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Liu MX, Zhou M, Li DL, Dong XX, Liang G, Pan CW. Corneal Biomechanics in Primary Open Angle Glaucoma and Ocular Hypertension: A Systematic Review and Meta-analysis. J Glaucoma 2023; 32:e24-e32. [PMID: 36583701 DOI: 10.1097/ijg.0000000000002170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 12/07/2022] [Indexed: 12/31/2022]
Abstract
PRCIS Normal tension glaucoma patients had softer corneas than normal controls, whereas high-tension glaucoma and ocular hypertension patients had stiffer corneas. PURPOSE To comprehensively identify the corneal biomechanical differences of patients with primary open angle glaucoma (POAG) and ocular hypertension (OHT) using the Ocular Response Analyzer or the Corvis ST. METHODS The electronic databases PubMed, Embase, and Web of Science were comprehensively searched for studies comparing corneal biomechanical differences between POAG and OHT patients with normal controls by Ocular Response Analyzer or Corvis ST. The weighted mean differences and 95% confidence intervals (CIs) were calculated. Subgroup analyses were performed according to the subtypes of POAG, including high-tension glaucoma (HTG) and normal tension glaucoma (NTG). RESULTS Thirty-one case-control studies were ultimately included, with 2462 POAG patients, 345 OHT patients, and 3281 normal controls. The corneal hysteresis (CH), corneal resistance factor (CRF), and highest concavity time (HC-t) were all lower in POAG patients than in normal controls. The CH, time at the second applanation (A2t), HC-t, highest concavity radius (HC-R), and deformation amplitude at the highest concavity (HC-DA) were lower in OHT patients, while the CRF, time at the first applanation (A1t), and stiffness parameter at the first applanation (SP-A1) were greater in OHT patients than in normal controls. The subgroup analyses showed that the CH, A2t, length at the second applanation (A2L), and HC-DA were lower in HTG, and the CH, CRF, A1t, and HC-t were lower in NTG patients than in normal controls. CONCLUSION The corneas of NTG patients are more deformable than normal controls, whereas the corneas of HTG and OHT patients are stiffer.
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Affiliation(s)
- Min-Xin Liu
- School of Public Health, Medical College of Soochow University, Suzhou
| | - Miao Zhou
- Department of Ophthalmology, Peking University People's Hospital, Beijing
| | - Dan-Lin Li
- School of Public Health, Medical College of Soochow University, Suzhou
| | - Xing-Xuan Dong
- School of Public Health, Medical College of Soochow University, Suzhou
| | - Gang Liang
- Department of Ophthalmology, The Affiliated Hospital of Yunnan University, Kunming
- Department of Ophthalmology, The Second People's Hospital of Yunnan Province, Kunming, China
| | - Chen-Wei Pan
- School of Public Health, Medical College of Soochow University, Suzhou
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Wasielica-Poslednik J, Schuster AK, Politino G, Marx-Gross S, Bell K, Pfeiffer N, Pitz S. Corneal topometric, aberrometric and biomechanical parameters in mucopolysaccharidosis patients. PLoS One 2019; 14:e0218108. [PMID: 31246979 PMCID: PMC6597047 DOI: 10.1371/journal.pone.0218108] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 05/27/2019] [Indexed: 11/19/2022] Open
Abstract
AIMS To report corneal topometric and aberrometric values in mucopolysaccharidosis (MPS) and to investigate their correlation with biomechanical corneal parameters. METHODS One randomly chosen eye of 20 MPS patients with no to moderate corneal clouding and one eye of 23 healthy controls with comparable age were prospectively included into this study. Corneal surface regularity was assessed by index of surface variance (ISV), -vertical asymmetry (IVA), -height asymmetry (IHA), -height decentration (IHD); keratoconus index (KI), central keratoconus index (CKI) and Zernike indices of anterior and posterior corneal surface using Scheimpflug imaging (Pentacam). Corneal resistance factor (CRF) and corneal hysteresis (CH) were assessed by Ocular Response Analyzer. Statistical analyses were performed using Mann-Whitney-Test and Spearman Correlation Coefficients. RESULTS IVA, ISV, IHD, IHA, but not KI and CKI were significantly higher in MPS patients compared to age matched healthy controls. Spherical aberration and asphericity coefficients either at the anterior or at the posterior corneal surface differed significantly between both groups. The grade of the MPS-associated corneal opacity correlated significantly with ISV (rho = 0.52), IVA (rho = 0.54), IHA (rho = 0.57) and IHD (rho = 0.48). Density of the MPS-affected corneas correlated significantly with ISV (rho = 0.52), IVA (rho = 0.72), IHA (rho = 0.57), IHD (rho = 0.69), 3rd order horizontal trefoil aberration at the posterior (rho = 0.62) and anterior surface (rho = 0.48) as well as with CH (rho = 0.55) and CRF (rho = 0.57). Spherical aberration at the back surface correlated with CRF and CH in MPS and in healthy controls. CONCLUSIONS This is the first study analyzing shape of the corneal surface in MPS patients. Topometric indices of corneal asymmetry are significantly increased and correlate with MPS-related corneal opacity and density. Spherical aberration and asphericity coefficient at the front and at the back corneal surface differ significantly between MPS and healthy controls.
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Affiliation(s)
- Joanna Wasielica-Poslednik
- Department of Ophthalmology, University Medical Center Mainz, Johannes Gutenberg- University Mainz, Mainz, Germany
- * E-mail:
| | - Alexander K. Schuster
- Department of Ophthalmology, University Medical Center Mainz, Johannes Gutenberg- University Mainz, Mainz, Germany
| | - Giuseppe Politino
- Department of Ophthalmology, University Medical Center Mainz, Johannes Gutenberg- University Mainz, Mainz, Germany
| | - Susanne Marx-Gross
- Department of Ophthalmology, University Medical Center Mainz, Johannes Gutenberg- University Mainz, Mainz, Germany
| | - Katharina Bell
- Department of Ophthalmology, University Medical Center Mainz, Johannes Gutenberg- University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center Mainz, Johannes Gutenberg- University Mainz, Mainz, Germany
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Jędzierowska M, Koprowski R. Novel dynamic corneal response parameters in a practice use: a critical review. Biomed Eng Online 2019; 18:17. [PMID: 30760270 PMCID: PMC6375180 DOI: 10.1186/s12938-019-0636-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 02/08/2019] [Indexed: 12/27/2022] Open
Abstract
Background Non-contact tonometers based on the method using air puff and Scheimpflug’s fast camera are one of the latest devices allowing the measurement of intraocular pressure and additional biomechanical parameters of the cornea. Biomechanical features significantly affect changes in intraocular pressure values, as well as their changes, may indicate the possibility of corneal ectasia. This work presents the latest and already known biomechanical parameters available in the new offered software. The authors focused on their practical application and the diagnostic credibility indicated in the literature. Discussion An overview of available literature indicates the importance of new dynamic corneal parameters. The latest parameters developed on the basis of biomechanics analysis of corneal deformation process, available in non-contact tonometers using Scheimpflug’s fast camera, are used in the evaluation of laser refractive surgery procedures, e.g. LASIK procedure. In addition, the assessment of changes in biomechanically corrected intraocular pressure confirms its independence from changes in the corneal biomechanics which may allow an intraocular pressure real assessment. The newly developed Corvis Biomechanical Index combined with the corneal tomography and topography assessment is an important aid in the classification of patients with keratoconus. Conclusion New parameters characterising corneal deformation, including Corvis Biomechanical Index and biomechanical compensated intraocular pressure, significantly extend the diagnostic capabilities of this device and may be helpful in assessing corneal diseases of the eye. Nevertheless, further research is needed to confirm their diagnostic pertinence.
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Affiliation(s)
- Magdalena Jędzierowska
- Department of Biomedical Computer Systems, Faculty of Computer Science and Materials Science, Institute of Computer Science, University of Silesia, ul. Będzińska 39, 41-200, Sosnowiec, Poland.
| | - Robert Koprowski
- Department of Biomedical Computer Systems, Faculty of Computer Science and Materials Science, Institute of Computer Science, University of Silesia, ul. Będzińska 39, 41-200, Sosnowiec, Poland
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Corneal hysteresis in post-radial keratotomy primary open-angle glaucoma. Graefes Arch Clin Exp Ophthalmol 2018; 256:1971-1976. [DOI: 10.1007/s00417-018-4073-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 06/24/2018] [Accepted: 07/16/2018] [Indexed: 11/27/2022] Open
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Wasielica-Poslednik J, Politino G, Schmidtmann I, Lorenz K, Bell K, Pfeiffer N, Pitz S. Influence of Corneal Opacity on Intraocular Pressure Assessment in Patients with Lysosomal Storage Diseases. PLoS One 2017; 12:e0168698. [PMID: 28081172 PMCID: PMC5230782 DOI: 10.1371/journal.pone.0168698] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 12/03/2016] [Indexed: 11/18/2022] Open
Abstract
AIMS To investigate an influence of mucopolysaccharidosis (MPS)- and Morbus Fabry-associated corneal opacities on intraocular pressure (IOP) measurements and to evaluate the concordance of the different tonometry methods. METHODS 25 MPS patients with or without corneal clouding, 25 Fabry patients with cornea verticillata ≥ grade 2 and 25 healthy age matched controls were prospectively included into this study. Outcome measures: Goldmann applanation tonometry (GAT); palpatory assessment of IOP; Goldmann-correlated intraocular pressure (IOPg), corneal-compensated intraocular pressure (IOPcc), corneal resistance factor (CRF) and corneal hysteresis (CH) assessed by Ocular Response Analyzer (ORA); central corneal thickness (CCT) and density assessed with Pentacam. Statistical analysis was performed using linear mixed effect models and Spearman correlation coefficients. The concordance between tonometry methods was assessed using Bland-Altman analysis. RESULTS There was no relevant difference between study groups regarding median GAT, IOPg, IOPcc and CCT measurements. The limits of agreement between GAT and IOPcc/IOPg/palpatory IOP in MPS were: [-11.7 to 12.1mmHg], [-8.6 to 15.5 mmHg] and [- 5.4 to 10.1 mmHg] respectively. Limits of agreement were less wide in healthy subjects and Fabry patients. Palpatory IOP was higher in MPS than in healthy controls and Fabry patients. Corneal opacity correlated more strongly with GAT, IOPg, CH, CRF, CCT and corneal density in MPS (r = 0.4, 0.5, 0.5, 0.7, 0.6, 0.6 respectively) than in Fabry patients (r = 0.3, 0.2, -0.03, 0.1, 0.3, -0.2 respectively). In contrast, IOPcc revealed less correlation with corneal opacity than GAT in MPS (r = 0.2 vs. 0.4). CONCLUSIONS ORA and GAT render less comparable IOP-values in patients suffering from MPS-associated corneal opacity in comparison to Fabry and healthy controls. The IOP seems to be overestimated in opaque MPS-affected corneas. GAT, IOPg and biomechanical parameters of the cornea correlate more strongly with the corneal clouding than IOPcc in MPS patients. TRIAL REGISTRATION ClinicalTrials.gov NCT01695161.
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Affiliation(s)
- Joanna Wasielica-Poslednik
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg- University Mainz, Germany
- * E-mail: ,
| | - Giuseppe Politino
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg- University Mainz, Germany
| | - Irene Schmidtmann
- Institute for Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center, Johannes Gutenberg University Mainz, Germany
| | - Katrin Lorenz
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg- University Mainz, Germany
| | - Katharina Bell
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg- University Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg- University Mainz, Germany
| | - Susanne Pitz
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg- University Mainz, Germany
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Lanza M, Iaccarino S, Mele L, Carnevale UAG, Irregolare C, Lanza A, Femiano F, Bifani M. Intraocular pressure evaluation in healthy eyes and diseased ones using contact and non contact devices. Cont Lens Anterior Eye 2015; 39:154-9. [PMID: 26481062 DOI: 10.1016/j.clae.2015.10.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 09/30/2015] [Accepted: 10/02/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE To analyze and compare intraocular pressure (IOP) values measured in healthy subjects (HS), keratoconus (KC) patients and patients that underwent myopic photorefractive keratectomy (REF), using Goldmann applanation tonometry (GAT), dynamic contour tonometry (DCT), ocular response analyzer (ORA) and Corvis ST (CST). METHODS The study included 76 eyes of 76HS, 15 eyes of 15 KC patients and 18 eyes of 18 subjects that underwent REF. Each participant underwent a complete ophthalmic evaluation, IOP measurement with GAT, DCT, ORA and CST. RESULTS HS showed a mean GAT value of 15.62±2.33 mm Hg, a mean DCT value of 17.44±2.51 mm Hg, a mean ORA value of 15.99±3.58 mm Hg and a mean CST value of 17.24±3.44 mm Hg. KC showed a mean GAT value of 15.07±1.83 mm Hg, a mean DCT value of 17.01±1.96 mm Hg, a mean ORA value of 13.58±2.99 mm Hg and a mean CST value of 14.37±1.89 mm Hg. REF showed a mean GAT value of 14.06±1.51 mm Hg, a mean DCT value of 15.12±2.34 mm Hg, a mean ORA value of 16.85±2.4 mm Hg and a mean CST value of 15.57±1.77 mm Hg. CONCLUSION Our data suggest that ORA and GAT could be used interchangeably in HS; GAT, ORA and CST could be used interchangeably in KC patients and that GAT provides lower IOP values compared to the other devices in eyes previously submitted to myopic PRK.
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Affiliation(s)
- Michele Lanza
- Dipartimento Multidisciplinare di Scienze Mediche, Chirurgiche e Odontoiatriche, Seconda Università di Napoli, Napoli, Italy; Centro Grandi Apparecchiature, Seconda Università di Napoli, Napoli, Italy.
| | - Stefania Iaccarino
- Centro Grandi Apparecchiature, Seconda Università di Napoli, Napoli, Italy
| | - Luigi Mele
- Dipartimento Multidisciplinare di Scienze Mediche, Chirurgiche e Odontoiatriche, Seconda Università di Napoli, Napoli, Italy
| | - Ugo Antonello Gironi Carnevale
- Dipartimento Multidisciplinare di Scienze Mediche, Chirurgiche e Odontoiatriche, Seconda Università di Napoli, Napoli, Italy
| | - Carlo Irregolare
- Centro Grandi Apparecchiature, Seconda Università di Napoli, Napoli, Italy
| | - Alessandro Lanza
- Dipartimento Multidisciplinare di Scienze Mediche, Chirurgiche e Odontoiatriche, Seconda Università di Napoli, Napoli, Italy
| | - Felice Femiano
- Dipartimento Multidisciplinare di Scienze Mediche, Chirurgiche e Odontoiatriche, Seconda Università di Napoli, Napoli, Italy
| | - Mario Bifani
- Dipartimento Multidisciplinare di Scienze Mediche, Chirurgiche e Odontoiatriche, Seconda Università di Napoli, Napoli, Italy
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Comparison of Rebound Tonometry, Perkins Applanation Tonometry and Ocular Response Analyser in Mucopolysaccharidosis Patients. PLoS One 2015; 10:e0133586. [PMID: 26317991 PMCID: PMC4552832 DOI: 10.1371/journal.pone.0133586] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 06/29/2015] [Indexed: 11/19/2022] Open
Abstract
AIMS To investigate the feasibility and to compare three devices measuring intraocular pressure (IOP) in mucopolysaccharidosis patients (MPS): iCare rebound tonometer (RT), Perkins applanation tonometer (PAT) and ocular response analyzer (ORA). METHODS MPS patients who underwent at least two examinations out of: RT, PAT and ORA at the same visit were identified and retrospectively analyzed in this study. RESULTS 17 patients fulfilled the inclusion criterion. In all 17 patients IOP measurements were performed with RT (34 eyes) and ORA (33 eyes), while PAT measurement was possible in only 12 (24 eyes) patients. The RT, corneal-compensated intraocular pressure (IOPcc) and Goldmann-correlated intraocular pressure (IOPg) differed relevantly from IOP assessed with PAT. Corneal clouding in MPS patients correlated positively with PAT, RT and IOPg (r = 0.3, 0.5, and 0.5 respectively), but not with IOPcc (r = 0.07). The MPS-related corneal clouding correlated positively with biomechanical corneal parameters assessed with ORA: corneal hysteresis (r = 0.77) and corneal resistance factor (r = 0.77) either. CONCLUSIONS RT and ORA measurements were tolerated better than applanation tonometry in MPS patients. IOP measurements assessed with RT and ORA differed relevantly from PAT. Corneal-compensated IOP assessed with ORA seems to be less affected by the MPS-related corneal clouding than applanation or rebound tonometry. RT and ORA measurements should be preferred for IOP assessment in patients with MPS.
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Cho AR, Choi YJ, Rhew JY, Choi KR. Diagnostic Availability of Ocular Response Analyzer in Korean Patients with Normal Tension Glaucoma. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.1.86] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Ah Ran Cho
- Institute of Ophthalmology and Optometry, Department of Ophthalmology, Ewha Womans University Medical Center, Ewha Womans University School of Medicine, Seoul, Korea
| | - Yun Jeong Choi
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jin Young Rhew
- Institute of Ophthalmology and Optometry, Department of Ophthalmology, Ewha Womans University Medical Center, Ewha Womans University School of Medicine, Seoul, Korea
| | - Kyu Ryong Choi
- Institute of Ophthalmology and Optometry, Department of Ophthalmology, Ewha Womans University Medical Center, Ewha Womans University School of Medicine, Seoul, Korea
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Choi YJ, Choi KR. Diurnal Variation in Intraocular Pressure Measured by Ocular Response Analyzer in Korean Patients with Normal Tension Glaucoma. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.12.1913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Yeon Jung Choi
- Department of Ophthalmology and The Institute of Ophthalmology and Optometry, Ewha Womans University School of Medicine, Seoul, Korea
| | - Kyu Ryong Choi
- Department of Ophthalmology and The Institute of Ophthalmology and Optometry, Ewha Womans University School of Medicine, Seoul, Korea
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