1
|
Abe RY, Oltramari L, Vessani RM, Schimiti RB, Magacho L, Kanadani FN, Costa VP. Trabeculectomy in Eyes With High Myopia. J Glaucoma 2024; 33:110-115. [PMID: 37671507 DOI: 10.1097/ijg.0000000000002293] [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: 03/19/2023] [Accepted: 08/07/2023] [Indexed: 09/07/2023]
Abstract
PRCIS Primary trabeculectomy was safe and effective at lowering intraocular pressure (IOP) in patients with primary open angle glaucoma and high myopia. PURPOSE To investigate the efficacy and safety of trabeculectomy in patients with glaucoma and high myopia. PATIENT AND METHODS Retrospective case-control study. Glaucomatous patients with high myopia undergoing primary trabeculectomy surgery with at least 1 year of follow-up were compared with an age-matched control group without high myopia undergoing the same procedure. Surgical success was defined as: IOP ≤ 15 mm Hg with (qualified) or without (complete) antiglaucoma medications and at least 20% reduction from baseline IOP at the end of 48 months of follow-up. RESULTS We included a total of 90 eyes from 90 patients (45 eyes with high myopia and 45 controls). Within the 90 eyes, 70 eyes underwent trabeculectomy and 20 eyes underwent combined phacoemulsification and trabeculectomy. Although patients with high myopia had higher chances for failure (37% vs. 22%) compared with controls, the difference was not statistically significant ( P =0.067). In the multivariable analysis, patients of African descent ( P =0.043) and those with juvenile glaucoma ( P =0.001) had more chances of failure, even after adjusting for myopia. There was no statistically significant difference between complication rates in both groups. CONCLUSION Trabeculectomy was effective in reducing IOP in patients with high myopia and glaucoma, without the additional risk of complications compared with a control group.
Collapse
Affiliation(s)
- Ricardo Y Abe
- Department of Opthalmology, University of Campinas-UNICAMP
- Hospital Oftalmológico de Brasília, Brasília, Distrito Federal
| | - Laura Oltramari
- Hospital Oftalmológico de Brasília, Brasília, Distrito Federal
| | - Roberto M Vessani
- Department of Ophthalmology and Visual Science, Glaucoma Service, Federal University of Sao Paulo, São Paulo
| | - Rui B Schimiti
- Department of Opthalmology, University of Campinas-UNICAMP
| | - Leopoldo Magacho
- Department of Ophthalmology, Federal University of Goiás
- VER Hospital de Olhos, Goiânia, Goiás
| | - Fábio N Kanadani
- Department of Ophthalmology, Glaucoma Institute of Belo Horizonte, Belo Horizonte, Brazil
| | - Vital P Costa
- Department of Opthalmology, University of Campinas-UNICAMP
| |
Collapse
|
2
|
Aoki S, Asaoka R, Fujino Y, Nakakura S, Murata H, Kiuchi Y. Comparing corneal biomechanic changes among solo cataract surgery, microhook ab interno trabeculotomy and iStent implantation. Sci Rep 2023; 13:19148. [PMID: 37932377 PMCID: PMC10628136 DOI: 10.1038/s41598-023-46709-5] [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: 03/10/2023] [Accepted: 11/03/2023] [Indexed: 11/08/2023] Open
Abstract
Minimally invasive glaucoma surgery has expanded the surgical treatment options in glaucoma, particularly when combined with cataract surgery. It is clinically relevant to understand the associated postoperative changes in biomechanical properties because they are influential on the measurement of intraocular pressure (IOP) and play an important role in the pathogenesis of open-angle glaucoma (OAG). This retrospective case-control study included OAG patients who underwent cataract surgery combined with microhook ab interno trabeculotomy (µLOT group: 53 eyes of 36 patients) or iStent implantation (iStent group: 59 eyes of 37 patients) and 62 eyes of 42 solo cataract patients without glaucoma as a control group. Changes in ten biomechanical parameters measured with the Ocular Response Analyzer and Corneal Visualization Scheimpflug Technology (Corvis ST) at 3 and 6 months postoperatively relative to baseline were compared among the 3 groups. In all the groups, IOP significantly decreased postoperatively. In the µLOT and control groups, significant changes in Corvis ST-related parameters, including stiffness parameter A1 and stress‒strain index, indicated that the cornea became softer postoperatively. In contrast, these parameters were unchanged in the iStent group. Apart from IOP reduction, the results show variations in corneal biomechanical changes from minimally invasive glaucoma surgery combined with cataract surgery.
Collapse
Affiliation(s)
- Shuichiro Aoki
- Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Ryo Asaoka
- Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-Ku, Hamamatsu City, Shizuoka, Japan.
- Seirei Christopher University, Hamamatsu City, Shizuoka, Japan.
- The Graduate School for the Creation of New Photonics Industries, Hamamatsu City, Shizuoka, Japan.
| | - Yuri Fujino
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-Ku, Hamamatsu City, Shizuoka, Japan
- Department of Ophthalmology, Shimane University Faculty of Medicine, Shimane, Japan
| | - Shunsuke Nakakura
- Department of Ophthalmology, Tsukazaki Memorial Hospital, Hyogo, Japan
| | - Hiroshi Murata
- Department of Ophthalmology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoshiaki Kiuchi
- Department of Ophthalmology and Visual Science, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
3
|
Elhusseiny AM, Scarcelli G, Saeedi OJ. Corneal Biomechanical Measures for Glaucoma: A Clinical Approach. Bioengineering (Basel) 2023; 10:1108. [PMID: 37892838 PMCID: PMC10604716 DOI: 10.3390/bioengineering10101108] [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: 08/08/2023] [Revised: 09/11/2023] [Accepted: 09/14/2023] [Indexed: 10/29/2023] Open
Abstract
Over the last two decades, there has been growing interest in assessing corneal biomechanics in different diseases, such as keratoconus, glaucoma, and corneal disorders. Given the interaction and structural continuity between the cornea and sclera, evaluating corneal biomechanics may give us further insights into the pathogenesis, diagnosis, progression, and management of glaucoma. Therefore, some authorities have recommended baseline evaluations of corneal biomechanics in all glaucoma and glaucoma suspects patients. Currently, two devices (Ocular Response Analyzer and Corneal Visualization Schiempflug Technology) are commercially available for evaluating corneal biomechanics; however, each device reports different parameters, and there is a weak to moderate agreement between the reported parameters. Studies are further limited by the inclusion of glaucoma subjects taking topical prostaglandin analogues, which may alter corneal biomechanics and contribute to contradicting results, lack of proper stratification of patients, and misinterpretation of the results based on factors that are confounded by intraocular pressure changes. This review aims to summarize the recent evidence on corneal biomechanics in glaucoma patients and insights for future studies to address the current limitations of the literature studying corneal biomechanics.
Collapse
Affiliation(s)
- Abdelrahman M. Elhusseiny
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA;
- Department of Ophthalmology, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Giuliano Scarcelli
- Fischell Department of Bioengineering, University of Maryland, College Park, MD 20742, USA;
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Osamah J. Saeedi
- Fischell Department of Bioengineering, University of Maryland, College Park, MD 20742, USA;
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| |
Collapse
|
4
|
Reed DM, Toris CB, Gilbert J, Trese M, Kristoff TJ, Fan S, Neely D, Ferguson S, Kazemi A, McLaren JW, Gulati V, Musch DC, Sit AJ, Moroi SE. Eye Dynamics and Engineering Network Consortium: Baseline Characteristics of a Randomized Trial in Healthy Adults. Ophthalmol Glaucoma 2023; 6:215-223. [PMID: 36096354 PMCID: PMC9998773 DOI: 10.1016/j.ogla.2022.09.001] [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: 04/13/2022] [Revised: 08/16/2022] [Accepted: 09/01/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE To improve understanding of intraocular pressure (IOP) and its variance, this project identifies systemic and ocular characteristics of healthy eyes of adult volunteers including IOP variation, ocular biometrics, and aqueous humor dynamics (AHDs). These data serve as baseline controls for further studies from the Eye Dynamics and Engineering Network (EDEN) Consortium. DESIGN Multicenter open-label clinical trial in healthy adults randomized to 1 week treatment with 2 approved glaucoma drugs in a crossover design. PARTICIPANTS Among 135 healthy participants, 122 participants (aged 55.2 ± 8.8 years; 92 females, 30 males) completed the protocol. METHODS Participants from the University of Michigan, Mayo Clinic, and University of Nebraska Medical Center underwent measurements of ocular biometrics, AHD, and IOP using 4 tonometers. Intraocular pressure data during 3 study visits without glaucoma medications were used in the analysis. The PhenX Toolkit survey acquired standardized data on medical history, surgical history, medications, smoking and alcohol exposures, and physical measures. MAIN OUTCOME MEASURES The variability of IOP measurements within eyes was assessed as visit-to-visit IOP variation, within-visit IOP variation, and within-visit positional IOP variation. The concordance (or correlation) between eyes was also assessed. RESULTS Average positional change of > 4.7 mmHg was detected with a range of 0.5-11.0 mmHg. Pearson correlation of IOP between eyes within a visit was 0.87 (95% confidence interval [CI], 0.82-0.91) for Goldmann applanation tonometry, 0.91 (95% CI, 0.88-0.94) for Icare rebound tonometry, and 0.91 (95% CI, 0.88-0.94) for pneumatonometry. There was a 4% to 12% asymmetric fluctuation of 3 mmHg or more between eyes between visits using rebound tonometry, 9% with Goldmann applanation tonometry, and 3% to 4% by pneumotonometry. The coefficient of variation between visits for the same eye ranged from 11.2% to 12.9% for pneumatonometry, from 13.6% to 17.4% for rebound tonometry, and 15.8% to 16.2% for Goldmann applanation tonometry. CONCLUSIONS The current study from the EDEN Consortium describes measurement methods and data analyses with emphasis on IOP variability. Future papers will focus on changes in ocular biometrics and AHD with timolol or latanoprost treatment. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
Collapse
Affiliation(s)
- David M Reed
- Department of Ophthalmology and Visual Sciences, Ohio State University Wexner Medical Center, The Ohio State University, Columbus, Ohio
| | - Carol B Toris
- Department of Ophthalmology and Visual Sciences, Ohio State University Wexner Medical Center, The Ohio State University, Columbus, Ohio; Department of Ophthalmology and Visual Sciences, Stanley Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska
| | - Jesse Gilbert
- Department of Ophthalmology and Visual Sciences, Ohio State University Wexner Medical Center, The Ohio State University, Columbus, Ohio
| | - Matthew Trese
- Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan; Beaumont Eye Institute, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan
| | - Tyler J Kristoff
- Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan; J. Willis Hurst Internal Medicine Residency, Emory University School of Medicine, Atlanta, Georgia
| | - Shan Fan
- Department of Ophthalmology and Visual Sciences, Stanley Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska
| | - Donna Neely
- Department of Ophthalmology and Visual Sciences, Stanley Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska
| | - Simone Ferguson
- Howard University Hospital, Washington, District of Columbia
| | - Arash Kazemi
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota
| | - Jay W McLaren
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota
| | - Vikas Gulati
- Department of Ophthalmology and Visual Sciences, Stanley Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska
| | - David C Musch
- Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Arthur J Sit
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota
| | - Sayoko E Moroi
- Department of Ophthalmology and Visual Sciences, Ohio State University Wexner Medical Center, The Ohio State University, Columbus, Ohio; Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan.
| |
Collapse
|
5
|
Catania F, Morenghi E, Rosetta P, Paolo V, Vinciguerra R. Corneal Biomechanics Assessment with Ultra High Speed Scheimpflug Camera in Primary Open Angle Glaucoma Compared with Healthy Subjects: A meta-analysis of the Literature. Curr Eye Res 2023; 48:161-171. [PMID: 35385343 DOI: 10.1080/02713683.2022.2059809] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE The aim of this meta-analysis of the literature is to provide a comprehensive analysis of the differences in Corvis ST dynamic corneal response (DCR) parameters between primary open-angle glaucoma (POAG) patients and healthy controls. METHODS A quantitative meta-analysis was conducted on articles published before September 10, 2021 identified by searching PubMed, EMBASE, and Web of Science. Prospective studies comparing DCR Corvis ST parameter in high tension POAG and healthy controls were included. The random-effects model was conducted. Assessment of heterogeneity was based on the calculation of I2. Funnel plots evaluation and meta-regression were performed in case of detection of high heterogeneity. RESULTS The selection process resulted in the inclusion of six articles. Pooled analysis revealed that POAG corneas respond to mechanical stimulus with a smaller concavity, showing lower deformation amplitude (DA) (CI95% -0.991 to -0.578; p < .001; I2 = 0%), higher highest concavity radius (HCR; confidence interval [CI]95% -0.01 to 0.34; p = .058; I2 = 6.7%), and lower peak distance (PD; CI95% -1.06 to -0.024; p = .040; I2 = 86.5%). They also show a slower loading phase, with lower highest concavity time (HCT; CI95% -0.39 to -0.02; p = .029; I2 = 3.3%) and lower applanation velocity-1 (CI95% -0.641 to -0.127; p = .003; I2 = 34.6%), and a faster restoration to the original form, shown by lower applanation time-2 (CI95% -1.123 to -0.544; p = .001; I2 = 44.8%) compared to healthy subjects. CONCLUSIONS High tension POAG patients are characterized by stiffer corneas compared to healthy controls. These differences are valid also after removing the effect of age, corneal thickness, and intraocular pressure (IOP).
Collapse
Affiliation(s)
- Fiammetta Catania
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.,Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy
| | - Emanuela Morenghi
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.,Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy
| | | | - Vinciguerra Paolo
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.,Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy
| | | |
Collapse
|
6
|
Li F, Wang K, Liu Z. In Vivo Biomechanical Measurements of the Cornea. BIOENGINEERING (BASEL, SWITZERLAND) 2023; 10:bioengineering10010120. [PMID: 36671692 PMCID: PMC9854753 DOI: 10.3390/bioengineering10010120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 01/18/2023]
Abstract
In early corneal examinations, the relationships between the morphological and biomechanical features of the cornea were unclear. Although consistent links have been demonstrated between the two in certain cases, these are not valid in many diseased states. An accurate assessment of the corneal biomechanical properties is essential for understanding the condition of the cornea. Studies on corneal biomechanics in vivo suggest that clinical problems such as refractive surgery and ectatic corneal disease are closely related to changes in biomechanical parameters. Current techniques are available to assess the mechanical characteristics of the cornea in vivo. Accordingly, various attempts have been expended to obtain the relevant mechanical parameters from different perspectives, using the air-puff method, ultrasound, optical techniques, and finite element analyses. However, a measurement technique that can comprehensively reflect the full mechanical characteristics of the cornea (gold standard) has not yet been developed. We review herein the in vivo measurement techniques used to assess corneal biomechanics, and discuss their advantages and limitations to provide a comprehensive introduction to the current state of technical development to support more accurate clinical decisions.
Collapse
Affiliation(s)
- Fanshu Li
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Health Science Center, Peking University, Beijing 100191, China
| | - Kehao Wang
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Engineering Medicine, Beihang University, Beijing 100191, China
| | - Ziyuan Liu
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Health Science Center, Peking University, Beijing 100191, China
- Correspondence:
| |
Collapse
|
7
|
Ang RET, Rixon A, Kilgore K, Schweitzer J. Goldmann and modified Goldmann tonometry measuring intraocular pressure changes in eyes which underwent myopic laser in situ Keratomileusis and photorefractive keratectomy. BMC Ophthalmol 2022; 22:503. [PMID: 36539706 PMCID: PMC9768993 DOI: 10.1186/s12886-022-02741-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Compare intraocular pressure (IOP) measured by a standard Goldmann applanation tonometer prism (IOPg) and a modified correcting applanation tonometer surface Goldmann prism (IOPc) before and after laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK). METHODS Goldmann tonometry was analyzed in a retrospective, cross-sectional study, using both GAT and modified-GAT prisms pre-operatively and at the 3 month post-operative appointment on 120 eyes (64 patients) who received LASIK (n = 58) or PRK (n = 62). Demographics, central corneal thickness (CCT), manifest refraction and corneal curvature (CC) data was collected at each visit as well as surgical parameters, including maximum ablation depth. RESULTS Mean paired IOP following LASIK decreased by - 3.28 ± 3.2 mmHg measured by IOPg and - 1.93 ± 3.3 mmHg by IOPc (p ≤ 0.0001). Mean paired IOP following PRK reduced by - 1.92 ± 3.6 mmHg measured by IOPg and - 1.06 ± 3.6 mmHg by IOPc (p ≤ 0.0001). Increased LASIK ablation depth and post-procedural change in CCT trended toward a statistically significant reduction in IOPg (p = 0.07,p = 0.12), but not IOPc (p = 0.18,p = 0.32). PRK ablation depth was not associated with a reduction in IOPg or IOPc. DISCUSSION The modified Goldmann (IOPc) prism measured less of an IOP reduction following LASIK and PRK compared to the standard (IOPg) prism, and the IOP reduction with both prisms was associated with the degree of myopic correction. WHAT IS ALREADY KNOWN AND THE RESIDUAL QUERY Corneal refractive surgery generally demonstrates significant postoperative Goldmann IOP reductions. Presumably, this is due to corneal biomechanical changes for which a newer method of Goldmann IOP measurement may be able to compensate. WHAT THIS STUDY ADDS A modified, corneal conforming Goldmann prism demonstrates significantly less IOP reduction following myopic LASIK and PRK compared to the standard flat Goldmann prism. HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY A newer, modified Goldmann prism may help detect glaucoma and OHT at an earlier stage in patients which have undergone LASIK or PRK. The findings corroborate predicted corneal biomechanical changes following the most common corneal refractive procedures.
Collapse
Affiliation(s)
- Robert Edward T. Ang
- Department of Ophthalmology, Cardinal Santos Medical Center, City, Metro Manila, San Juan, Philippines ,grid.476917.a0000 0004 9154 7342Cornea and Refractive Surgery Service, Asian Eye Institute, City, Metro Manila, Makati, Philippines ,grid.476917.a0000 0004 9154 7342Glaucoma Service, Asian Eye Institute, City, Metro Manila, Makati, Philippines
| | - Andrew Rixon
- grid.413847.d0000 0004 0420 4721Veterans Administration, Memphis, TN U.S.A.
| | | | | |
Collapse
|
8
|
Lu W, Ding W, Ji R, Tian Y, Zhao C, Li H, Jiao M, Guo Z, Leng L. Repeatability and correlation of corneal biomechanical measurements obtained by Corvis ST in orthokeratology patients. Cont Lens Anterior Eye 2022; 46:101793. [PMID: 36509642 DOI: 10.1016/j.clae.2022.101793] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 12/02/2022] [Accepted: 12/04/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE To evaluate the repeatability of the corneal biomechanical measurements obtained by Corvis ST in post-orthokeratology patients and analyze the correlation between the biomechanical and ocular parameters. METHODS Fifty-one eyes of 51 myopic subjects were included in this study. The biomechanical parameters were assessed using Corvis ST. Repeatability was assessed using one-way ANOVA based on within-subject standard deviation (Sw), repeatability coefficient (RC), intraclass correlation coefficient (ICC) and correlation of variation (CoV). The correlation was evaluated using Pearson correlation analysis. RESULTS All parameters measured by Corvis ST, except length of flattened cornea at the first and second applanations (A1L and A2L), showed a good intraobserver repeatability after a 3-month follow-up period. The ICC values for A1L and A2L were 0.444 and 0.654, whereas the other parameters were higher than 0.8. Similar trends were obtained for CoV, wherein the CoV values for A1L and A2L were greater than 13 %. The corneal biomechanical parameters were correlated with age, refraction, axial length (AL), steep and flat keratometry before and after orthokeratology, and central corneal thickness (CCT). Following orthokeratology treatment, post-keratometry demonstrated a higher correlation with stiffness parameter at first applanation (SP-A1), velocity of corneal apex at the first applanation (A1V), and radius than pre-keratometry, which showed a weak correlation with SP-A1. CONCLUSION Corneal biomechanical parameters assessed using Corvis ST demonstrated a good repeatability, except A1L and A2L. The corneal biomechanical parameters were correlated with age, refraction, AL and pre- and post-keratometry. Thus, Corvis ST is a suitable device for investigating biomechanical parameter.
Collapse
Affiliation(s)
- Weicong Lu
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Shandong, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong, China; School of Ophthalmology, Shandong First Medical University, Shandong, China
| | - Wenzhi Ding
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Shandong, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong, China; School of Ophthalmology, Shandong First Medical University, Shandong, China
| | - Rongyuan Ji
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Shandong, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong, China; School of Ophthalmology, Shandong First Medical University, Shandong, China
| | - Yuyin Tian
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Shandong, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong, China; School of Ophthalmology, Shandong First Medical University, Shandong, China
| | - Chenpei Zhao
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Shandong, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong, China; School of Ophthalmology, Shandong First Medical University, Shandong, China
| | - Honglei Li
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Shandong, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong, China; School of Ophthalmology, Shandong First Medical University, Shandong, China
| | - Mengjun Jiao
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Shandong, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong, China; School of Ophthalmology, Shandong First Medical University, Shandong, China
| | - Zhen Guo
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Shandong, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong, China; School of Ophthalmology, Shandong First Medical University, Shandong, China
| | - Lin Leng
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Shandong, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong, China; School of Ophthalmology, Shandong First Medical University, Shandong, China.
| |
Collapse
|
9
|
Shokrollahzadeh F, Hashemi H, Yekta A, Ostadimoghaddam H, Khabazkhoob M. Corneal Biomechanical Parameters after 60-Year-Old. J Curr Ophthalmol 2022; 34:284-289. [PMID: 36644461 PMCID: PMC9832466 DOI: 10.4103/joco.joco_201_21] [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: 06/23/2021] [Revised: 01/08/2022] [Accepted: 01/12/2022] [Indexed: 12/09/2022] Open
Abstract
Purpose To determine the distribution of corneal biomechanical parameters in an elderly population. Methods This cross-sectional study was conducted in subjects above 60 years living in Tehran. The participants were selected using multi-stage cluster sampling. Corneal biomechanical parameters were measured in a randomly selected subsample of this population using the Reichert Ocular Response Analyzer (Reichert Ophthalmic Instruments, Inc., Buffalo, NY, USA). Results Of 470 subjects, the data of 420 participants aged over 60 years were analyzed (mean age: 69.3 ± 6.5 years and range: 61-88 years), 363 (86.4%) of whom were male. The mean and standard deviation of corneal hysteresis (CH) and corneal resistance factor (CRF) were 8.37 ± 1.55 mmHg (95% confidence interval [CI]: 8.02-8.72) and 9.06 ± 1.70 mmHg (95% CI: 8.69-9.44), respectively. The mean CH was 8.27 ± 1.54 mmHg in men and 9.25 ± 1.28 mmHg in women, and the mean CRF was 9.00 ± 1.71 mmHg in men and 9.63 ± 1.37 mmHg in women. According to the results of multiple linear logistic regression analysis, CH had a significant association with younger age (β = -0.05, P = 0.032), female sex (β = 1.83, P < 0.001), reduced maximum keratometry (β = -0.22, P = 0.06), and increased anterior chamber volume (β = 0.01, P = 0.007). CRF had a significant correlation with a younger age (β = -0.06, P = 0.02), female sex (β = 1.01, P = 0.05), central corneal thickness (β = 0.02, P < 0.001), and reduced maximum keratometry (β = -0.39, P = 0.010). Conclusion The mean CH and CRF values were low in this sample of the Iranian population aged over 60 years indicating the weaker elasticity of the corneal connective tissue.
Collapse
Affiliation(s)
- Fereshteh Shokrollahzadeh
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Abbasali Yekta
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran,Address for correspondence: Abbasali Yekta, Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran. E-mail:
| | - Hadi Ostadimoghaddam
- Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehdi Khabazkhoob
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
10
|
Strzalkowska A, Pirlich N, Stingl JV, Schuster AK, Rezapour J, Wagner FM, Buse J, Hoffmann EM. Intraocular Pressure Measurement in Childhood Glaucoma under Standardized General Anaesthesia: The Prospective EyeBIS Study. J Clin Med 2022; 11:2846. [PMID: 35628971 PMCID: PMC9144815 DOI: 10.3390/jcm11102846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 05/08/2022] [Accepted: 05/10/2022] [Indexed: 02/01/2023] Open
Abstract
Objective: We aimed to compare intraocular pressure (IOP) measurements using iCare® PRO rebound tonometry (iCare) and Perkins applanation tonometry (Perkins) in childhood glaucoma subjects and healthy children and the influence of anaesthesia depth, age and corneal thickness. Material: Prospective clinical, case-control study of children who underwent an ophthalmologic examination under general anaesthesia according to our protocol. Children were 45.45 ± 29.76 months old (mean ± SD (standard deviation)). Of all children, 54.05% were female. IOP was taken three times (T1−T3), according to duration and the depth of anaesthesia. The order of measurement alternated, starting with iCare. Agreement between the device measurements was evaluated using Bland−Altman analysis. Results: 53 glaucoma subjects and 22 healthy controls. Glaucoma subjects: IOP measured with iCare was at T1: 27.2 (18.1−33.8), T2: 21.6 (14.8−30.6), T3: 20.4 mmHg (14.5−27.0) and Perkins 17.5 (12.0−23.0), 15.5 (10.5−20.5), 15.0 mmHg (10.5−21.0) (median ± IQR (interquartile range)). Healthy controls: IOP with iCare: T1: 13.3 (11.1−17.0), T2: 10.6 (8.1−12.4), T3: 9.6 mmHg (7.7−11.7) and Perkins 10.3 (8.0−12.0), 7.0 (5.5−10.5), 7.0 mmHg (5.5−8.5) (median ± IQR). The median IOP was statistically significantly higher with iCare than with Perkins (p < 0.001) in both groups. The mean difference (iCare and Perkins) was 6.0 ± 6.1 mmHg for T1−T3, 7.3 at T1, 6.0 at T2, 4.9 mmHg at T3. Conclusion: The IOP was the highest in glaucoma subjects and healthy children at T1 (under sedation), independently of the measurement method. iCare always leads to higher IOP compared to Perkins in glaucoma and healthy subjects, regardless of the duration of anesthesia.
Collapse
Affiliation(s)
- Alicja Strzalkowska
- Department of Ophthalmology, University Medical Centre of the Johannes Gutenberg, University Mainz, 55131 Mainz, Germany; (A.S.); (J.V.S.); (A.K.S.); (J.R.); (F.M.W.); (J.B.)
| | - Nina Pirlich
- Department of Anaesthesiology, University Medical Centre of the Johannes Gutenberg, University Mainz, 55131 Mainz, Germany;
| | - Julia V. Stingl
- Department of Ophthalmology, University Medical Centre of the Johannes Gutenberg, University Mainz, 55131 Mainz, Germany; (A.S.); (J.V.S.); (A.K.S.); (J.R.); (F.M.W.); (J.B.)
| | - Alexander K. Schuster
- Department of Ophthalmology, University Medical Centre of the Johannes Gutenberg, University Mainz, 55131 Mainz, Germany; (A.S.); (J.V.S.); (A.K.S.); (J.R.); (F.M.W.); (J.B.)
| | - Jasmin Rezapour
- Department of Ophthalmology, University Medical Centre of the Johannes Gutenberg, University Mainz, 55131 Mainz, Germany; (A.S.); (J.V.S.); (A.K.S.); (J.R.); (F.M.W.); (J.B.)
| | - Felix M. Wagner
- Department of Ophthalmology, University Medical Centre of the Johannes Gutenberg, University Mainz, 55131 Mainz, Germany; (A.S.); (J.V.S.); (A.K.S.); (J.R.); (F.M.W.); (J.B.)
| | - Justus Buse
- Department of Ophthalmology, University Medical Centre of the Johannes Gutenberg, University Mainz, 55131 Mainz, Germany; (A.S.); (J.V.S.); (A.K.S.); (J.R.); (F.M.W.); (J.B.)
| | - Esther M. Hoffmann
- Department of Ophthalmology, University Medical Centre of the Johannes Gutenberg, University Mainz, 55131 Mainz, Germany; (A.S.); (J.V.S.); (A.K.S.); (J.R.); (F.M.W.); (J.B.)
| |
Collapse
|
11
|
Rahimi M, Panahi Bazaz M, Sharifipour F, Hajizadeh M, Cheraghian B. Corneal biomechanical changes after Descemet stripping automated endothelial keratoplasty, penetrating keratoplasty, and phacoemulsification. Int Ophthalmol 2022; 42:3183-3190. [PMID: 35552955 DOI: 10.1007/s10792-022-02318-1] [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: 10/20/2021] [Accepted: 04/18/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate corneal biomechanical changes after Descemet stripping automated endothelial keratoplasty (DSAEK), penetrating keratoplasty (PK), and phacoemulsification (PE). METHODS This prospective study included 138 eyes which underwent PK (26 eyes), DSAEK (26 eyes), PE (57 eyes), and 29 normal eyes. Intraocular pressure (IOP) was measured by Goldmann applanation tonometer (GAT), and central corneal thickness (CCT) and axial length by ultrasound. The ocular response analyzer was used to measure corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-related IOP (IOPg), and cornea-compensated IOP (IOPcc) preoperatively and 1, 3, and 6 months postoperatively. RESULTS At baseline, PK group had the lowest CH and CRF. There was a significant increase in CH and CRF to normal values in PK (P = 0.015 and 0.006) and PE (P = 0.005 and 0.0001) groups over the study period. At 6 months, CH and CRF increased and reached normal values in the PK group; increased to a lower level than normal in the DSAEK group; and, after an initial reduction, increased to normal values in the PE group. At 6 months, DSAEK group had the lowest CH and CRF. There was a significant positive correlation between CRF and GAT (r = 0.281, P = 0.009), IOPg and GAT (r = 0.335, P = 0.001), and IOPcc and GAT (r = 0.282, P = 0.001). CH was negatively correlated with age (r = - 0.189, P = 0.04). CONCLUSION Corneal biomechanical factors increase after DSAEK and PK. At post-operative month six, they reach normal values in PK group, but are lower than normal in DSAEK group.
Collapse
Affiliation(s)
- Mahnaz Rahimi
- Department of Ophthalmology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Farideh Sharifipour
- Department of Ophthalmology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science and Department of Ophthalmology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science and Department of Ophthalmology, Labbafinejad Medical Center, Boostan 9th st., Pasdaran Ave, Tehran, 1666663111, Iran.
| | - Maryam Hajizadeh
- Department of Ophthalmology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bahman Cheraghian
- Department of Biostatics and Epidemiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| |
Collapse
|
12
|
Díaz-Barreda MD, Sánchez-Marín I, Boned-Murillo A, Pérez-Navarro I, Martínez J, Pardina-Claver E, Pérez D, Ascaso FJ, Ibáñez J. Modification of Corneal Biomechanics and Intraocular Pressure Following Non-Penetrating Deep Sclerectomy. J Clin Med 2022; 11:jcm11051216. [PMID: 35268307 PMCID: PMC8911357 DOI: 10.3390/jcm11051216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/16/2022] [Accepted: 02/21/2022] [Indexed: 12/18/2022] Open
Abstract
Changes in the cornea can influence outcomes in patients with primary open-angle glaucoma (POAG). We aimed to evaluate the relevance of changes in corneal biomechanics and intraocular pressure (IOP) in patients undergoing non-penetrating deep sclerectomy (NPDS) with the Esnoper V2000 implant® (AJL Ophthalmic S.A., Gasteiz, Spain). We included 42 eyes of 42 patients with POAG scheduled for NPDS with the Esnoper V2000 implant. Biomechanical properties were measured by Ocular Response Analyzer® G3 (ORA; Reichert Inc., Depew, NY, USA). Corneal hysteresis (CH), corneal resistance factor (CRF), corneal compensated IOP (IOPcc), and Goldmann-correlated IOP (IOPg) were measured the day before surgery and on day 1, 7, and 30 and 2 and 3 months after surgery. CH initially increased, fell below the presurgical value at 30 days after the surgery, and increased again at 2 and 3 months. CRF, IOPcc, and IOPg decreased on the first day after surgery, then followed a trend of increasing but stayed below pre-surgery levels. All values reached statistical significance. While observed changes in corneal biomechanics after NPDS and Esnoper V2000 implant were significant, more studies are needed if we are to understand their influence on corneal biomechanics and their clinical relevance in POAG.
Collapse
Affiliation(s)
- María Dolores Díaz-Barreda
- Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain; (I.S.-M.); (A.B.-M.); (I.P.-N.); (J.M.); (E.P.-C.); (D.P.); (J.I.)
- Department of Surgery, School of Medicine, University of Zaragoza, 50009 Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain
- Correspondence: (M.D.D.-B.); (F.J.A.); Tel.: +34-629-863-827 (M.D.D.-B.); +34-686-574-389 (F.J.A.)
| | - Ignacio Sánchez-Marín
- Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain; (I.S.-M.); (A.B.-M.); (I.P.-N.); (J.M.); (E.P.-C.); (D.P.); (J.I.)
| | - Ana Boned-Murillo
- Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain; (I.S.-M.); (A.B.-M.); (I.P.-N.); (J.M.); (E.P.-C.); (D.P.); (J.I.)
- Department of Surgery, School of Medicine, University of Zaragoza, 50009 Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain
| | - Itziar Pérez-Navarro
- Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain; (I.S.-M.); (A.B.-M.); (I.P.-N.); (J.M.); (E.P.-C.); (D.P.); (J.I.)
| | - Juana Martínez
- Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain; (I.S.-M.); (A.B.-M.); (I.P.-N.); (J.M.); (E.P.-C.); (D.P.); (J.I.)
| | - Elena Pardina-Claver
- Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain; (I.S.-M.); (A.B.-M.); (I.P.-N.); (J.M.); (E.P.-C.); (D.P.); (J.I.)
| | - Diana Pérez
- Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain; (I.S.-M.); (A.B.-M.); (I.P.-N.); (J.M.); (E.P.-C.); (D.P.); (J.I.)
- Department of Surgery, School of Medicine, University of Zaragoza, 50009 Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain
| | - Francisco Javier Ascaso
- Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain; (I.S.-M.); (A.B.-M.); (I.P.-N.); (J.M.); (E.P.-C.); (D.P.); (J.I.)
- Department of Surgery, School of Medicine, University of Zaragoza, 50009 Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain
- Correspondence: (M.D.D.-B.); (F.J.A.); Tel.: +34-629-863-827 (M.D.D.-B.); +34-686-574-389 (F.J.A.)
| | - Juan Ibáñez
- Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain; (I.S.-M.); (A.B.-M.); (I.P.-N.); (J.M.); (E.P.-C.); (D.P.); (J.I.)
- Department of Surgery, School of Medicine, University of Zaragoza, 50009 Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain
| |
Collapse
|
13
|
Iglesias M, Kudsieh B, Laiseca A, Santos C, Nadal J, Barraquer R, Casaroli-Marano RP. Intraocular pressure after myopic laser refractive surgery measured with a new Goldmann convex prism: correlations with GAT and ORA. BMC Ophthalmol 2022; 22:79. [PMID: 35168601 PMCID: PMC8849021 DOI: 10.1186/s12886-022-02309-x] [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: 11/22/2021] [Accepted: 02/09/2022] [Indexed: 12/04/2022] Open
Abstract
Background The purpose of this study is to describe measurements using a newly developed modified Goldmann convex tonometer (CT) 1 year after myopic laser refractive surgery. Intraocular pressure (IOP) measurements were compared with IOP values obtained by Goldmann applanation tonometer (GAT), and Ocular Response Analyzer (ORA). Methods Prospective double-masked study performed on thirty eyes of thirty patients that underwent laser in situ keratomileusis (LASIK; n = 19) or photorefractive keratectomy (PRK; n = 11). IOP was measured before and 3 and 12 months after surgery. Intraclass correlation coefficient (ICC) and Bland-Altman plot were calculated to assess the agreement between GAT, CT, IOPg (Goldmann-correlated IOP) and IOPcc (corneal-compensated IOP) from ORA. Results Twelve months after LASIK, IOP measured with CT showed the best correlation with IOP measured with GAT before surgery (GATpre) (ICC = 0.886, 95% CI: 0.703–0.956) (15.60 ± 3.27 vs 15.80 ± 3.22; p < 0.000). However, a moderate correlation was found for IOP measured with IOPcc and CT 12 months after LASIK (ICC = 0.568, 95% CI: − 0.185 – 0.843) (15.80 ± 3.22 vs 12.87 ± 2.77; p < 0.004). Twelve months after PRK, CT showed a weak correlation (ICC = − 0.266, 95% CI: − 3.896 – 0.663), compared to GATpre (17.30 ± 3.47 vs 16.01 ± 1.45; p < 0.642), as well as poor correlation (ICC = 0.256, 95% CI: − 0.332 – 0.719) with IOPcc (17.30 ± 3.47 vs 13.38 ± 1.65; p < 0.182). Conclusions Twelve months after LASIK, IOP measured with CT strongly correlated with GAT before surgery and could therefore provide an alternative method for measuring IOP after this surgery. More studies regarding this new convex prism are needed to assess its accuracy.
Collapse
Affiliation(s)
- María Iglesias
- Instituto Universitario Barraquer, Barraquer Ophthalmology Centre, Laforja 88, 08012, Barcelona, Spain.
| | - Bachar Kudsieh
- Department of Ophthalmology, Hospital Universitario Puerta De Hierro, 28222, Madrid, Spain
| | - Andrea Laiseca
- Instituto Universitario Barraquer, Barraquer Ophthalmology Centre, Laforja 88, 08012, Barcelona, Spain
| | - Cristina Santos
- Unitat Antropologia Biològica, Department Biologia Animal, Biologia Vegetal i Ecologia, Universitat Autònoma de Barcelona (UAB), 08193, Barcelona, Spain
| | - Jeroni Nadal
- Instituto Universitario Barraquer, Barraquer Ophthalmology Centre, Laforja 88, 08012, Barcelona, Spain
| | - Rafael Barraquer
- Instituto Universitario Barraquer, Barraquer Ophthalmology Centre, Laforja 88, 08012, Barcelona, Spain.,International University of Catalunya (UIC), 08017, Barcelona, Spain
| | - Ricardo P Casaroli-Marano
- Department of Surgery, School of Medicine and Hospital Clinic de Barcelona, University of Barcelona (UB), 08036, Barcelona, Spain
| |
Collapse
|
14
|
Merola RV, Cronemberger S, Veloso AW, Diniz-Filho A. Twenty-four hours intraocular pressure in keratoconic eyes assessed by applanation tonometry and Tono-Pen AVIA. Int J Ophthalmol 2022; 15:52-58. [PMID: 35047356 DOI: 10.18240/ijo.2022.01.08] [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: 03/27/2021] [Accepted: 07/27/2021] [Indexed: 11/23/2022] Open
Abstract
AIM To assess intraocular pressure (IOP) during the daily curve of intraocular pressure (DCPo) in keratoconic eyes and compare Goldmann applanation tonometer (GAT), without and with astigmatism correction (nGAT and cGAT) and Tono-Pen AVIA (TPA) assessment methods. METHODS Thirty-nine keratoconic eyes of 24 patients were assessed. DCPo was evaluated with five IOP measurements; four were performed with a GAT (nGAT and cGAT), and a Tono-Pen AVIA (TPA) at various times throughout the day. RESULTS Mean IOP DCPo values (mm Hg) were: nGAT, 9.9±2.6; cGAT, 11.3±2.6; TPA 12.3±3.1. Mean IOP DCPo differences (mm Hg) and Spearman's correlation coefficients were as follows: cGATc-nGAT, 1.32±1.31, r s=0.879 (P<0.01); cGAT-TPA, -1.02±2.08, r s=0.723 (P<0.01); and nGAT-TPA, -2.35±2.23, r s=0.730 (P<0.01). Bland-Altman analysis for agreement between cGAT-TPA and nGAT-TPA mean IOP DCPo measurements revealed a mean difference of 1.02 (95%CI, 0.35-1.70) and 2.35 (95%CI, 1.62-3.07) mm Hg, respectively. Regression analysis yielded the following equation: TPA IOP=5.49+0.775×cGAT-0.015×ACD-0.299×corneal astig matism, which allowed us to infer TPA IOP values from other parameters. CONCLUSION In keratoconic eyes, IOP peaks of DCPo measurements are identified at 6 a.m., independent of the tonometer. The mean DCPo values are: TPA>cGAT>nGAT. IOP TPA measures are predictive of cGAT values, adjusted according to anterior chamber depth and corneal astigmatism.
Collapse
Affiliation(s)
- Rafael Vidal Merola
- Nassim Calixto Glaucoma Service of São Geraldo Eye Hospital, Clinic Hospital, Federal University of Minas Gerais-Belo Horizonte, Belo Horizonte 30130-100, State of Minas Gerais, Brazil
| | - Sebastião Cronemberger
- Nassim Calixto Glaucoma Service of São Geraldo Eye Hospital, Clinic Hospital, Federal University of Minas Gerais-Belo Horizonte, Belo Horizonte 30130-100, State of Minas Gerais, Brazil
| | - Artur William Veloso
- Nassim Calixto Glaucoma Service of São Geraldo Eye Hospital, Clinic Hospital, Federal University of Minas Gerais-Belo Horizonte, Belo Horizonte 30130-100, State of Minas Gerais, Brazil
| | - Alberto Diniz-Filho
- Nassim Calixto Glaucoma Service of São Geraldo Eye Hospital, Clinic Hospital, Federal University of Minas Gerais-Belo Horizonte, Belo Horizonte 30130-100, State of Minas Gerais, Brazil
| |
Collapse
|
15
|
Choi YJ, Lee EJ. The Effects of Anti-glaucoma Eyedrops on Corneal Hysteresis in Patients with Open-angle Glaucoma and Glaucoma-suspect. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2022. [DOI: 10.3341/jkos.2022.63.1.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: We explored the effects of topical anti-glaucoma medications on the corneal biochemical properties of patients with open-angle glaucoma (OAG) and glaucoma suspect (GS patients).Methods: We retrospectively reviewed data on 115 OAG and 98 GS patients (225 and 128 eyes respectively). Corneal hysteresis (CH) was measured using an ocular response analyzer. Factors influencing CH were determined using a generalized estimation equation.Results: The mean CH was lower in OAG than GS patients (p < 0.001). A lower cornea-compensated intraocular pressure, concomitant use of a beta-adrenergic blocker and an alpha2-adrenergic agonist, a higher visual field mean deviation, and a larger central corneal thickness were associated with a higher CH in the OAG group.Conclusions: Concomitant use of a topical beta-adrenergic blocker and an alpha2-adrenergic agonist was associated with a higher CH.
Collapse
|
16
|
Boszczyk A, Kasprzak H, Przeździecka-Dołyk J. Novel Method of Measuring Corneal Viscoelasticity Using the Corvis ST Tonometer. J Clin Med 2022; 11:jcm11010261. [PMID: 35012002 PMCID: PMC8745689 DOI: 10.3390/jcm11010261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 12/21/2021] [Accepted: 12/30/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The process of rapid propagation of the corneal deformation in air puff tonometer depends not only on intraocular pressure, but also on the biomechanical properties of the cornea and anterior eye. One of the biomechanical properties of the cornea is viscoelasticity, which is the most visible in its high-speed deformations. It seems reasonable to link the corneal viscoelasticity parameter to two moments of the highest speed of corneal deformations, when the cornea buckles. The aim of this work is to present a method of determining the time and place of occurrence of corneal buckling, examine spatial and temporal dependencies between two corneal applanations and bucklings in the Corvis ST tonometer, and correlate these dependencies with corneal viscoelastic properties. METHODS Images of the horizontal cross section of the Corvis ST deformed cornea from the air puff tonometer Corvis ST were used. 14 volunteers participated in the study, each of them had one eye measured eight times. Mutual changes in the profile slopes of the deformed corneas were numerically determined. They describe pure corneal deformation, eliminating the influence of rotation, and displacement of the entire eyeball. For each point in the central area of the corneal profile, the maximum velocities of mutual slope changes accompanying the applanations were estimated. The times of their occurrence were adopted as buckling times. RESULTS The propagation of buckling along the corneal profile is presented, as well as the repeatability and mutual correlations between the buckling parameters and intraocular pressure. Based on the relationship between them, a new parameter describing corneal hysteresis: Corvis Viscoelasticity (CVE) is introduced. It is characterized by high repeatability: ICC = 0.82 (0.69-0.93 CI) and low and insignificant correlation with intraocular pressure: r = 0.25 (p-value = 0.38). CONCLUSION The results show for the first time how to measure the corneal buckling and viscoelastic effects with Corvis ST. CVE is a new proposed biomechanical parameter related to the viscoelastic properties of the cornea, which has high repeatability for the examined subject. The distribution of its values is planned to be tested on different groups of patients in order to investigate its clinical applicability.
Collapse
Affiliation(s)
- Agnieszka Boszczyk
- Department of Optics and Photonics, Wroclaw University of Science and Technology, 50-370 Wrocław, Poland; (H.K.); (J.P.-D.)
- Correspondence:
| | - Henryk Kasprzak
- Department of Optics and Photonics, Wroclaw University of Science and Technology, 50-370 Wrocław, Poland; (H.K.); (J.P.-D.)
| | - Joanna Przeździecka-Dołyk
- Department of Optics and Photonics, Wroclaw University of Science and Technology, 50-370 Wrocław, Poland; (H.K.); (J.P.-D.)
- Department of Ophthalmology, Wroclaw Medical University, 50-556 Wrocław, Poland
| |
Collapse
|
17
|
Corneal-compensated intraocular pressure, Goldmann-correlated intraocular pressure and their associated factors in the geriatric population, a population-based study. Int Ophthalmol 2022; 42:2085-2092. [PMID: 34981293 DOI: 10.1007/s10792-021-02207-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 12/24/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To determine the distribution of corneal-compensated intraocular pressure (IOPcc), Goldmann-correlated intraocular pressure (IOPg) and their associated factors in a geriatric population. METHODS The present cross-sectional study was performed in individuals above 60 years of age in Tehran, the capital of Iran. The sampling was performed using multi-stage random cluster sampling method. All participants underwent preliminary ocular examinations, and then imaging by Pentacam HR and IOL master 500. Measurement of IOPg, IOPcc, and corneal biomechanical indices including corneal hysteresis (CH) and corneal resistant factor (CRF) was performed in a random sub-sample using ocular response analyzer (ORA). RESULTS The mean IOPg and IOPcc were 16.76 ± 4.71 mmHg and 19.05 ± 4.67 mmHg, respectively. There were no statistically significant differences in both IOPg (p = 0.891) and IOPcc (p = 0.248) between males and females. Based on the multiple linear regression models, both IOPg and IOPcc showed a statistically significant direct relationship with CRF (P < 0.001) and a significant inverse relationship with CH (P < 0.001 for IOPg and IOPcc), anterior chamber angle (ACA) (p = 0.006 for IOPg and p = 0.017 for IOPcc), and spherical equivalent refractive error (p = 0.032 for IOPg and p = 0.046 for IOPcc). CONCLUSION Mean IOPg and IOPcc in the present study were higher compared to most previous studies. Corneal biomechanical indices including CH and CRF, refractive error and anterior chamber angle were independent associated factors of IOPg and IOPcc in the present study. There was no significant relationship between ORA-derived IOP values and CCT.
Collapse
|
18
|
Lopes BT, Bao F, Wang J, Liu X, Wang L, Abass A, Eliasy A, Elsheikh A. Review of in-vivo characterisation of corneal biomechanics. MEDICINE IN NOVEL TECHNOLOGY AND DEVICES 2021. [DOI: 10.1016/j.medntd.2021.100073] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
|
19
|
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.
Collapse
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
| |
Collapse
|
20
|
Corneal Biomechanical Changes Caused by Acute Elevation of IOP in Eyes with and without Glaucoma. Optom Vis Sci 2021; 98:367-373. [PMID: 33828042 DOI: 10.1097/opx.0000000000001668] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE Although corneal biomechanical parameters are well linked with glaucoma, their clinical utility has not yet been fully elucidated. This study was designed to provide unique evidence about the dynamic nature of corneal biomechanical parameters and their potential prognostic ability for glaucoma. PURPOSE This study aimed to evaluate the effect of acute intraocular pressure (IOP) elevation on corneal hysteresis (CH) and corneal resistance factor (CRF) and the associations of these biomechanical parameters with glaucomatous disease. METHODS Subjects participating in a prospective, longitudinal glaucoma research study had CH and CRF measured before and during ophthalmodynamometry during visits in the years 2011 to 2012. All participants were diagnosed with primary open-angle glaucoma, ocular hypertension, glaucoma suspect, or normal eyes and had a minimum of 3 years of study participation with at least five reliable visual field (VF) tests. Changes in CH, CRF, and IOP induced by ophthalmodynamometry were compared between diagnostic groups and evaluated for relationships with existing and future glaucomatous VF loss. RESULTS In 248 eyes of 248 subjects followed up for 7.7 ± 2.3 years, ophthalmodynamometry induced a mean IOP increase from 15.1 to 29.9 mmHg, causing a mean 34 ± 28% increase in CRF and 21 ± 25% decrease in CH. Magnitude of CH change did not differ between diagnostic groups or between eyes that did (n = 20) and did not (n = 95) develop new VF loss during the study period, nor was it related to rate of future VF progression. CONCLUSIONS Ophthalmodynamometry-induced IOP elevation resulted in significant acute changes in CH and CRF in this study; this suggests accounting for IOP may be important in clinical interpretation of these parameters. However, because the degree of CH change was not related to glaucoma or its progression, acute changes in CH and CRF do not seem to have a prognostic value for glaucoma.
Collapse
|
21
|
Corneal Biomechanical Parameters and Central Corneal Thickness in Glaucoma Patients, Glaucoma Suspects, and a Healthy Population. J Clin Med 2021; 10:jcm10122637. [PMID: 34203884 PMCID: PMC8232810 DOI: 10.3390/jcm10122637] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/01/2021] [Accepted: 06/10/2021] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To evaluate and compare corneal hysteresis (CH), corneal resistance factor (CRF), and central corneal thickness (CCT), measurements were taken between a healthy population (controls), patients diagnosed with glaucoma (DG), and glaucoma suspect patients due to ocular hypertension (OHT), family history of glaucoma (FHG), or glaucoma-like optic discs (GLD). Additionally, Goldmann-correlated intraocular pressure (IOPg) and corneal-compensated IOP (IOPcc) were compared between the different groups of patients. METHODS In this prospective analytical-observational study, a total of 1065 patients (one eye of each) were recruited to undergo Ocular Response Analyzer (ORA) testing, ultrasound pachymetry, and clinical examination. Corneal biomechanical parameters (CH, CRF), CCT, IOPg, and IOPcc were measured in the control group (n = 574) and the other groups: DG (n = 147), FHG (n = 78), GLD (n = 90), and OHT (n = 176). We performed a variance analysis (ANOVA) for all the dependent variables according to the different diagnostic categories with multiple comparisons to identify the differences between the diagnostic categories, deeming p < 0.05 as statistically significant. RESULTS The mean CH in the DG group (9.69 mmHg) was significantly lower compared to controls (10.75 mmHg; mean difference 1.05, p < 0.001), FHG (10.70 mmHg; mean difference 1.00, p < 0.05), GLD (10.63 mmHg; mean difference 0.93, p < 0.05) and OHT (10.54 mmHg; mean difference 0.84, p < 0.05). No glaucoma suspects (FHG, GLD, OHT groups) presented significant differences between themselves and the control group (p = 1.00). No statistically significant differences were found in the mean CRF between DG (11.18 mmHg) and the control group (10.75 mmHg; mean difference 0.42, p = 0.40). The FHG and OHT groups showed significantly higher mean CRF values (12.32 and 12.41 mmHg, respectively) than the DG group (11.18 mmHg), with mean differences of 1.13 (p < 0.05) and 1.22 (p < 0.001), respectively. No statistically significant differences were found in CCT in the analysis between DG (562 μ) and the other groups (control = 556 μ, FHG = 576 μ, GLD = 569 μ, OHT = 570 μ). The means of IOPg and IOPcc values were higher in the DG patient and suspect groups than in the control group, with statistically significant differences in all groups (p < 0.001). CONCLUSION This study presents corneal biomechanical values (CH, CRF), CCT, IOPg, and IOPcc for diagnosed glaucoma patients, three suspected glaucoma groups, and a healthy population, using the ORA. Mean CH values were markedly lower in the DG group (diagnosed with glaucoma damage) compared to the other groups. No significant difference was found in CCT between the DG and control groups. Unexpectedly, CRF showed higher values in all groups than in the control group, but the difference was only statistically significant in the suspect groups (FHG, GLD, and OHT), not in the DG group.
Collapse
|
22
|
Aoki S, Miki A, Omoto T, Fujino Y, Matsuura M, Murata H, Asaoka R. Biomechanical Glaucoma Factor and Corneal Hysteresis in Treated Primary Open-Angle Glaucoma and Their Associations With Visual Field Progression. Invest Ophthalmol Vis Sci 2021; 62:4. [PMID: 34086046 PMCID: PMC8185393 DOI: 10.1167/iovs.62.7.4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate the relationship between biomechanical glaucoma factor (BGF) measured with Corvis ST and glaucomatous visual field (VF) progression, compared to corneal hysteresis (CH) measured with ocular response analyzer using a longitudinal dataset of primary open-angle glaucoma (POAG). The discriminative powers of BGF and CH were also compared using a cross-sectional dataset. Methods The longitudinal dataset included 166 POAG eyes. The rate of VF change during the follow-up period was evaluated using the mean of 52 pointwise total deviations in the Humphrey 24-2 field test. Variables associated with the VF progression rate were identified from BGF, CH, age, baseline VF severity, and intraocular pressure during the VF follow-up period by identifying the optimal model. The cross-sectional dataset included 68 POAG eyes and 68 healthy eyes. Using this dataset, the area under the curve (AUC) values of the receiver-operating curve were compared between CH and BGF. Results The optimal multivariate linear mixed model to describe the VF rate included age and CH, but not BGF. Between POAG and healthy eyes, CH was statistically different (P < 0.001), although this was not the case with BGF. The AUC values were 0.61 and 0.71 for BGF and CH, respectively (P = 0.027). Conclusions CH, but not BGF, was associated with VF progression in POAG patients under treatment. BGF was not useful to discriminate POAG between treated and normal eyes.
Collapse
Affiliation(s)
- Shuichiro Aoki
- Department of Ophthalmology, Sapporo City General Hospital, Sapporo, Japan.,Department of Ophthalmology, the University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Atsuya Miki
- Department of Ophthalmology and Visual Science, Osaka University, Osaka, Japan.,Department of Innovative Visual Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takashi Omoto
- Department of Ophthalmology, the University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Yuri Fujino
- Department of Ophthalmology, the University of Tokyo Graduate School of Medicine, Tokyo, Japan.,Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | - Masato Matsuura
- Department of Ophthalmology, the University of Tokyo Graduate School of Medicine, Tokyo, Japan.,Orthopic and Visual Science, Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan.,Department of Ophthalmology, Saneikai Tsukazaki Hospital, Hyogo, Japan
| | - Hiroshi Murata
- Department of Ophthalmology, the University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Ryo Asaoka
- Department of Ophthalmology, the University of Tokyo Graduate School of Medicine, Tokyo, Japan.,Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.,Nanovision Research Division, Research Institute of Electronics, Shizuoka University, Shizuoka, Japan.,The Graduate School for the Creation of New Photonics Industries, Shizuoka, Japan
| |
Collapse
|
23
|
Franco S, Lira M. Biomechanical properties of the cornea measured by the Ocular Response Analyzer and their association with intraocular pressure and the central corneal curvature. Clin Exp Optom 2021; 92:469-75. [DOI: 10.1111/j.1444-0938.2009.00414.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Sandra Franco
- Physics Department (Optometry), University of Minho, Portugal E‐mail:
| | - Madalena Lira
- Physics Department (Optometry), University of Minho, Portugal E‐mail:
| |
Collapse
|
24
|
Park HM, Choi J, Lee WJ, Uhm KB. Rate of central corneal thickness changes in primary angle closure eyes: long-term follow-up results. BMC Ophthalmol 2021; 21:145. [PMID: 33752630 PMCID: PMC7986557 DOI: 10.1186/s12886-021-01908-4] [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: 12/09/2020] [Accepted: 03/11/2021] [Indexed: 11/28/2022] Open
Abstract
Background Central corneal thickness (CCT) and its association with intraocular pressure, which is a pivotal parameter in glaucoma management, has previously been reported. In this study, we intended to investigate the long-term change of CCT in terms of rate in eyes with primary angle-closure (PAC). Additionally, we aimed to analyze events that could affect CCT. Methods In this retrospective study, 26 patients with PAC who had a follow-up period of more than 5 years were analyzed. The rate of CCT changes from baseline was evaluated from the serial CCT measurements over the average follow-up period. The pattern of CCT change rate according to modes of treatment and history of angle-closure attack was analyzed using the repeated linear mixed model analysis. Results A total of 52 eyes were enrolled. The CCT reduction rate of the entire study population was − 0.72 ± 0.22 μm/yr (P = 0.001) with statistical significance. The CCT thinning rate of the laser peripheral iridotomy (PI) group was − 0.53 ± 0.25 μm/yr (P = 0.034) and that of the surgical trabeculectomy group was − 1.32 ± 0.43 μm/yr (P = 0.002), and it was not statistically significant (P = 0.112). The rate of CCT thinning in patients with a history of acute angle-closure attack was − 0.81 ± 0.31 μm/yr (P = 0.009) and that in patients without an attack was − 0.63 ± 0.30 μm/yr (P = 0.001), and it was not statistically significant (P = 0.680). Baseline CCT appeared to be the only significant factor affecting the rate of CCT changes (P < 0.001). Conclusions We found a significant reduction in CCT over a long observation period in PAC eyes. We also found that the rates of CCT reduction were not affected by different treatment modalities or acute angle-closure attacks. The analysis of long-term CCT changes in conjunction with baseline CCT would also be helpful in the clinical evaluation of the PAC patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-021-01908-4.
Collapse
Affiliation(s)
- Hae Min Park
- Department of Ophthalmology, Hanyang University College of Medicine, 222-1, Wangsimni-ro Seongdong-gu, Seoul, 04763, South Korea.,Department of Ophthalmology, Hanyang University Seoul Hospital, 222-1, Wangsimni-ro Seongdong-gu, Seoul, 04763, South Korea
| | - Jiin Choi
- Office of Hospital Information, Seoul National University Hospital, Seoul, South Korea
| | - Won June Lee
- Department of Ophthalmology, Hanyang University College of Medicine, 222-1, Wangsimni-ro Seongdong-gu, Seoul, 04763, South Korea. .,Department of Ophthalmology, Hanyang University Seoul Hospital, 222-1, Wangsimni-ro Seongdong-gu, Seoul, 04763, South Korea.
| | - Ki Bang Uhm
- Department of Ophthalmology, Hanyang University College of Medicine, 222-1, Wangsimni-ro Seongdong-gu, Seoul, 04763, South Korea
| |
Collapse
|
25
|
Konstantinidis A, Panagiotopoulou EK, Panos GD, Sideroudi H, Mehmet A, Labiris G. The Effect of Antiglaucoma Procedures (Trabeculectomy vs. Ex-PRESS Glaucoma Drainage Implant) on the Corneal Biomechanical Properties. J Clin Med 2021; 10:jcm10040802. [PMID: 33671167 PMCID: PMC7922603 DOI: 10.3390/jcm10040802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 02/09/2021] [Accepted: 02/13/2021] [Indexed: 11/03/2022] Open
Abstract
The aim of this study is to investigate the effect of two antiglaucoma procedures, namely trabeculectomy and Ex-PRESS mini-shunt insertion on the biomechanical properties of the cornea. This is a prospective study. Thirty patients (30 eyes) were included in the study. Nineteen eyes had an Ex-PRESS shunt inserted (Group 1) and 11 had trabeculectomy (Group 2). The examination time points for both groups were one to three weeks preoperatively and at month 1, 6, and 12 postoperatively. Corneal biomechanical properties (corneal hysteresis (CH) corneal resistance factor (CRF)) were measured with the Ocular Response Analyzer (ORA). In group 1, CH was significantly increased at 6 and 12 months compared to baseline values. Corneal hysteresis was also higher at 1 month postoperatively, but this increase did not reach statistical significance. In group 2, the CH was significantly increased at all time points compared to the preoperative values. CRF decreased at all time points postoperatively compared to the preoperative values in both groups. The difference (preoperative values to postoperative values at all time points) of the CH and CRF between the two groups was also compared and no significant differences were detected between the two surgical techniques. Trabeculectomy and the EX-PRESS mini-shunt insertion significantly alter the corneal biomechanical properties as a result of the surgical trauma and the presence of the shunt in the corneal periphery. When compared between them, they affect the corneal biomechanical properties in a similar way.
Collapse
|
26
|
A Combined Biomechanical and Tomographic Model for Identifying Cases of Subclinical Keratoconus. Cornea 2021; 39:461-467. [PMID: 31738245 DOI: 10.1097/ico.0000000000002205] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To develop a combined biomechanical and tomographic model for identifying eyes with subclinical keratoconus (SKC) that are categorized as normal or borderline in the Pentacam Belin/Ambrósio Enhanced Ectasia Display. METHODS This case-control study comprised 62 eyes with SKC and randomly selected eyes of 186 age-matched healthy controls. SKC was defined as the presence of the following: 1) normal topography, topometric indices, and slit lamp; 2) normal or borderline Belin/Ambrósio Enhanced Ectasia Display D index, back and front elevation difference; and 3) keratoconus in the fellow eye. Stepwise logistic regression analysis was performed to identify the best variable combination for detecting SKC cases from Ocular Response Analyzer and Pentacam parameters. Receiver operating characteristic curve analysis was used to determine the predictive accuracy [area under the curve (AUC)] of the model. Based on the predictors in the final logistic regression model, a linear equation was derived using the discriminant function analysis. RESULTS The final model (AUC: 0.948, sensitivity: 87.1%, and specificity: 91.4%) chose corneal hysteresis (CH) and D index from a total of 63 candidate variables. The final model had a higher AUC compared with D (0.933, P = 0.053) and CH (0.80, P < 0.001) alone. According to the discriminant function analysis, a higher CH was required with increasing D index to classify an eye as normal. CONCLUSIONS The proposed combined model provided varying cutoffs for CH and D as a function of the other. The probability plot as a function of CH and D index may be used for identifying eyes with SKC.
Collapse
|
27
|
Biomechanical Properties in Different Types of Thin Corneas in Menoufia Population. J Ophthalmol 2021; 2021:6613143. [PMID: 33520298 PMCID: PMC7817240 DOI: 10.1155/2021/6613143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/20/2020] [Accepted: 12/10/2020] [Indexed: 12/03/2022] Open
Abstract
Background To evaluate and compare corneal hysteresis (CH) and corneal resistance factor (CRF) in normal thin (NT) healthy corneas with central corneal thickness (CCT) of 470–500 μm with matched thickness in keratoconus suspect (KCS) and keratoconus (KC) eyes. Methods A total of 103 eyes in three groups were included prospectively: NT, KCS, and KC groups based on clinical examination and Pentacam findings. Corneal hysteresis (CH) and corneal resistance factor (CRF) were measured using the ocular response analyzer (ORA). CCT, CH, and CRF were compared between the three groups and statistically analyzed by variance tests. Results The three groups consisted of 44 NT, 26 KCS, and 33 KC. The mean CH measured was 8.689 ± 1.775, 9.051 ± 1.1190, and 8.129 ± 0.8539 mmHg in NT, KCS, and KC eyes, respectively. The mean CRF was 8.441 ± 1.663, 8.337 ± 1.114, and 7.2422 ± 1.3110 mmHg in NT, KCS, and KC eyes, respectively. Within the range of central corneal thickness (470–500 μm), only mean CRF was statistically significantly different between the NT and KC (P < 0.05); there was no statistically significant difference between NT and KCS, nor was the mean CH between each group (P > 0.05). Conclusions CRF only can be helpful in differentiating KC from NT eyes; KCS could not be predicted with either corneal biomechanical metrics. There was no benefit from CH in differentiating between the three study groups.
Collapse
|
28
|
Sahebjada S, Chan E, Xie J, Snibson GR, Daniell M, Baird PN. Risk factors and association with severity of keratoconus: the Australian study of Keratoconus. Int Ophthalmol 2020; 41:891-899. [PMID: 33200389 DOI: 10.1007/s10792-020-01644-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/29/2020] [Indexed: 01/12/2023]
Abstract
SIGNIFICANCE Our results show that asthmatic patients tend to have more severe KC and thus close monitoring for disease progression would be advised, and appropriate treatment strategies may be actioned stabilise the condition that may reduce the need for future corneal transplantation. PURPOSE To explore a wide range of risk factors associated with the severity of keratoconus (KC). METHODS A cross-sectional study of KC patients was undertaken in Melbourne, Australia. A questionnaire addressing age, gender, educational background, ocular and medical history, smoking and alcohol consumption, and physical examination comprising anthropometric measurements was collected; eye examination was undertaken. The associations between a range of risk factors and the severity of KC were determined using univariate and multivariable linear regression analyses. RESULTS A total of 260 KC subjects were included in this study. Mean age of subject was 35.5 (SD = 14.8) years and the majority of the subjects were European 171 (68.2%). Initial univariate regression analysis identified the following risk factors at the p < 0.1 level with KC: higher body mass index, smoking cigarettes, diabetes, rheumatoid arthritis and asthma were associated with increased severity of KC, whereas eczema was associated with less severe KC. Following multivariable regression analysis, only asthma remained as a significant risk factor associated with 2.2 diopters (D) steeper average mean keratometry compared to KC subjects having no asthma [p = 0.03; β = 2.18; 95% confidence intervals: 1.22, 4.14]. CONCLUSION Our study describes the comprehensive assessment of all the known risk factors in a large KC cohort recruited in Australia. Our study has reported asthma as the only risk factor found to be significantly associated with the severity of KC. The results of this study allow us to better understand the aetiology of KC and such knowledge could be useful in instigate systemic management of patients to slow or prevent KC.
Collapse
Affiliation(s)
- Srujana Sahebjada
- Centre for Eye Research Australia, Melbourne, VIC, Australia. .,The University of Melbourne, Melbourne, VIC, Australia.
| | - Elsie Chan
- Centre for Eye Research Australia, Melbourne, VIC, Australia.,The University of Melbourne, Melbourne, VIC, Australia.,Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
| | - Jing Xie
- Centre for Eye Research Australia, Melbourne, VIC, Australia.,Monash University Melbourne, Melbourne, VIC, Australia
| | - Grant R Snibson
- Centre for Eye Research Australia, Melbourne, VIC, Australia.,The University of Melbourne, Melbourne, VIC, Australia.,Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
| | - Mark Daniell
- Centre for Eye Research Australia, Melbourne, VIC, Australia.,The University of Melbourne, Melbourne, VIC, Australia.,Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
| | - Paul N Baird
- The University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
29
|
|
30
|
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
|
31
|
Chang YS, Tai MC, Weng SF, Wang JJ, Tseng SH, Jan RL. Risk of Mitral Valve Prolapse in Patients with Keratoconus in Taiwan: A Population-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176049. [PMID: 32825286 PMCID: PMC7503773 DOI: 10.3390/ijerph17176049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 08/17/2020] [Accepted: 08/19/2020] [Indexed: 02/04/2023]
Abstract
This retrospective, nationwide, matched-cohort study included 4488 new-onset keratoconus (KCN) patients, ≥12 years old, recruited between 2004 and 2011 from the Taiwan National Health Insurance Research Database. The control group included 26,928 non-KCN patients selected from the Taiwan Longitudinal Health Insurance Database 2000. Information for each patient was collected and tracked from the index date until December 2013. The incidence rate of mitral valve prolapse (MVP) was 1.77 times (95% confidence interval (CI) = 1.09–2.88; p = 0.0206) higher in KCN patients ≥40 years old and 1.49 times (95% CI = 1.12–1.98; p = 0.0060) higher in female KCN patients than in controls. After using the Cox proportional hazard regression analysis to adjust for potential confounders, including hypertension, hyperlipidemia, and congestive heart failure, KCN maintained an independent risk factor, MVP being 1.77 times (adjusted hazard ratio (HR) = 1.77, 95% CI = 1.09–2.88) and 1.48 times (adjusted HR = 1.48, 95% CI = 1.11–1.97) more likely to develop in patients ≥40 years old and female patients in the study cohort, respectively. We found that KCN patients ≥40 years of age and female KCN patients have increased risks of MVP. Therefore, it is recommended that KCN patients should be alerted to MVP.
Collapse
Affiliation(s)
- Yuh-Shin Chang
- Department of Ophthalmology, Chi Mei Medical Center, Tainan 710, Taiwan; (Y.-S.C.); (S.-H.T.)
- Graduate Institute of Medical Sciences, College of Health Sciences, Chang Jung Christian University, Tainan 711, Taiwan
| | - Ming-Cheng Tai
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan;
| | - Shih-Feng Weng
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
| | - Jhi-Joung Wang
- Department of Medical Research, Chi Mei Medical Center, Tainan 710, Taiwan;
| | - Sung-Huei Tseng
- Department of Ophthalmology, Chi Mei Medical Center, Tainan 710, Taiwan; (Y.-S.C.); (S.-H.T.)
- Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Ren-Long Jan
- Graduate Institute of Medical Sciences, College of Health Sciences, Chang Jung Christian University, Tainan 711, Taiwan
- Department of Pediatrics, Chi Mei Medical Center, Liouying, Tainan 736, Taiwan
- Correspondence: ; Tel.: +886-6-622-6999 (ext. 77601); Fax: +886-6-283-2639 (ext. 77610)
| |
Collapse
|
32
|
Radcliffe N, Berdahl J, Ibach M, Schweitzer J, Levine J, McCafferty S. Improved Efficacy of Topical Latanoprost 0.005% Demonstrated by Corneal Biomechanical Correcting Modified Goldmann Prism. Clin Ophthalmol 2020; 14:2245-2253. [PMID: 32884231 PMCID: PMC7434574 DOI: 10.2147/opth.s264055] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 07/22/2020] [Indexed: 12/29/2022] Open
Abstract
PURPOSE To evaluate intraocular pressure (IOP) reduction measured by a Goldmann applanation tonometer (GAT) prism and a modified surface Goldmann (CATS) prism with the institution of a topical prostaglandin analog (PGA) or alternatively a topical beta blocker. DESIGN Prospective, open-label, randomized, controlled, and reference device comparison. METHODS Thirty-six (36) treatment naïve glaucoma patients (72 eyes) were randomized equally to treatment with latanoprost 0.005% or timolol maleate 0.5%. Each patient underwent IOP measurement with standard GAT and CATS prisms before and at 1, 3, and 6 months of treatment. Central corneal thickness (CCT) and corneal hysteresis (CH) were also measured. Medication response was defined as a 20% reduction in IOP from baseline. RESULTS The CATS prism demonstrated the IOP reduction with topical latanoprost at a mean of 1.9 mmHg lower than the IOP measured with GAT (p=0.01). The CATS and GAT prisms detected no difference in IOP reduction with timolol (p=0.23). The number of latanoprost treatment non-responders was reduced from 36.1% measured with GAT to 13.8% when measured with the CATS prism (p=0.005). Timolol indicated no difference in the treatment non-response rate at 22.2% (p=0.999). CH increased significantly with latanoprost treatment by an average of 0.55 mmHg (p=0.014) and remained unchanged with timolol at -0.014 mmHg (p=0.68). DISCUSSION IOP reduction and responder rates were increased when measured with a CATS prism in patients using latanoprost and not with timolol use. Latanoprost-induced alterations in corneal biomechanics may dampen the actual IOP reduction measured with a standard GAT prism. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov NCT04178863.
Collapse
|
33
|
Rahman N, O'Neill E, Irnaten M, Wallace D, O'Brien C. Corneal Stiffness and Collagen Cross-Linking Proteins in Glaucoma: Potential for Novel Therapeutic Strategy. J Ocul Pharmacol Ther 2020; 36:582-594. [PMID: 32667842 DOI: 10.1089/jop.2019.0118] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Biomechanical properties of the cornea have recently emerged as clinically useful in risk assessment of diagnosing glaucoma and predicting disease progression. Corneal hysteresis (CH) is a dynamic tool, which measures viscoelasticity of the cornea. It represents the overall deformability of the cornea, and reduces significantly with age. Low CH has also been associated with optic nerve damage and progression of visual field loss in glaucoma. The extracellular matrix (ECM) constituents of the cornea, trabecular meshwork (TM), sclera, and lamina cribrosa (LC) are similar, as they are predominantly made of fibrillar collagen. This suggests that biomechanical changes in the cornea may also reflect optic nerve compliance in glaucomatous optic neuropathy, and in the known increase of TM tissue stiffness in glaucoma. Increased collagen cross-linking contributes to tissue stiffening throughout the body, which is observed in normal aging and occurs at an accelerated rate in systemic conditions such as fibrotic and cardiovascular diseases, cancer, and glaucoma. We reviewed 3 ECM cross-linking proteins that may have a potential role in the disease process of increased tissue stiffness in glaucoma, including lysyl oxidase (LOX)/lysyl oxidase-like 1 (LOXL1), tissue transglutaminase (TG2), and advanced glycation end products. We also report elevated messenger RNA (mRNA) levels of LOX and TG2 in glaucoma LC cells to support our proposed theory that increased levels of cross-linking proteins in glaucoma play a role in LC tissue stiffness. We highlight areas of research that are needed to better understand the role of cross-linking in glaucoma pathogenesis, leading potentially to a novel therapeutic strategy.
Collapse
Affiliation(s)
- Najiha Rahman
- UCD Department of Ophthalmology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Evelyn O'Neill
- UCD Department of Ophthalmology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Mustapha Irnaten
- UCD Clinical Research, Catherine Mcauley Centre, Dublin, Ireland
| | - Deborah Wallace
- UCD Clinical Research, Catherine Mcauley Centre, Dublin, Ireland
| | - Colm O'Brien
- UCD Department of Ophthalmology, Mater Misericordiae University Hospital, Dublin, Ireland.,UCD Clinical Research, Catherine Mcauley Centre, Dublin, Ireland
| |
Collapse
|
34
|
Fu D, Zhao Y, Zhou X. Corneal Biomechanical Properties after Small Incision Lenticule Extraction Surgery on Thin Cornea. Curr Eye Res 2020; 46:168-173. [PMID: 32643431 DOI: 10.1080/02713683.2020.1792507] [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] [Indexed: 10/23/2022]
Abstract
PURPOSE To explore the biomechanical changes in thin corneas after the small incision lenticule extraction (SMILE) surgery. METHODS This prospective survey screened patients scheduled for the SMILE surgery from November 2017 to March 2018. Patients with thin corneas (central corneal thickness [CCT] ≤500 μm) and those with normal corneal thickness (CCT > 500 μm) were enrolled. Corneal biomechanics were examined by the ocular response analyser and Corvis ST, preoperatively and at 1 day, 3 weeks, and 3 months postoperatively. RESULTS Twenty-seven patients (46 eyes) with mean spherical equivalent of -5.1 ± 1.7 D were assigned to the thin cornea group, and 28 (45 eyes) cases with mean spherical equation of -5.3 ± 1.8 D were assigned to the control group. Safety and efficacy did not differ between the two age- and refraction-matched groups (safety index, 1.15 ± 0.14 vs 1.14 ± 0.17 [P = .7]; efficacy index, 1.11 ± 0.13 vs 1.16 ± 0.22 [P = .2]). All biomechanical parameters changed significantly after SMILE. The thin cornea group showed less decrease in the second applanation time (A2 Time), stiffness parameters at first applanation (SP-A1). Pooling data from two groups, lower CCT was correlated with less A2 Time change (r = 0.37, P < .01) and less SP-A1 change (r = -0.33, P < .01). Less bIOP change was correlated with higher residual stromal thickness index and thicker CCT (P = .003, R2 = 0.12). CONCLUSION Over a short-term observation period, less corneal biomechanic deterioration may have contributed to the safety of SMILE on thin cornea.
Collapse
Affiliation(s)
- Dan Fu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University , Shanghai, China.,NHC Key Laboratory of Myopic (Fudan University) , Shanghai, China.,Shanghai Research Centre of Ophthalmology and Optometry , Shanghai, China
| | - Yu Zhao
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University , Shanghai, China.,NHC Key Laboratory of Myopic (Fudan University) , Shanghai, China.,Shanghai Research Centre of Ophthalmology and Optometry , Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University , Shanghai, China.,NHC Key Laboratory of Myopic (Fudan University) , Shanghai, China.,Shanghai Research Centre of Ophthalmology and Optometry , Shanghai, China
| |
Collapse
|
35
|
Feizi S, Karjou Z, Abbasi H, Javadi MA, Azari AA. Characterization of In Vivo Biomechanical Properties in Macular Corneal Dystrophy. Am J Ophthalmol 2020; 215:8-13. [PMID: 32205123 DOI: 10.1016/j.ajo.2020.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 02/29/2020] [Accepted: 03/05/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE To measure and compare corneal biomechanics in patients with macular corneal dystrophy (MCD), versus those who underwent penetrating keratoplasty (PK) for MCD, versus normal subjects. DESIGN Cross-sectional study. METHODS This study enrolled 24 eyes with MCD, 25 eyes that underwent PK in patients with preoperative diagnosis of MCD, and 28 normal eyes. The ocular response analyzer was used to measure corneal biomechanical properties, including corneal resistance factor (CRF) and corneal hysteresis (CH). Intraocular pressure (IOP) was measured using a Goldmann applanation tonometer, and central corneal thickness (CCT) was measured using an ultrasonic pachymeter. The CCT, CRF, CH, and IOP were compared among the study group. RESULTS CCT was significantly lower in the MCD group (423 ± 47 mμ) than in the PK group (541 ± 31 mμ; P < .001) and the controls (540 ± 26 mμ; P < .001). Meanwhile, CCT was comparable between the PK and control groups (P = .98). CRF did not differ between the MCD (8.34 ± 2.12 mm Hg) and the PK (8.66 ± 1.66 mm Hg) groups (P = .89); however, both of these groups had lower CRF values than the control (9.76 ± 1.83 mm Hg, P = .02) group. No significant differences were observed among the 3 groups in CH (P = .13). IOP values did not differ between the MCD (11.25 ± 1.69 mm Hg) and PK (12.0 ± 2.67 mm Hg) groups (P = .95); however, the IOP values for both of these groups differed significantly from those of the controls (13.46 ± 2.17 mm Hg; P = .006). CONCLUSIONS CRF was significantly reduced in MCD and did not return to normal values even after PK. The reduced corneal rigidity could result in underestimating IOP in patients with MCD and in those undergoing PK for this stromal dystrophy.
Collapse
Affiliation(s)
- Sepehr Feizi
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Zahra Karjou
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Abbasi
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Javadi
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir A Azari
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
36
|
Chun H, Moon JI, Jung Y. Analysis of Factors Affecting Corneal Deflection Amplitude in Normal Korean Eyes. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2020. [DOI: 10.3341/jkos.2020.61.5.538] [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]
|
37
|
Corneal pulsation and biomechanics during induced ocular pulse. An ex-vivo pilot study. PLoS One 2020; 15:e0228920. [PMID: 32053692 PMCID: PMC7018024 DOI: 10.1371/journal.pone.0228920] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 01/15/2020] [Indexed: 01/16/2023] Open
Abstract
The purpose of this study was to ascertain the relationships between the amplitude of the corneal pulse (CP) signal and the parameters of corneal biomechanics during ex-vivo intraocular pressure (IOP) elevation experiments on porcine eyes with artificially induced ocular pulse cycles. Two experiments were carried out using porcine eyes. In the first one, a selected eye globe was subjected to three IOP levels (15, 30 and 45 mmHg), where changes in physical ocular pulse amplitude were controlled by infusion/withdrawal volumes (ΔV). In the second experiment, six eyes were subjected to IOP from 15 mmHg to 45 mmHg in steps of 5 mmHg with a constant ΔV, where corneal deformation parameters were measured using Corvis ST. In both experiments, at each IOP, the CP and IOP signals were acquired synchronically using a non-contact ultrasonic distance sensor and a pressure transmitter, respectively. Based on the amplitudes of the CP and IOP signals ocular pulse based corneal rigidity index (OPCRI) was calculated. Results indicate positive correlations between ΔV and the physical ocular pulse amplitude, and between ΔV and the corneal pulse amplitude (both p < 0.001). OPCRI was found to increase with elevated IOP. Furthermore, IOP statistically significantly differentiated changes in OPCRI, the amplitudes of CP and IOP signals and in most of the corneal deformation parameters (p < 0.05). The partial correlation analysis, with IOP as a control variable, revealed a significant correlation between the length of the flattened cornea during the first applanation (A1L) and the corneal pulse amplitude (p = 0.002), and between A1L and OPCRI (p = 0.003). In conclusion, this study proved that natural corneal pulsations, detected with a non-contact ultrasonic technique, reflect pressure-volume dynamics and can potentially be utilized to assess stiffness of the cornea. The proposed new rigidity index could be a simple approach to estimating corneal rigidity.
Collapse
|
38
|
Kang BS, Jeoung JW, Oh JY. Inaccuracy of intraocular pressure measurement in congenital corneal opacity: three case reports. BMC Ophthalmol 2020; 20:3. [PMID: 31898507 PMCID: PMC6941358 DOI: 10.1186/s12886-019-1287-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 12/24/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To report three cases of congenital corneal opacity where intraocular pressure (IOP) readings were high despite the use of multiple anti-glaucoma eye drops and normalized after corneal transplantation. CASE PRESENTATION Three Korean infants presented with bilateral dense stromal opacification which had been present since birth. IOPs measured by rebound tonometer were high despite administration of multiple anti-glaucoma medications. One eye of each patient underwent penetrating keratoplasty (PK) because corneal opacity impaired visual development. Immediately after PK, IOPs were normalized and maintained normal without medication, whereas they remained high in the contralateral unoperated eye. On histology, stromal fibrosis was observed in the removed corneal button, and molecular assays revealed increased levels of type 1 and 5 collagens. CONCLUSION The IOP measurement using the conventional applanation-based tonometry can be inaccurate in congenital corneal opacity which is marked by corneal fibrosis. Therefore, IOP values should be interpreted with caution in these patients, and the possibility of false-positive diagnosis of glaucoma considered.
Collapse
Affiliation(s)
- Byeong Soo Kang
- Department of Ophthalmology, Seoul National University College of Medicine, 103, Daehak-ro, Jongno-gu, Seoul, 03080, South Korea
| | - Jin Wook Jeoung
- Department of Ophthalmology, Seoul National University College of Medicine, 103, Daehak-ro, Jongno-gu, Seoul, 03080, South Korea
| | - Joo Youn Oh
- Department of Ophthalmology, Seoul National University College of Medicine, 103, Daehak-ro, Jongno-gu, Seoul, 03080, South Korea. .,Laboratory of Ocular Regenerative Medicine and Immunology, Biomedical Research Institute, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
| |
Collapse
|
39
|
Ocular Surface Changes in Prostaglandin Analogue-Treated Patients. J Ophthalmol 2019; 2019:9798272. [PMID: 31885896 PMCID: PMC6925925 DOI: 10.1155/2019/9798272] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 11/25/2019] [Indexed: 11/18/2022] Open
Abstract
Glaucoma is the second leading cause of blindness globally. Reducing intraocular pressure (IOP) has been acknowledged to be the main therapy for glaucoma. Prostaglandin analogues (PGAs) have become the first-line therapy for patients with glaucoma due to their powerful efficacy for lowering (IOP). However, usage of PGAs can also cause several notable side effects, including the changes in ocular surface. The relationship between PGAs and ocular surface changes is complicated and still remains unclear. In the present review, we summarize the recent studies of the effects of PGAs on ocular changes as well as the possible mechanisms that might provide new considerations during clinical medication.
Collapse
|
40
|
Radcliffe NM, Tracer N, De Moraes CGV, Tello C, Liebmann JM, Ritch R. Relationship between optic disc hemorrhage and corneal hysteresis. Can J Ophthalmol 2019; 55:239-244. [PMID: 31879066 DOI: 10.1016/j.jcjo.2019.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 10/16/2019] [Accepted: 10/24/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine the relationship between optic disc hemorrhage (DH) and corneal hysteresis (CH). METHODS Consecutive patients with prior or current photographic evidence of unilateral DH who had undergone CH measurement with the Ocular Response Analyzer (ORA; Reichert, Buffalo, NY) were enrolled. Eyes with a history of corneal disease, refractive surgery, or bilateral DH were excluded. Central corneal thickness (CCT), visual field data, 5 consecutive previous intraocular pressures (IOPs), and maximum documented peak IOP were obtained by chart review. Vertical cup-to-disc ratio (VCDR), the presence of neuroretinal rim notching, number of clock hours of beta zone parapapillary atrophy (ßPPA), and eye with greater ßPPA width were determined from photographs by 2 masked expert examiners. RESULTS We identified and analyzed 49 patients with photographically documented unilateral DH. Compared to fellow non-DH eyes, eyes with DH had lower CH (8.7 ± 1.9 vs 9.2 ± 1.7; p = 0.002), higher IOP (15.6 ± 3.6 vs 14.3 ± 4.1; p = 0.017), and greater VCDR (0.79 ± 0.13 vs 0.68 ± 0.23; p < 0.001), but were similar with respect to CCT, ßPPA extent, rim notching, peak IOP, and visual field damage (all p > 0.05). Using multivariate conditional logistic regression analysis, only CH (p = 0.012) and VCDR (p = 0.004) predicted the laterality of the DH. CONCLUSIONS Lower CH and greater VCDR are independently associated with DH. This suggests that CH may be a structural biomarker for an abnormality of the optic nerve complex that may be associated with progressive glaucoma. Eyes in which DH were detected had lower CH.
Collapse
Affiliation(s)
| | | | | | - Celso Tello
- Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY
| | - Jeffrey M Liebmann
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY
| | - Robert Ritch
- Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY
| |
Collapse
|
41
|
Jędzierowska M, Koprowski R, Wilczyński S, Krysik K. A new method for detecting the outer corneal contour in images from an ultra-fast Scheimpflug camera. Biomed Eng Online 2019; 18:115. [PMID: 31796067 PMCID: PMC6888987 DOI: 10.1186/s12938-019-0735-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 11/22/2019] [Indexed: 01/28/2023] Open
Abstract
Background The Corvis® ST tonometer is an innovative device which, by combining a classic non-contact tonometer with an ultra-fast Scheimpflug camera, provides a number of parameters allowing for the assessment of corneal biomechanics. The acquired biomechanical parameters improve medical diagnosis of selected eye diseases. One of the key elements in biomechanical measurements is the correct corneal contour detection, which is the basis for further calculations. The presented study deals with the problem of outer corneal edge detection based on a series of images from the afore-mentioned device. Corneal contour detection is the first and extremely important stage in the acquisition and analysis of corneal dynamic parameters. Result A total of 15,400 images from the Corvis® ST tonometer acquired from 110 patients undergoing routine ophthalmologic examinations were analysed. A method of outer corneal edge detection on the basis of a series of images from the Corvis® ST was proposed. The method was compared with known and commonly used edge detectors: Sobel, Roberts, and Canny operators, as well as others, known from the literature. The analysis was carried out in MATLAB® version 9.0.0.341360 (R2016a) with the Image Processing Toolbox (version 9.4) and the Neural Network Toolbox (version 9.0). The method presented in this paper provided the smallest values of the mean error (0.16%), stability (standard deviation 0.19%) and resistance to noise, characteristic for Corvis® ST tonometry tests, compared to the methods known from the literature. The errors were 5.78 ± 9.19%, 3.43 ± 6.21%, and 1.26 ± 3.11% for the Roberts, Sobel, and Canny methods, respectively. Conclusions The proposed new method for detecting the outer corneal contour increases the accuracy of intraocular pressure measurements. It can be used to analyse dynamic parameters of the cornea.
Collapse
Affiliation(s)
- Magdalena Jędzierowska
- Institute of Biomedical Engineering, Faculty of Science and Technology, University of Silesia in Katowice, ul. Będzińska 39, 41-200, Sosnowiec, Poland.
| | - Robert Koprowski
- Institute of Biomedical Engineering, Faculty of Science and Technology, University of Silesia in Katowice, ul. Będzińska 39, 41-200, Sosnowiec, Poland
| | - Sławomir Wilczyński
- Department of Basic Biomedical Science, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia in Katowice, Kasztanowa Street 3, 41-200, Sosnowiec, Poland
| | - Katarzyna Krysik
- Department of Ophthalmology with Paediatric Unit, St. Barbara Hospital, Trauma Centre, Plac Medykow 1, 41-200, Sosnowiec, Poland
| |
Collapse
|
42
|
The influence of corneal geometrical and biomechanical properties on tonometry readings in keratoconic eyes. Int Ophthalmol 2019; 40:849-857. [PMID: 31792851 DOI: 10.1007/s10792-019-01248-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 11/25/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE To identify the effect of corneal geometrical and biomechanical parameters on the intraocular pressure (IOP) measurements obtained by Goldmann Applanation Tonometer (GAT), non-contact tonometer, iCare Pro Rebound Tonometer (IRT), Tonopen and Ocular Response Analyzer (ORA, Goldmann-correlated IOP: IOPg, corneal compensated IOP: IOPcc). METHODS We prospectively recruited patients with a tomographically confirmed diagnosis of keratoconus. IOP measurements were performed in the following order: non-contact tonometry, ORA, IRT, GAT and Tonopen. The means of the three IOP measurements were used for the analysis. Correlation analyses were performed to assess the association between tonometer readings and the corneal geometrical and biomechanical parameters including ORA waveform parameters. Tonometer variability was assessed using a stepwise linear regression analysis. RESULTS Fifty-one patients with keratoconus (27 females, mean age 30.8 ± 8.7 years) were evaluated. The highest mean IOP was measured by IOPcc (14.6 ± 2.3 mmHg) followed by IRT IOP (13.0 ± 3.2 mmHg), Tonopen IOP 12.0 ± 2.6 mmHg), GAT IOP (11.7 ± 3.1 mmHg), NCT IOP (10.2 ± 3.2 mmHg) and IOPg (10.2 ± 3.6 mmHg). NCT and IOPg were affected from all corneal parameters including thickness, curvature and biomechanical parameters. While GAT and IRT had significant correlations with corneal resistance factor (CRF) and corneal hysteresis, IOPcc only had a significant correlation with CRF. None of the corneal factors had any statistically significant correlation with Tonopen. CRF predicted tonometer measurement variability in 7 of the 15 inter-device variability assessments. CONCLUSION Tonopen was the least affected from the corneal parameters followed by IOPcc and GAT. CRF was a strong determinant of tonometer variability.
Collapse
|
43
|
De Stefano VS, Seven I, Randleman JB, Dupps WJ. Custom air puff-derived biomechanical variables in a refractive surgery screening setting: Study from 2 centers. J Cataract Refract Surg 2019; 44:589-595. [PMID: 29773456 DOI: 10.1016/j.jcrs.2018.03.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Revised: 03/13/2018] [Accepted: 03/16/2018] [Indexed: 11/18/2022]
Abstract
PURPOSE To assess the ability of air puff-derived biomechanical variables to predict surgeon-perceived candidacy for laser in situ keratomileusis (LASIK). SETTING Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, and Emory Eye Institute, Emory University, Atlanta, Georgia, USA. DESIGN Retrospective case series. METHODS Data were collected from refractive surgery screening examinations by 2 surgeons at 2 centers. Disqualified cases (19 eyes and 28 eyes from each surgeon) were judged not to be candidates based on available data including standard variables from the Ocular Response Analyzer. Controls consisted of LASIK candidates (n = 26 and 23). Three custom biomechanical variables not available during screening were calculated and compared by group and surgeon. RESULTS The hysteresis loop area was significantly different between disqualified cases and controls for both surgeons (Surgeon 1: controls, 121.50 ± 25.38 [SD], disqualified, 107.62 ± 18.50, P = .04; Surgeon 2: controls, 135.89 ± 22.47, disqualified, 106.11 ± 16.40, P < .001). The area under the curves of the receiver operating characteristics and the cutoff values were statistically significant for the concavity minimum and hysteresis loop area for Surgeon 1 and for all variables except concavity minimum for Surgeon 2. The hysteresis loop area had the highest odds ratio (Surgeon 1, 4.48, Surgeon 2, 20.00). Adjusted R2 in best-subsets regressions were 40.2% for Surgeon 1 and 62.9% for Surgeon 2. CONCLUSIONS The hysteresis loop area was predictive of which patients were disqualified for LASIK at different sites. Certain measures of the corneal dynamic response to an air puff might serve as correlates to clinically perceived ectasia risk.
Collapse
Affiliation(s)
- Vinicius S De Stefano
- From the Cole Eye Institute (De Stefano, Seven, Dupps) and the Department of Biomedical Engineering (Dupps), Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, and the Keck School of Medicine (Randleman) and the Roski Eye Institute (Randleman), University of Southern California Los Angeles, Los Angeles, California, USA; Ophthalmology (De Stefano), Federal University of São Paulo, São Paulo, Brazil
| | - Ibrahim Seven
- From the Cole Eye Institute (De Stefano, Seven, Dupps) and the Department of Biomedical Engineering (Dupps), Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, and the Keck School of Medicine (Randleman) and the Roski Eye Institute (Randleman), University of Southern California Los Angeles, Los Angeles, California, USA; Ophthalmology (De Stefano), Federal University of São Paulo, São Paulo, Brazil
| | - J Bradley Randleman
- From the Cole Eye Institute (De Stefano, Seven, Dupps) and the Department of Biomedical Engineering (Dupps), Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, and the Keck School of Medicine (Randleman) and the Roski Eye Institute (Randleman), University of Southern California Los Angeles, Los Angeles, California, USA; Ophthalmology (De Stefano), Federal University of São Paulo, São Paulo, Brazil
| | - William J Dupps
- From the Cole Eye Institute (De Stefano, Seven, Dupps) and the Department of Biomedical Engineering (Dupps), Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, and the Keck School of Medicine (Randleman) and the Roski Eye Institute (Randleman), University of Southern California Los Angeles, Los Angeles, California, USA; Ophthalmology (De Stefano), Federal University of São Paulo, São Paulo, Brazil.
| |
Collapse
|
44
|
Effect of congenital blepharoptosis on corneal biomechanical properties and changes after ptosis surgery. Eye (Lond) 2019; 34:1055-1062. [PMID: 31558826 DOI: 10.1038/s41433-019-0586-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 07/11/2019] [Accepted: 08/27/2019] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES We studied the difference in the corneal biomechanical parameters of ptotic and fellow eyes in patients with congenital blepharoptosis. The correlations between corneal biomechanical parameters and demographic or ocular parameters, and the changes after surgery were also researched. METHODS The corneal biomechanical parameters were measured by Corvis ST tonometry. The central corneal thickness (CCT), axial length (AL) and keratometry measurements were performed with LenStar LS900, and intraocular pressure (IOP) by non-contact applanation tonometry. The parameters were evaluated for the effect of ptosis and the relationship of corneal biomechanical parameters. These examinations were repeated 6 months after blepharoptosis surgery. RESULTS Twenty-nine patients were enroled. The Corvis ST parameters (Deformation amplitude [DA], A1 times, and A1 velocity), CCT, IOP with NCT, IOP with corrected, differed significantly between ptotic and fellow eyes. CCT was significantly positively correlated with Length A1 and IOP with Corvis, and negatively correlated with IOP corrected by Corvis of the ptotic eyes. The same tendency was found in the fellow eyes. Six months after the ptosis surgery, the differences in corneal biomechanics parameters between ptotic eyes and fellow eyes were not significantly changed. CONCLUSIONS Congenital blepharoptosis causes significant corneal biomechanical changes measured by Corvis ST. The ptotic eyes had thicker and less deformable corneas. The differences in corneal biomechanics between ptotic eyes and fellow eyes were mostly related to CCT changes. Six months after surgery, these differences in corneal biomechanics did not change significantly.
Collapse
|
45
|
Jiménez R, Molina R, García JA, Redondo B, Vera J. Wearing Swimming Goggles Reduces Central Corneal Thickness and Anterior Chamber Angle, and Increases Intraocular Pressure. Curr Eye Res 2019; 45:535-541. [PMID: 31526280 DOI: 10.1080/02713683.2019.1662056] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose/Aim: To assess the changes in anterior eye segment biometrics and intraocular pressure during and after wearing swimming goggles.Materials and methods: Anterior segment biometry and intraocular pressure were assessed in 20 healthy young adults (22.2 ± 4.7 years) during the wearing of a drilled swimming goggle. The central corneal thickness, anterior chamber depth, anterior chamber volume, and anterior chamber angle, using the Pentacam rotating Scheimpflug camera (Oculus Optikgerate GmbH, Wetzlar, Germany), and intraocular pressure, using a rebound tonometer, were obtained before, at 2, 3.5, and 5 min of wearing swimming goggle, just after removal, as well as after 5 min of recovery.Results: During swimming goggles wear, there was a significant corneal thinning (54.8 ± 41.1 µm, p < .001, ƞp2 = 0.532), iridocorneal angle reduction (2.6 ± 2.6 degrees, p < .001, ƞp2 = 0.241) and intraocular pressure elevation (4.0 ± 1.9 mmHg, p < .001, ƞp2 = 0.530). These changes returned to baseline values immediately after swimming goggle removal (corrected p-value <0.05 in all cases). No significant effects of swimming goggles use were observed for anterior chamber depth and anterior chamber volume.Conclusions: Wearing swimming goggles leads to acute corneal thinning, iridocorneal angle reduction, and intraocular pressure elevation. These findings may be of special relevance for individuals with corneal ectasias, as well as for individuals at high risk of glaucoma onset or progression.
Collapse
Affiliation(s)
| | - Rubén Molina
- Department of Optics, University of Granada, Granada, Spain
| | | | | | - Jesús Vera
- Department of Optics, University of Granada, Granada, Spain
| |
Collapse
|
46
|
Khawaja AP, Rojas Lopez KE, Hardcastle AJ, Hammond CJ, Liskova P, Davidson AE, Gore DM, Hafford Tear NJ, Pontikos N, Hayat S, Wareham N, Khaw KT, Tuft SJ, Foster PJ, Hysi PG. Genetic Variants Associated With Corneal Biomechanical Properties and Potentially Conferring Susceptibility to Keratoconus in a Genome-Wide Association Study. JAMA Ophthalmol 2019; 137:1005-1012. [PMID: 31246245 DOI: 10.1001/jamaophthalmol.2019.2058] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Keratoconus is an important cause of visual loss in young adults, but little is known about its genetic causes. Understanding the genetic determinants of corneal biomechanical factors may in turn teach us about keratoconus etiology. Objectives To identify genetic associations with corneal biomechanical properties and to examine whether these genetic variants are associated with keratoconus. Design, Setting, and Participants A stage 1 discovery and replication genome-wide association study (GWAS) of corneal biomechanical properties was performed in 2 cross-sectional populations (6645 participants from the European Prospective Investigation into Cancer and Nutrition [EPIC]-Norfolk Eye Study and 2384 participants from the TwinsUK study). In stage 2, the association of genetic determinants identified in stage 1 with keratoconus was examined in a case-control study. A total of 752 patients with keratoconus were compared with 974 TwinsUK participants (undergoing direct sequencing) or 13 828 EPIC-Norfolk participants (undergoing genotyping and imputation) who were not part of the stage 1 analysis. Data were collected from March 1, 1993, through March 13, 2017, and analyzed from November 1, 2015, through February 1, 2018. Exposures In stage 1, allele dosage at genome-wide single-nucleotide polymorphisms (SNPs); in stage 2, allele dosage at SNPs with genome-wide significance (P < 5 × 10-8) in stage 1 and not previously reported as associated with corneal disease. Main Outcomes and Measures In stage 1, corneal hysteresis (CH) and corneal resistance factor (CRF), measured with the Ocular Response Analyzer (ORA); in stage 2, association with keratoconus compared with controls. Results Among 6645 participants in the discovery cohort (3635 women (54.7%); mean age, 69 years [range, 48-92 years]), 7 genome-wide significant loci associated with CH or CRF were identified that were independently replicated. Two further suggestive loci were identified after meta-analysis. To date, 5 of the identified loci, at ANAPC1, ADAMTS8, ADAMTS17, ABCA6, and COL6A1, have not previously been reported as associated with corneal disease. The ABCA6 locus (rs77542162) was associated with keratoconus using the TwinsUK (odds ratio [OR], 0.50; 95% CI, 0.27-0.92; P = .03) and EPIC-Norfolk controls (OR, 0.39; 95% CI, 0.22-0.70; P = .002). The other loci were associated with keratoconus using TwinsUK (OR per effect allele for ADAMTS8, 0.51 [95% CI, 0.37-0.71; P = 7.9 × 10-5]; for COL6A1, 1.65 [95% CI, 1.05-2.59; P = .03]) or EPIC-Norfolk (OR per effect allele for ANAPC1, 0.78 [95% CI, 0.68-0.89; P = 3.7 × 10-4]; for ADAMTS17, 0.82 [95% CI, 0.68-0.99; P = .04]) controls. Conclusions and Relevance Five loci that are associated with corneal biomechanical properties and that have suggestive associations with keratoconus were reported. These findings suggest the role of type VI collagen, extracellular matrix, and connective-tissue development for corneal biomechanics and keratoconus and the role of CH and CRF as biomarkers for keratoconus.
Collapse
Affiliation(s)
- Anthony P Khawaja
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.,National Institute of Health Research Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital and University College London, London, United Kingdom
| | | | | | - Chris J Hammond
- Department of Ophthalmology, King's College London, St Thomas' Hospital, London, United Kingdom
| | - Petra Liskova
- UCL Institute of Ophthalmology, University College London, London, England
| | - Alice E Davidson
- UCL Institute of Ophthalmology, University College London, London, England
| | - Daniel M Gore
- National Institute of Health Research Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital and University College London, London, United Kingdom
| | | | - Nikolas Pontikos
- UCL Institute of Ophthalmology, University College London, London, England
| | - Shabina Hayat
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Nick Wareham
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Stephen J Tuft
- National Institute of Health Research Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital and University College London, London, United Kingdom
| | - Paul J Foster
- National Institute of Health Research Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital and University College London, London, United Kingdom
| | - Pirro G Hysi
- Department of Ophthalmology, King's College London, St Thomas' Hospital, London, United Kingdom
| |
Collapse
|
47
|
Osapoetra LO, Watson DM, McAleavey SA. Intraocular Pressure-dependent Corneal Elasticity Measurement Using High-frequency Ultrasound. ULTRASONIC IMAGING 2019; 41:251-270. [PMID: 31271117 DOI: 10.1177/0161734619858386] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Measurement of corneal biomechanical properties can aid in predicting corneal responses to diseases and surgeries. For delineation of spatially resolved distribution of corneal elasticity, high-resolution elastography system is required. In this study, we demonstrate a high-resolution elastography system using high-frequency ultrasound for ex-vivo measurement of intraocular pressure (IOP)-dependent corneal wave speed. Tone bursts of 500 Hz vibrations were generated on the corneal surface using an electromagnetic shaker. A 35-MHz single-element transducer was used to track the resulting anti-symmetrical Lamb wave in the cornea. We acquired spatially resolved wave speed images of the cornea at IOPs of 7, 11, 15, 18, 22, and 29 mmHg. The IOP dependence of corneal wave speed is apparent from these images. Statistical analysis of measured wave speed as a function of IOP revealed a linear relation between wave speed and IOP cs = 0.37 + 0.22 × IOP, with the coefficient of determination R2 = 0.86. We also observed depth-dependent variations of wave speed in the cornea, decreasing from anterior toward posterior. This depth dependence is more pronounced at higher IOP values. This study demonstrates the potential of high-frequency ultrasound elastography in the characterization of spatially resolved corneal biomechanical properties.
Collapse
Affiliation(s)
| | - Dan M Watson
- 1 Department of Physics and Astronomy, University of Rochester, Rochester, NY, USA
| | - Stephen A McAleavey
- 2 Department of Biomedical Engineering, University of Rochester, Rochester, NY, USA
| |
Collapse
|
48
|
Intraocular pressure measurement after corneal transplantation. Surv Ophthalmol 2019; 64:639-646. [DOI: 10.1016/j.survophthal.2019.02.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 02/20/2019] [Accepted: 02/25/2019] [Indexed: 11/20/2022]
|
49
|
Matsuura M, Murata H, Fujino Y, Yanagisawa M, Nakao Y, Tokumo K, Nakakura S, Kiuchi Y, Asaoka R. Relationship between novel intraocular pressure measurement from Corvis ST and central corneal thickness and corneal hysteresis. Br J Ophthalmol 2019; 104:563-568. [DOI: 10.1136/bjophthalmol-2019-314370] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 05/30/2019] [Accepted: 06/17/2019] [Indexed: 11/03/2022]
Abstract
AimsCorvis ST (CST) yields biomechanical corrected IOP (bIOP) which is purported to be less dependent on biomechanical properties. In our accompanied paper, it was suggested that the repeatability of bIOP is high. The purpose of the current study was to assess the relationship between intraocular pressure (IOP) measured with CST and central corneal thickness (CCT) and corneal hysteresis (CH), in comparison with IOP measured with Goldmann applanation tonometry (GAT) and the ocular response analyzer (ORA).MethodsA total of 141 eyes from 141 subjects (35 healthy eyes and 106 glaucomatous eyes) underwent IOP measurements with GAT, CST and ORA. The relationships between IOP measurements (ORA-IOPg, ORA-IOPcc, CST-bIOP and GAT IOP) and biomechanical properties (CCT, CH and corneal resistance factor (CRF)) were analysed using the linear regression analysis.ResultsIOPg, IOPcc and GAT IOP were significantly associated with CCT (p<0.001), whereas bIOP was not significantly associated with CCT (p=0.19). IOPg, bIOP and GAT IOP were significantly associated with CH (IOPg: p<0.001; bIOP: p<0.001; GAT IOP: p=0.0054), whereas IOPcc was not significantly associated with CH (p=0.18). All of IOP records were associated with CRF (p<0.001).ConclusionThe bIOP measurement from CST is independent from CCT, but dependent on CH and CRF.
Collapse
|
50
|
Shilova NF, Nahum Y, Adler A, Bahar I, Malyugin BE, Anisimova NS, Livny E. Comparative analysis of biomechanical parameters of the corneas following Descemet membrane endothelial keratoplasty and contralateral healthy corneas. Graefes Arch Clin Exp Ophthalmol 2019; 257:1925-1929. [PMID: 31187244 DOI: 10.1007/s00417-019-04387-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 05/22/2019] [Accepted: 05/31/2019] [Indexed: 10/26/2022] Open
Abstract
PURPOSE To compare the biomechanical properties of the unilateral operated corneas in patients who had undergone Descemet membrane endothelial keratoplasty (DMEK) for pseudophakic bullous keratopathy (PBK) with those of the contralateral normal corneas. METHODS This was a retrospective cohort study conducted at university hospitals (Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel, and S. Fyodorov Eye Microsurgery State Institution, Moscow, Russia). Forty eyes of 20 patients who underwent DMEK for unilateral PBK 3.5 to 36 months ago and with normal fellow eyes were included in the study. An ocular response analyzer was used to measure the corneal biomechanical properties in the operated and normal fellow eyes. The main outcome measures were corneal hysteresis (CH) and corneal resistance factor (CRF). RESULTS The mean CH (8.4 ± 1.5 mmHg vs. 8.2 ± 1.5 mmHg, P = 0.707) and the mean CRF (8.7 ± 1.6 mmHg vs. 8.3 ± 1.6 mmHg, P = 0.419) values did not show any statistically significant difference between the operated and the normal fellow eyes. CONCLUSIONS In our study, the corneas that underwent DMEK for PBK showed normal values for biomechanical parameters. These findings support the previous studies that have reported near complete visual, functional, and ultra-structural rehabilitation of the corneas following DMEK.
Collapse
Affiliation(s)
| | - Yoav Nahum
- Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Avital Adler
- Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Irit Bahar
- Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | | | - Eitan Livny
- Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|