intraocular pressure (IOP) sensor in patients with primary open angle glaucoma (POAG). DESIGN prospective, noncomparative, open-label, multicenter clinical investigation. METHODS In this study, patients with POAG, regularly scheduled for cataract surgery, were implanted with a ring-shaped, sulcus-placed, foldable IOP sensor in a single procedure after intraocular lens implantation. Surgical complications as well as adverse events (AEs) during 12 months of follow-up were recorded. At each follow-up visit, a complete ophthalmic examination, including visual acuity, IOP, slit lamp examination, and dilated funduscopy as well as comparative measurements between Goldmann applanation tonometry and the EYEMATE-IO implant were performed. RESULTS The EYEMATE-IO implant was successfully implanted in 22 patients with few surgical complications and no unexpected device-related AEs. All ocular AEs resolved quickly under appropriate treatment. Comparative measurements showed good agreement between EYEMATE-IO and Goldmann applanation tonometry (GAT) with an intraclass correlation coefficient (ICC(3,k)) of 0.783 (95% confidence interval [CI]: 0.743, 0.817). EYEMATE-IO measurements were higher than GAT, with a mean difference of 3.2 mm Hg (95% CI: 2.8, 3.5 mm Hg). CONCLUSIONS The EYEMATE-IO sensor was safely implanted in 22 patients and performed reliably until the end of follow-up. This device allows for continual and long-term measurements of IOP.
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Riaz R, Elsherif M, Moreddu R, Rashid I, Hassan MU, Yetisen AK, Butt H. Anthocyanin-Functionalized Contact Lens Sensors for Ocular pH Monitoring. ACS OMEGA 2019; 4:21792-21798. [PMID: 31891056 PMCID: PMC6933553 DOI: 10.1021/acsomega.9b02638] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 11/18/2019] [Indexed: 05/03/2023]
Abstract
Anthocyanins are bioactive compounds naturally found in a variety of leaves, fruits, and vegetables. Anthocyanin pigments undergo a modification in their chemical structure when exposed to different concentrations of hydrogen ions, and they were extensively studied to be used as active elements in biocompatible pH sensors. The ocular pH is a significant parameter to assess the ocular physiology in cases of postocular surgery, keratoconjunctivitis, and ocular rosacea. Contact lenses have the potential to be used as medical diagnostic devices for in situ continuous monitoring of the ocular physiology. Here, anthocyanin-functionalized contact lenses were developed as wearable sensors to monitor the ocular pH. Anthocyanin pigments were extracted from Brassica oleracea and used to functionalize the polymeric matrices of commercial soft contact lenses by soaking and drop-casting processes. Contact lenses responded to the physiological ocular pH of 6.5, 7.0, and 7.5, exhibiting a systematic color shift from pink (pH 6.5) to purple (pH 7.0) and blue (pH 7.5). The functionalization of contact lens sensors was evaluated as a function of the dye concentration. Quantitative values were obtained by comparing the RGB triplets of the colors obtained with the naturally extracted dye and with delphinidin chloride dye in 0.0 to 1.5 mmol L-1 aqueous solution. The functionalization of contact lenses was studied as a function of the soaking time, resulting in best results when soaking for 24 h. The dye leakage from the contact lenses in deionized water was evaluated, and a negligible leakage after 18 h was observed. Poly-2-hydroxy ethylmethacrylate contact lenses were fabricated and cross-linked with anthocyanin dye, resulting in a slight color shift upon pH changes from 6.5 to 7.4. Contact lens pH sensors may be used to continuously monitor the ocular pH at point-of-care settings.
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Affiliation(s)
- Rafia
Sarah Riaz
- School
of Engineering and School of Chemical Engineering, University
of Birmingham, Edgbaston, Birmingham B15 2TT, U.K.
| | - Mohamed Elsherif
- School
of Engineering and School of Chemical Engineering, University
of Birmingham, Edgbaston, Birmingham B15 2TT, U.K.
- Department of Experimental Physics, Nuclear Research Center, Egyptian Atomic Energy Authority, Cairo 11865, Egypt
| | - Rosalia Moreddu
- School
of Engineering and School of Chemical Engineering, University
of Birmingham, Edgbaston, Birmingham B15 2TT, U.K.
- Department of Chemical Engineering, Imperial College London, South Kensington Campus, London SW7 2AZ, U.K.
| | - Ijaz Rashid
- School
of Engineering and School of Chemical Engineering, University
of Birmingham, Edgbaston, Birmingham B15 2TT, U.K.
| | - Muhammad Umair Hassan
- School
of Engineering and School of Chemical Engineering, University
of Birmingham, Edgbaston, Birmingham B15 2TT, U.K.
| | - Ali K. Yetisen
- Department of Chemical Engineering, Imperial College London, South Kensington Campus, London SW7 2AZ, U.K.
| | - Haider Butt
- Department of Mechanical
Engineering, Khalifa University, Abu Dhabi 127788, UAE
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Role of 24-Hour Intraocular Pressure Monitoring in Glaucoma Management. J Ophthalmol 2019; 2019:3632197. [PMID: 31641532 PMCID: PMC6770303 DOI: 10.1155/2019/3632197] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/11/2019] [Accepted: 08/01/2019] [Indexed: 12/29/2022] Open
Abstract
Glaucoma is the leading cause of irreversible blindness worldwide and the prevalence is on the rising trend. Intraocular pressure (IOP) reduction is the mainstay of treatment. The current practice of IOP monitoring is based on spot measurements during clinic visits during office hours. However, there are up to 50% of glaucoma patients who had normal initial IOP, while some treated patients continued to have progressive glaucomatous optic nerve damage even with a low IOP. Recent studies have shown that the IOP of glaucoma patients fluctuated during the day with different patterns, and some of them had peak IOP outside office hours. These findings provided us with new insights on the role of 24-hour IOP monitoring in managing normal tension glaucoma and patients with progressive deterioration despite apparently well-controlled IOP. Nevertheless, results to date are rather inconsistent, and there is no consensus yet. In this review, we briefly highlighted the current modalities of 24-hour IOP monitoring and summarized the characteristic 24-hour IOP pattern and the clinical relevance of IOP parameters in predicting glaucomatous progression in different glaucoma subtypes. We also discussed the therapeutic efficacy of current glaucoma treatment modalities with respect to the mentioned 24-hour IOP profiles, so as to strengthen the role of 24-hour IOP monitoring in identifying and stratifying the risks of progression in glaucoma patients, as well as optimizing treatments according to their IOP profiles.
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Gillmann K, Bravetti GE, Niegowski LJ, Mansouri K. Using sensors to estimate intraocular pressure: a review of intraocular pressure telemetry in clinical practice. EXPERT REVIEW OF OPHTHALMOLOGY 2019. [DOI: 10.1080/17469899.2019.1681264] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Kevin Gillmann
- Glaucoma Research Center, Montchoisi Clinic, Swiss Visio, Lausanne, Switzerland
| | | | | | - Kaweh Mansouri
- Glaucoma Research Center, Montchoisi Clinic, Swiss Visio, Lausanne, Switzerland
- Department of Ophthalmology, University of Colorado School of Medicine, Denver, CO, USA
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Bezrouk A, Hosszú T, Falzon O, Voda P, Vachek M, Záhora J, Mašín V, Camilleri KP, Kremláček J. Digital orbitoplethysmograph: A new device to study the regional cerebral circulation using extraorbital plethysmography. J Neurosci Methods 2019; 329:108459. [PMID: 31614161 DOI: 10.1016/j.jneumeth.2019.108459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 10/07/2019] [Accepted: 10/07/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Noninvasive diagnostic methods utilizing pulse wave measurements on the surface of the head are an important tool in diagnosing various types of cerebrovascular disease. The measurement of extraorbital pressure fluctuations reflects intraocular and intracranial pressure changes and can be used to estimate pressure changes in intracranial arteries and the collateral circulation. NEW METHOD In this paper, we describe our patented (CZ 305757) digital device for noninvasive measuring and monitoring of orbital movements using pressure detection. We conducted preclinical tests (126 measurements on 42 volunteers) to evaluate the practical capabilities of our device. Two human experts visually assessed the quality of the pressure pulsation and discriminability among various test conditions (specifically, subject lying, sitting, and the Matas carotid occlusion test). RESULTS The results showed that our device provided clinically relevant outcomes with a sufficient level of detail of the pulse wave and a high reliability (not less than 85%) in all clinically relevant situations. It was possible to record the effect of the Matas carotid occlusion test. COMPARISON WITH EXISTING METHOD(S) Our fully noninvasive, lightweight (185 g), portable, and wireless device provides a considerably cheaper alternative to the current diagnostic methods (e.g., transcranial ultrasound, X-ray, or MRI angiography) for specific assessment of cerebral circulation. Within a minute, it can detect the Willis circle integrity and thus eliminate the potential risks associated with the Matas test using standard EEG. CONCLUSIONS Our device represents an improvement and a valid alternative to the current methods diagnosing regional cerebral circulation.
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Affiliation(s)
- Aleš Bezrouk
- Department of Medical Biophysics, Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic.
| | - Tomáš Hosszú
- Department of Neurosurgery, University hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Owen Falzon
- Centre for Biomedical Cybernetics, University of Malta, Msida, Malta
| | - Petr Voda
- Department of Medical Biophysics, Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Mikuláš Vachek
- Department of Neurosurgery, University hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Jiří Záhora
- Department of Medical Biophysics, Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Vladimír Mašín
- Department of Medical Biophysics, Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Kenneth P Camilleri
- Department of Systems & Control Engineering, Faculty of Engineering, University of Malta, Msida, Malta
| | - Jan Kremláček
- Department of Pathological Physiology, Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
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