1
|
Gómez C, Piñero DP, Alió JL, Cavas F. Comparative evaluation of methods for obtaining the stress-free geometry of keratoconus corneas with different levels of severity. Comput Biol Med 2024; 170:107870. [PMID: 38217971 DOI: 10.1016/j.compbiomed.2023.107870] [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: 07/27/2023] [Revised: 12/07/2023] [Accepted: 12/17/2023] [Indexed: 01/15/2024]
Abstract
A biomechanical model that simulates the physiological pressure load on the cornea without considering the stresses in vivo will result in an overstress or underestimation of the stress field and incorrect deformation of the corneal structure. Therefore, it is essential to propose numerical models that consider the stress-free geometry of the cornea. In this study, the Displacement and Pre-stress methods were compared to obtain the stress-free geometry (S-FG) and the physiological estimated geometry (P-EG), based on the patient-specific geometric behavior and the computational time required to reach each geometry. The same shape and contour conditions were considered in the models obtained from both methods for each of the pathological scenarios analyzed. Both methods behaved differently to obtain the free geometry, and this difference increased with the severity grade of the disease. However, they behaved in a similar way to reach the physiological estimated geometry. The Displacement method required a lower computational cost to reach the free geometry, with both methods presenting a similar computational cost to obtain the physiological geometry. The stress-free geometries obtained by both methods allowed to characterize the existing biomechanical decompensation during the progression of the diseases. In conclusion, the calculation of the stress-free corneal geometry associated to the clinically measured intraocular pressure with the Displacement and Prestress Methods in keratoconus eyes allows the development of accurate and useable models in clinical practice in real time. This displacement method shows some benefits in terms of computational cost.
Collapse
Affiliation(s)
- Carmelo Gómez
- International School of Doctorate, Technical University of Cartagena, 30202, Cartagena, Spain
| | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, 03690, Alicante, Spain
| | - Jorge L Alió
- Cornea, Cataract and Refractive Surgery Department, VISSUM, Alicante, Spain; Division of Ophthalmology, Department of Pathology and Surgery, Faculty of Medicine, Miguel Hernández University, Alicante, Spain
| | - Francisco Cavas
- Department of Structures, Construction and Graphic Expression, Technical University of Cartagena, 30202, Cartagena, Spain.
| |
Collapse
|
2
|
Toprak I, Cavas F, Velázquez JS, del Barrio JLA, Alio JL. A three-dimensional morpho-volumetric similarity study of Down syndrome keratopathy vs. keratoconus. EYE AND VISION (LONDON, ENGLAND) 2023; 10:4. [PMID: 36593521 PMCID: PMC9809058 DOI: 10.1186/s40662-022-00315-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 10/26/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND To compare and contrast morpho-volumetric features between Down syndrome (DS) cornea and non-DS keratoconic cornea by three-dimensional (3D) modelling. METHODS Forty-three subjects (43 eyes) with DS and 99 patients matching their age and sex (99 eyes) with keratoconus (KC) were included in this single-center cross-sectional study. Main outcome measures were high-order aberrations (HOA), central corneal thickness (CCT), spherical equivalent refraction, and morpho-volumetric parameters established using a 3D corneal model, such as deviation of anterior and posterior corneal apices (Dapexant/Dapexpost) and minimum thickness points (Dmctant/Dmctpost) from corneal vertex, areas of the anterior and posterior surfaces (Aant/Apost), sagittal area passing through the anterior and posterior corneal apices (Aapexant/Aapexpost) and minimum thickness point (Amctpost) and corneal volume of the complete cornea (Vtotal). RESULTS Age, gender, spherical equivalent refraction, CCT and Vtotal were similar between the net on-DS KC and DS groups (P > 0.05), while non-DS KC group had higher HOA than the DS group (P < 0.05). Dapexant, Aant, Apost and Aapexant showed higher values in the DS group than in the non-DS KC group, whereas Dapexpost showed a reduction in the DS group when compared with the non-DS KC group (P < 0.05). CONCLUSIONS This study demonstrated that anterior and posterior corneal apex dynamics were specifically different in DS subjects, as the anterior apex tends to displace more prominently when compared to that from the non-DS KC group, while the posterior apex appears to be more stable than that in non-DS KC, which also support the theory that DS patients suffer from a specific keratopathy, distinctively different to KC but strongly related to it, and probably showing a diversity of corneal phenotypes in all cases of DS.
Collapse
Affiliation(s)
- Ibrahim Toprak
- grid.411742.50000 0001 1498 3798Department of Ophthalmology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Francisco Cavas
- grid.218430.c0000 0001 2153 2602Bioengineering and Applied Computational Simulation Research Group, Technical University of Cartagena, Cartagena, Spain ,grid.218430.c0000 0001 2153 2602Department of Structures, Construction and Graphical Expression, Technical University of Cartagena, Cartagena, Spain
| | - José S. Velázquez
- grid.218430.c0000 0001 2153 2602Bioengineering and Applied Computational Simulation Research Group, Technical University of Cartagena, Cartagena, Spain ,grid.218430.c0000 0001 2153 2602Department of Structures, Construction and Graphical Expression, Technical University of Cartagena, Cartagena, Spain
| | - Jorge L. Alio del Barrio
- grid.419256.dDepartment of Research and Development, VISSUM, Calle Cabañal, 1, Edificio Vissum, 03016 Alicante, Spain ,grid.419256.dCornea, Cataract and Refractive Surgery Department, VISSUM, Calle Cabañal, 1, Edificio Vissum, 03016 Alicante, Spain ,grid.26811.3c0000 0001 0586 4893Division of Ophthalmology, Department of Pathology and Surgery, Faculty of Medicine, Miguel Hernández University, Calle Cabañal, 1, Edificio Vissum, 03016 Alicante, Spain
| | - Jorge L. Alio
- grid.419256.dDepartment of Research and Development, VISSUM, Calle Cabañal, 1, Edificio Vissum, 03016 Alicante, Spain ,grid.419256.dCornea, Cataract and Refractive Surgery Department, VISSUM, Calle Cabañal, 1, Edificio Vissum, 03016 Alicante, Spain ,grid.26811.3c0000 0001 0586 4893Division of Ophthalmology, Department of Pathology and Surgery, Faculty of Medicine, Miguel Hernández University, Calle Cabañal, 1, Edificio Vissum, 03016 Alicante, Spain
| |
Collapse
|
3
|
Tafti MF, Aghamollaei H, Moghaddam MM, Jadidi K, Alio JL, Faghihi S. Emerging tissue engineering strategies for the corneal regeneration. J Tissue Eng Regen Med 2022; 16:683-706. [PMID: 35585479 DOI: 10.1002/term.3309] [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: 11/23/2021] [Revised: 04/16/2022] [Accepted: 04/19/2022] [Indexed: 11/10/2022]
Abstract
Cornea as the outermost layer of the eye is at risk of various genetic and environmental diseases that can damage the cornea and impair vision. Corneal transplantation is among the most applicable surgical procedures for repairing the defected tissue. However, the scarcity of healthy tissue donations as well as transplantation failure has remained as the biggest challenges in confront of corneal grafting. Therefore, alternative approaches based on stem-cell transplantation and classic regenerative medicine have been developed for corneal regeneration. In this review, the application and limitation of the recently-used advanced approaches for regeneration of cornea are discussed. Additionally, other emerging powerful techniques such as 5D printing as a new branch of scaffold-based technologies for construction of tissues other than the cornea are highlighted and suggested as alternatives for corneal reconstruction. The introduced novel techniques may have great potential for clinical applications in corneal repair including disease modeling, 3D pattern scheming, and personalized medicine.
Collapse
Affiliation(s)
- Mahsa Fallah Tafti
- Stem Cell and Regenerative Medicine Group, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran
| | - Hossein Aghamollaei
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | | | - Khosrow Jadidi
- Vision Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Jorge L Alio
- Department of Research and Development, VISSUM, Alicante, Spain.,Cornea, Cataract and Refractive Surgery Department, VISSUM, Alicante, Spain.,Department of Pathology and Surgery, Division of Ophthalmology, Faculty of Medicine, Miguel Hernández University, Alicante, Spain
| | - Shahab Faghihi
- Stem Cell and Regenerative Medicine Group, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran
| |
Collapse
|
4
|
Toprak I, Cavas F, Vega A, Velázquez JS, Alio del Barrio JL, Alio JL. Evidence of a Down Syndrome Keratopathy: A Three-Dimensional (3-D) Morphogeometric and Volumetric Analysis. J Pers Med 2021; 11:jpm11020082. [PMID: 33573177 PMCID: PMC7911434 DOI: 10.3390/jpm11020082] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 01/06/2023] Open
Abstract
The aim of this study was to investigate whether a different and abnormal corneal profile is present in Down syndrome (DS) by personalized three-dimensional (3D) modelling. This single-centre cross-sectional study included 43 patients with DS (43 eyes) and 58 age-sex-matched control subjects (58 eyes) with normal karyotype and topography. Refraction, central corneal thickness (CCT), aberrations (high-order, coma and spherical), asphericity and morphogeometric/volumetric parameters based on a 3D corneal model that was generated from raw topographical data were evaluated. Deviation of anterior/posterior apex (Dapexant/Dapexpost) and thinnest point (Dmctant/Dmctpost) from corneal vertex, anterior/posterior surface area (Aant/Apost), sagittal area passing through the anterior/posterior apex (Aapexant/Aapexpost) and thinnest point (Amctpost), total corneal volume (Vtotal) and volumetric progression for each 0.05 mm step of the radius value centred to the thinnest point (VOLMCT) and anterior/posterior apex (VOLAAP/VOLPAP) comprised the morphogeometric/volumetric parameters. In the DS group, 58.1% of the eyes presented abnormal topography. High-order and coma aberrations, asphericity, Dapexant, Aant, Apost and Aapexant were significantly higher, whereas CCT, Aapexpost, Amctpost, Vtotal, VOLAAP, VOLPAP and VOLMCT were lower in the DS group than in the control group (p < 0.05). Dapexpost did not differ between the groups (p > 0.05). This study demonstrates that corneas of the subjects with DS are different and more aberrated than those of normal age- and sex-matched non-DS controls. Anterior corneal apex appears to be displaced in DS even with normal topography, while posterior apex seems stable although topography is abnormal. These findings may help to modify our approach in the diagnosis of keratopathy in subjects with DS.
Collapse
Affiliation(s)
- Ibrahim Toprak
- Department of Research and Development, VISSUM, 03016 Alicante, Spain; (I.T.); (A.V.); (J.L.A.d.B.)
- Department of Ophthalmology, Faculty of Medicine, Pamukkale University, Denizli 20160, Turkey
| | - Francisco Cavas
- Department of Structures, Construction and Graphical Expression, Technical University of Cartagena, 30202 Cartagena, Spain;
- Correspondence: ; Tel.: +34-968-338-856
| | - Alfredo Vega
- Department of Research and Development, VISSUM, 03016 Alicante, Spain; (I.T.); (A.V.); (J.L.A.d.B.)
- Cornea, Cataract and Refractive Surgery Department, VISSUM, 03016 Alicante, Spain;
- Division of Ophthalmology, Department of Pathology and Surgery, Faculty of Medicine, Miguel Hernández University, 03016 Alicante, Spain
| | - José S. Velázquez
- Department of Structures, Construction and Graphical Expression, Technical University of Cartagena, 30202 Cartagena, Spain;
| | - Jorge L. Alio del Barrio
- Department of Research and Development, VISSUM, 03016 Alicante, Spain; (I.T.); (A.V.); (J.L.A.d.B.)
- Cornea, Cataract and Refractive Surgery Department, VISSUM, 03016 Alicante, Spain;
- Division of Ophthalmology, Department of Pathology and Surgery, Faculty of Medicine, Miguel Hernández University, 03016 Alicante, Spain
| | - Jorge L. Alio
- Cornea, Cataract and Refractive Surgery Department, VISSUM, 03016 Alicante, Spain;
- Division of Ophthalmology, Department of Pathology and Surgery, Faculty of Medicine, Miguel Hernández University, 03016 Alicante, Spain
| |
Collapse
|
5
|
Xue H, Wang B, Meng T, Zhao S, Wang Q, Zhang X, Kang M, Xiang W. Differences of Sleep Disorders Between Vestibular Migraine and Benign Paroxysmal Positional Vertigo. Front Psychiatry 2021; 12:726038. [PMID: 34867516 PMCID: PMC8637153 DOI: 10.3389/fpsyt.2021.726038] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 10/13/2021] [Indexed: 12/31/2022] Open
Abstract
Introduction: Sleep disorders can affect the overall health and quality of life of patients. This study was conducted to compare the differences of sleep disorders in vestibular migraine (VM) patients and benign paroxysmal positional vertigo (BPPV) patients. Methods: VM patients, BPPV patients, and healthy controls (HCs) were recruited. Pittsburgh sleep quality index and polysomnography monitoring were used as subjective and objective, respectively, evaluation methods to evaluate the sleep quality of participants in the latest month. Results: Fifty-seven BPPV patients, 48 VM patients, and 42 HCs were included in this study. There were 79.16% VM patients, 54.39% BPPV patients, and 14.28% HCs with sleep disorders. The difference in the incidence rate of sleep disorders was significant between VM patients and BPPV patients (p = 0.008) and significantly higher in both the VM group (p < 0.00001) and BPPV group (p = 0.00004) than in the HC groups (14.28%). Compared with BPPV patients, the VM patients had the significantly lower sleep efficiency (p < 0.001) and N3 (p < 0.001) and the significantly higher time of wake-up after sleep onset (p < 0.001), N1 (p < 0.001), and N2 (p < 0.001). Meanwhile, the VM patients had significantly higher incidence rates of severe obstructive sleep apnea hypoventilation syndrome (p = 0.001) and periodic leg movement in sleep (p = 0.016). Conclusion: The incidence rate of sleep disorders was significantly higher in both VM and BPPV patients than in the HC groups. To improve the curative effects, clinicians should pay more attention to the comorbidity of sleep disorders in treating VM and BPPV.
Collapse
Affiliation(s)
- Hui Xue
- Department of Neurology, Baotou Central Hospital, Baotou, China
| | - Baojun Wang
- Department of Neurology, Baotou Central Hospital, Baotou, China
| | - Tianyu Meng
- Department of Neurology, Baotou Central Hospital, Baotou, China
| | - Shijun Zhao
- Department of Neurology, Baotou Central Hospital, Baotou, China
| | - Qingyin Wang
- Department of Neurology, Baotou Central Hospital, Baotou, China
| | - Xin Zhang
- Department of Neurology, Baotou Central Hospital, Baotou, China
| | - Min Kang
- Department of Neurology, Baotou Central Hospital, Baotou, China
| | - Wenping Xiang
- Department of Neurology, Baotou Central Hospital, Baotou, China
| |
Collapse
|
6
|
Relationship between Corneal Morphogeometrical Properties and Biomechanical Parameters Derived from Dynamic Bidirectional Air Applanation Measurement Procedure in Keratoconus. Diagnostics (Basel) 2020; 10:diagnostics10090640. [PMID: 32867063 PMCID: PMC7555946 DOI: 10.3390/diagnostics10090640] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 08/25/2020] [Accepted: 08/25/2020] [Indexed: 02/07/2023] Open
Abstract
The morphogeometric analysis of the corneal structure has become a clinically relevant diagnostic procedure in keratoconus (KC) as well as the in vivo evaluation of the corneal biomechanical properties. However, the relationship between these two types of metrics is still not well understood. The current study investigated the relationship of corneal morphogeometry and volume with two biomechanical parameters: corneal hysteresis (CH) and corneal resistance factor (CRF), both provided by an Ocular Response Analyzer (Reichert). It included 109 eyes from 109 patients (aged between 18 and 69 years) with a diagnosis of keratoconus (KC) who underwent a complete eye examination including a comprehensive corneal topographic analysis with the Sirius system (CSO). With the topographic information obtained, a morphogeometric and volumetric analysis was performed, defining different variables of clinical use. CH and CRF were found to be correlated with these variables, but this correlation was highly influenced by corneal thickness. This suggests that the mechanical properties of KC cornea contribute only in a partial and limited manner to these biomechanical parameters, being mostly influenced by morphogeometry under normal intraocular pressure levels. This would explain the limitation of CH and CRF as diagnostic tools for the detection of incipient cases of KC.
Collapse
|
7
|
Alifa R, Piñero D, Velázquez J, L. Alió del Barrio J, Cavas F, Alió JL. Changes in the 3D Corneal Structure and Morphogeometric Properties in Keratoconus after Corneal Collagen Crosslinking. Diagnostics (Basel) 2020; 10:diagnostics10060397. [PMID: 32545294 PMCID: PMC7345591 DOI: 10.3390/diagnostics10060397] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 02/07/2023] Open
Abstract
Keratoconus is an ectatic disorder that is presently considered one of the most prevalent reasons for keratoplasty. Corneal collagen crosslinking (CXL) is the only proven treatment option available that is capable of halting the progression of the disease by stabilizing the cone in 90% of cases, and by also reducing refractive error and maximal keratometry. This study assesses, by means of a 3D morphogeometric analysis procedure developed by our research team, the corneal structure changes that occur immediately after CXL treatment and during a 6 month follow-up period. A total of 19 eyes from 19 patients diagnosed with keratoconus who underwent CXL were included, and several variables derived from the morphogeometric analysis were calculated and evaluated for the pre-operative, 3 month postoperative, and 6 month postoperative states. Significant reductions were detected in central corneal thickness and corneal spherical-like root mean square (RMS) 3 months after surgery, with non-significant regression of the effect afterward. Significant reductions in the total corneal area/volume were found, with some levels of regression after 6 months in certain volumetric parameters. In conclusion, the eyes with higher values for morphogeometric parameters—posterior apex deviation (PAD), anterior minimum thickness point deviation (AMTPD), and posterior minimum thickness point deviation (PMTPD)—seemed more likely to undergo aberrometric improvement as a result of CXL surgery.
Collapse
Affiliation(s)
- Ramón Alifa
- Doctorate Program in Industrial Technologies, International School of Doctorate, Technical University of Cartagena, 30202 Cartagena, Spain;
| | - David Piñero
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, 03690 Alicante, Spain;
| | - José Velázquez
- Department of Structures, Construction and Graphical Expression, Technical University of Cartagena, 30202 Cartagena, Spain;
| | - Jorge L. Alió del Barrio
- Department of Research and Development, VISSUM, 03016 Alicante, Spain; (J.L.A.d.B.); (J.L.A.)
- Cornea, Cataract and Refractive Surgery Department, VISSUM, 03016 Alicante, Spain
- Division of Ophthalmology, Department of Pathology and Surgery, Faculty of Medicine, Miguel Hernández University, 03202 Alicante, Spain
| | - Francisco Cavas
- Department of Structures, Construction and Graphical Expression, Technical University of Cartagena, 30202 Cartagena, Spain;
- Correspondence: ; Tel.: +34-968-328856
| | - Jorge L. Alió
- Department of Research and Development, VISSUM, 03016 Alicante, Spain; (J.L.A.d.B.); (J.L.A.)
- Cornea, Cataract and Refractive Surgery Department, VISSUM, 03016 Alicante, Spain
- Division of Ophthalmology, Department of Pathology and Surgery, Faculty of Medicine, Miguel Hernández University, 03202 Alicante, Spain
| |
Collapse
|