1
|
Xie M, Tang J, Zhang Y, Deng Y, Ma K, Xiang X, Tang L. Assessment of the Corneal Biomechanical Features of Sturge-Weber Syndrome Using Dynamic Ultrahigh-speed Scheimpflug Imaging. Cornea 2024:00003226-990000000-00650. [PMID: 39104013 DOI: 10.1097/ico.0000000000003617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 05/29/2024] [Indexed: 08/07/2024]
Abstract
PURPOSE To evaluate the corneal biomechanical characteristics of eyes with Sturge-Weber syndrome (SWS) secondary glaucoma (SSG) by analyzing corneal biomechanical parameters obtained using the Corneal Visualization Scheimpflug Technology instrument (Corvis ST). METHODS In patients with SWS, eyes affected by SSG were designated as the SSG group while the contralateral eyes were designated as the SWS contralateral group (SC group). Patients from the myopia clinic served as the control group. Dynamic corneal response parameters (DCRs) including the stress-strain index (SSI)-a critical material stiffness parameter that excludes interference from IOP and central corneal thickness (CCT)-were analyzed. RESULTS For CCT, no significant difference was observed between the SSG and SC groups. However, significant differences were found between the SSG and control groups and between the SC and control groups. Parameters such as HC Time, A1 Deformation Amp., A2 Deformation Amp., length of Whole Eye Movement (WEM), DA Ratio Max (2 mm), PachySlope, DA Ratio Max (1 mm), and ARTh showed significant differences between the SSG group and control group. In the SSG group, 4 of night eyes had an SSI of less than 0.85. CONCLUSIONS Some DCRs indicated a stiffer cornea in the SSG group, possibly due to a thicker cornea in this group. On analyzing SSI, it was found that corneal material properties change, becoming less stiff in some of the patients with SSG. In conclusion, our study provides a preliminary exploration of the biomechanical properties of SWS secondary glaucoma.
Collapse
Affiliation(s)
- Mengzhen Xie
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Jing Tang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Yao Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Yingping Deng
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Ke Ma
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Xingye Xiang
- School of Life Science and Engineering, Southwest Jiaotong University, Chengdu, Sichuan, China; and
- Georgia State University, Atlanta, GA
| | - Li Tang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
2
|
Shu N, He Y, Zhang Y. Research progress on measurement methods and clinical applications of corneal elastic modulus. Exp Eye Res 2024; 245:109974. [PMID: 38897271 DOI: 10.1016/j.exer.2024.109974] [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: 03/19/2024] [Revised: 06/07/2024] [Accepted: 06/16/2024] [Indexed: 06/21/2024]
Abstract
Various corneal diseases are strongly associated with corneal biomechanical characteristics, and early measurement of patients' corneal biomechanics can be utilized in their diagnosis and treatment. Measurement methods for corneal biomechanical characteristics are classified into ex vivo and in vivo. Some of these methods can directly measure certain corneal biomechanical parameters, while others require indirect calculation through alternative methods. However, due to diversities in measurement techniques and environmental conditions, significant differences may exist in the corneal mechanical properties measured by these two methods. Therefore, comprehensive research on current measurement methods and the exploration of novel measurement techniques may have great clinical significance. The corneal elastic modulus, a critical indicator in corneal biomechanics, reflects the cornea's ability to return to its initial shape after undergoing stress. This review aims to provide a comprehensive summary of the corneal elastic modulus, which is a critical biomechanical parameter, and discuss its direct, indirect, and potential measurement methods and clinical applications.
Collapse
Affiliation(s)
- Nanqi Shu
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, 130041, Jilin Province, China
| | - Yuxi He
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, 130041, Jilin Province, China
| | - Yan Zhang
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, 130041, Jilin Province, China; Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China.
| |
Collapse
|
3
|
Wu JH, Halfpenny W, Bu J, Brar M, Weinreb RN, Baxter SL. Social factors associated with the risk of glaucoma suspect conversion to glaucoma: analysis of the nationwide All of Us Program. Ophthalmol Glaucoma 2024:S2589-4196(24)00102-9. [PMID: 38959998 DOI: 10.1016/j.ogla.2024.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 06/13/2024] [Accepted: 06/26/2024] [Indexed: 07/05/2024]
Abstract
PURPOSE To examine social factors associated with the 5-year risk of glaucoma suspects (GS) converting to open-angle glaucoma (OAG). DESIGN Retrospective cohort analysis. SUBJECTS We screened for participants diagnosed with GS in the All of Us database. Cases that converted to OAG within 5 years of GS diagnosis (the "conversion group") were compared with control cases that did not convert. METHODS Demographic, socioeconomic and healthcare utilization data of the cases were extracted and compared between the conversion group and the control group. Multivariable Cox proportional hazards modeling was used to identify potential factors associated with the risk of conversion. MAIN OUTCOME MEASURES Hazard ratios (HRs) of significant factors associated with the risk of conversion. RESULTS A total of 5274 GS participants were identified, and 786 (15%) cases converted to OAG within 5-year follow-up. The two groups showed significant differences in age, race, gender, employment status, income/education level, history of intra-ocular surgery, and healthcare utilization patterns. In the multivariable model, African American/Black race (HR [95% confidence interval] =1.70 [1.44-2.00]), older age at GS diagnosis (1.17 [1.09-1.25]), male gender (1.30 [1.13-1.50], no history of recreational drug use (1.23 [1.07-1.42]), history of intra-ocular surgery (1.60 [1.02-1.53]) and having more reasons for delayed healthcare access (2.27 [1.23-4.18]) were associated with a greater hazard of conversion, while being employed (0.71 [0.60-0.86]) was associated with a smaller hazard of conversion (P<0.05 for all). CONCLUSIONS Several social factors were associated with the conversion from GS to OAG, which may help to identify patients at higher risk of disease progression. Future studies are needed to examine the basis for these findings and the potential interventions that could address them.
Collapse
Affiliation(s)
- Jo-Hsuan Wu
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California; Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California; Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, United States
| | - Willam Halfpenny
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California; Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California
| | - Jennifer Bu
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California; Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California
| | - Manreet Brar
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California; Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California
| | - Robert N Weinreb
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California; Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, United States
| | - Sally L Baxter
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California; Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California; Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, United States.
| |
Collapse
|
4
|
Liu MX, Li DL, Yin ZJ, Li YZ, Zheng YJ, Qin Y, Ma R, Liang G, Pan CW. Corneal stress‒strain index in relation to retinal nerve fibre layer thickness among healthy young adults. Eye (Lond) 2024; 38:1654-1659. [PMID: 38402288 PMCID: PMC11156841 DOI: 10.1038/s41433-024-02985-7] [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: 05/31/2023] [Revised: 01/19/2024] [Accepted: 02/05/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND/OBJECTIVES To determine the relationship between corneal stress-strain index (SSI) and retinal nerve fibre layer (RNFL) thickness. SUBJECTS/METHODS 1645 healthy university students from a university-based study contributed to the analysis. The RNFL thickness was measured by high-definition optical coherence tomography (HD-OCT), axial length (AL) was measured by IOL Master, and corneal biomechanics including SSI, biomechanical corrected intraocular pressure (bIOP), and central corneal thickness (CCT) were measured by Corvis ST. Multivariate linear regression was performed to evaluate the relationship between the SSI and RNFL thickness after adjusting for potential covariates. RESULTS The mean age of the participants was 19.0 ± 0.9 years, and 1132 (68.8%) were women. Lower SSI was significantly associated with thinner RNFL thickness ( β =8.601, 95% confidence interval [CI] 2.999-14.203, P = 0.003) after adjusting for age, CCT, bIOP, and AL. No significant association between SSI and RNFL was found in men, while the association was significant in women in the fully adjusted model. The association was significant in the nonhigh myopic group ( P for trend = 0.021) but not in the highly myopic group. Eyes with greater bIOP and lower SSI had significantly thinner RNFL thickness. CONCLUSIONS Eyes with lower SSI had thinner RNFL thickness after adjusting for potential covariates, especially those with higher bIOP. Our findings add novel evidence of the relationship between corneal biomechanics and retinal ganglion cell damage.
Collapse
Affiliation(s)
- Min-Xin Liu
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Dan-Lin Li
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Zhi-Jian Yin
- Department of Ophthalmology, the First Affiliated Hospital of Dali University, Dali, China
| | - Yue-Zu Li
- Department of Ophthalmology, the Affiliated Hospital of Yunnan University, Kunming, China
- Department of Ophthalmology, the Second People's Hospital of Yunnan Province, Kunming, China
| | - Ya-Jie Zheng
- Department of Ophthalmology, the Affiliated Hospital of Yunnan University, Kunming, China
- Department of Ophthalmology, the Second People's Hospital of Yunnan Province, Kunming, China
| | - Yu Qin
- Department of Ophthalmology, the Affiliated Hospital of Yunnan University, Kunming, China
- Department of Ophthalmology, the Second People's Hospital of Yunnan Province, Kunming, China
| | - Rong Ma
- Department of Ophthalmology, the Affiliated Hospital of Yunnan University, Kunming, China
- Department of Ophthalmology, the Second People's Hospital of Yunnan Province, Kunming, China
| | - Gang Liang
- Department of Ophthalmology, the Affiliated Hospital of Yunnan University, Kunming, China.
- Department of Ophthalmology, the Second People's Hospital of Yunnan Province, Kunming, China.
| | - Chen-Wei Pan
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China.
| |
Collapse
|
5
|
Mao J, Wang Y, Gao Y, Wan S, Jiang W, Pan Y, Yan Y, Cong Y, Shi X, Huang L, Yang Y. Correlation Between Anterior Chamber Angle Status and Limbal Stem Cell Deficiency in Primary Angle-Closure Glaucoma. Am J Ophthalmol 2024; 262:178-185. [PMID: 38360335 DOI: 10.1016/j.ajo.2024.01.034] [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: 11/08/2023] [Revised: 01/06/2024] [Accepted: 01/25/2024] [Indexed: 02/17/2024]
Abstract
PURPOSE To investigate the correlation between the opening and closing states of anterior chamber angle (ACA) and the density of limbal epithelial basal cells (LEBCs) in subjects with primary angle-closure glaucoma (PACG). DESIGN Cross-sectional observational study. METHODS A total of 54 eyes of 29 patients diagnosed with PACG were included in the study. Fifty-four eyes from normal subjects were included as control. Automatic evaluation system for ultrasound biomicroscopy images of anterior chamber angle was used to assist ophthalmologists in identifying the opening or closing state of ACA, and the in vivo confocal microscopy (IVCM) was used to evaluate the density of LEBCs in different directions. RESULTS (1) The average density of LEBCs in the superior, inferior, nasal, and temporal limbus of the eyes in the PACG group was lower than that in the control group, and this pattern did not align with the density distribution observed in the control group. (2) In the early, moderate and advanced PACG, the density of LEBCs corresponding to the closed angle was lower than that in the control group (P < .05). Compared with the density of LEBCs corresponding to the closed angle and the open angle, the closed angle of PACG in the early, moderate and advanced stages was less than that in the open angle (P < .05 in the early and moderate stages; advanced stage P > .05). (3) The basal cell density was processed by dimensionless analysis. In the data calculated by averaging and minimizing, both closed angle dimensionless values were smaller than the open angle (P < .05). (4) Comparative analysis was conducted among the normal, open-angle, and closed-angle conditions in the superior, inferior, nasal, and temporal limbus. In the early stage of PACG, significant differences were observed in 4 limbal regions (P < .05), while in the moderate PACG stage, this difference was noted in 3 limbal regions (P < .05). In advanced PACG, 2 limbal regions exhibited significant differences (P < .05). These findings suggest that during the early PACG stage, angle closure is the predominant influencing factor on LEBCs density, while in the advanced stage, the decrease in density is attributed to a combination of angle closure and the natural progression of the disease. CONCLUSIONS There is a significant correlation between anterior chamber angle status and LEBCs. Advanced PACG and angle closure should be highly suspected of the occurrence of limbal stem cell deficiency (LSCD).
Collapse
Affiliation(s)
- Jiewen Mao
- From the Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yujin Wang
- From the Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yuelan Gao
- From the Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Shanshan Wan
- From the Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Weiyan Jiang
- From the Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yumiao Pan
- From the Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yulin Yan
- From the Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yuyu Cong
- From the Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xiaoshuo Shi
- From the Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Linying Huang
- From the Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, China.
| | - Yanning Yang
- From the Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, China.
| |
Collapse
|
6
|
Harvey DH, Roberts CJ, Mahmoud AM, Nuñez FM, Ma Y, Fleming GP. Biomechanical and Vascular Metrics Between Eyes of Patients With Asymmetric Glaucoma and Symmetric Glaucoma. J Glaucoma 2024; 33:334-339. [PMID: 38194297 PMCID: PMC11052687 DOI: 10.1097/ijg.0000000000002363] [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: 08/21/2023] [Accepted: 11/25/2023] [Indexed: 01/10/2024]
Abstract
PRCIS Corneal hysteresis (CH) and pulsatile ocular blood volume (POBV) were significantly lower in the eye with greater damage in asymmetric glaucoma, without a difference in intraocular pressure (IOP) or central corneal thickness (CCT), and no difference in elastic parameters. OBJECTIVE To compare biomechanical and vascular metrics between the eyes of patients with asymmetric glaucoma (ASYMM) and those with symmetric glaucoma (SYMM). PATIENTS AND METHODS Forty-five patients were prospectively recruited and divided into ASYMM, defined as cup-to-disc (C/D) ratio difference >0.1 between eyes and SYMM, with C/D difference ≤0.1. For ASYMM, the smaller C/D was defined as the best eye ("best") and the fellow eye was defined as the worst eye ("worse"). All metrics were subtracted as "worse" minus "best," including the viscoelastic parameter CH, and elastic parameters from the Corvis ST, including stiffness parameter at first applanation, stiffness parameter at highest concavity, integrated inverse radius, deformation amplitude ratio, IOP, CCT, mean deviation (MD), ganglion cell complex (GCC), and POBV were included. Paired t tests were performed between eyes in both groups. Statistical analyses were performed with SAS using a significance threshold of P <0.05. RESULTS For ASYMM (16 patients), "worse" showed significantly lower CH (-0.76 ± 1.22), POBV (-0.38 ± 0.305), MD (-3.66 ± 6.55), and GCC (-7.9 ± 12.2) compared with "best." No other parameters were significantly different. For SYMM (29 patients), there were no significantly different metrics between eyes. CONCLUSIONS Lower CH, POBV, GCC, and worse MD were associated with greater glaucomatous damage in asymmetric glaucoma without a difference in IOP or CCT. Lower CH and GCC are consistent with previous studies. POBV, a new clinical parameter that may indicate reduced blood flow, is also associated with greater damage.
Collapse
Affiliation(s)
| | - Cynthia J Roberts
- Ophthalmology and Visual Sciences, The Ohio State University
- Biomedical Engineering, The Ohio State University
| | - Ashraf M Mahmoud
- Ophthalmology and Visual Sciences, The Ohio State University
- Biomedical Engineering, The Ohio State University
| | | | - Yanhui Ma
- Ophthalmology and Visual Sciences, The Ohio State University
| | - Gloria P Fleming
- Ophthalmology and Visual Sciences, The Ohio State University
- Biomedical Engineering, The Ohio State University
| |
Collapse
|
7
|
Hammelef E, Rapuano CJ, Benedetto DA, Syed ZA, Myers JS, Razeghinejad MR, Silver FH, Pulido JS. New forays into measurement of ocular biomechanics. Curr Opin Ophthalmol 2024; 35:225-231. [PMID: 38484223 DOI: 10.1097/icu.0000000000001032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2024]
Abstract
PURPOSE OF REVIEW The field of corneal biomechanics has rapidly progressed in recent years, reflecting technological advances and an increased understanding of the clinical significance of measuring these properties. This review will evaluate in-vivo biomechanical properties obtained by current technologies and compare them regarding their relevance to established biomechanical properties obtained by gold-standard ex-vivo techniques normally conducted on elastic materials. RECENT FINDINGS Several new technologies have appeared in recent years, including vibrational optical coherence tomography (VOCT) and the corneal indentation device (CID). These techniques provide promising new opportunities for minimally invasive and accurate measurements of corneal viscoelastic properties. SUMMARY Alterations in corneal biomechanics are known to occur in several corneal degenerative diseases and after refractive surgical procedures. The measurement of corneal biomechanical properties has the capability to diagnose early disease and monitor corneal disease progression. Several new technologies have emerged in recent years, allowing for more accurate and less invasive measurements of corneal biomechanical properties, most notably the elastic modulus.
Collapse
Affiliation(s)
- Emma Hammelef
- Sidney Kimmel Medical College at Thomas Jefferson University at Thomas Jefferson University
| | - Christopher J Rapuano
- Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Dominick A Benedetto
- Center for Advanced Eye Care, Vero Beach, Florida
- OptoVibronex, LLC, Bethlehem, Pennsylvania
| | - Zeba A Syed
- Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jonathan S Myers
- Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - M Reza Razeghinejad
- Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Fred H Silver
- OptoVibronex, LLC, Bethlehem, Pennsylvania
- Department of Pathology and Laboratory Medicine, Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
| | - Jose S Pulido
- Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| |
Collapse
|
8
|
Jin G, Zou M, Li L, Liu Z, Young C, Qi H, Zheng D. Corneal biomechanics and their association with severity of lens dislocation in Marfan syndrome. Int Ophthalmol 2024; 44:148. [PMID: 38502381 DOI: 10.1007/s10792-024-03079-9] [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: 10/24/2023] [Accepted: 02/16/2024] [Indexed: 03/21/2024]
Abstract
PURPOSE To investigate corneal biomechanical properties and its associations with the severity of lens dislocation in patients with Marfan syndrome. METHODS A total of 30 patients with Marfan syndrome and 30 age-, sex- and axial length (AL)-matched controls were recruited. Corneal biomechanical parameters of both groups were measured by CorVis ST and were compared between groups. Potential associations between corneal biomechanical parameters and severity of lens dislocation were also investigated. RESULTS Lower applanation 1 velocity (A1V) (0.13 ± 0.004 vs. 0.15 ± 0.003, P = 0.016), shorter applanation 2 time (A2T)(22.64 ± 0.11 vs. 22.94 ± 0.11, P = 0.013), longer peak distance (PD) (5.03 ± 0.07 vs. 4.81 ± 0.05, P = 0.008), longer radius (R) of highest concavity (7.44 ± 0.16 vs. 6.93 ± 0.14, P = 0.012), greater Ambrosio relational thickness horizontal (ARTh) (603 ± 20 vs. 498 ± 12, P < 0.001), and integrated radius (IR) (8.32 ± 0.25 vs. 8.95 ± 0.21, P = 0.033) were detected among Marfan eyes compared with controls (all P < 0.05). Marfan individuals with more severe lens dislocation tended to have increased stiffness parameter as longer A1T, slower A1V, shorter A2T, slower application 2 velocity (A2V), smaller PD and smaller Distance Amplitude (DA) (P < 0.05). CONCLUSION Marfan patients were detected to have increased corneal stiffness compared with normal subjects. Corneal biomechanical parameters were significantly associated with the severity of lens dislocation in Marfan patients.
Collapse
Affiliation(s)
- Guangming Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Minjie Zou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Longhui Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Zhenzhen Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Charlotte Young
- Albany Medical College, 49 New Scotland Ave, Albany, NY, USA
| | - Haotian Qi
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Danying Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China.
| |
Collapse
|
9
|
Martinez-Sánchez MI, Bolívar G, Dastiridou A, Escámez P, Teus MA. Predictive Value of Dynamic Corneal Response Parameters Evaluated with Scheimpflug High-Speed Video (Corvis ST) on the Visual Field Progression in Prostaglandin Treated Ocular Hypertension and Open-Angle Glaucoma Patients. Ophthalmol Ther 2023; 12:3177-3186. [PMID: 37733223 PMCID: PMC10640486 DOI: 10.1007/s40123-023-00810-0] [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: 06/23/2023] [Accepted: 08/31/2023] [Indexed: 09/22/2023] Open
Abstract
INTRODUCTION The aim of this work is to compare the Corvis ST stress-strain index (SSI) and highest concavity (HC) parameters at baseline and 1 month after initiating monotherapy with prostaglandin analogues (PGs) in eyes showing visual field (VF) progression or stability. METHODS In this prospective, single-center, observational study, newly diagnosed and treatment-naïve OAG patients were examined at baseline and 1 month after beginning monotherapy with topical PGs monotherapy. Goldmann applanation tonometry pressure readings, Corneal Hysteresis (ORA-CH), and the Corvis ST measurements were obtained at both visits. VF progression (Humphrey) was evaluated based on data from 6 years of follow-up after the baseline visit. Stress-strain index (SSI) and HC parameters in progressing (P) and non-progressing (NP) eyes were the main outcome measures. RESULTS Sixty-three eyes were analyzed; mean age was 64.63 ± 11.26 years; 47 eyes were NP and 16 eyes were P according to the event analysis performed by the Humphrey device. There were no significant differences in IOP, CCT, or Corvis parameters between NP and P groups at baseline. Nevertheless, at 1 month, the SSI index was 1.60 ± 0.34 vs. 1.80 ± 0.34 (p = 0.003) in NP vs. P eyes, respectively. HC parameters were different between the groups at 1 month (p < 0.05) suggesting an increased scleral rigidity in the P group. There was no significant difference in IOP between groups at 1 month. CONCLUSIONS The Corvis ST provides a corneal rigidity index (SSI) that seems to be related to VF progression when measured 1 month after initiating PGs monotherapy. Differences in HC parameters, indicative of increased scleral stiffness, are also evident at 1 month on latanoprost in the P eyes.
Collapse
Affiliation(s)
- Marta I Martinez-Sánchez
- Hospital Universitario "Principe de Asturias", Alcalá de Henares, Madrid, Spain
- Hospital Universitario "Infanta Leonor", Madrid, Spain
| | - Gema Bolívar
- Hospital Universitario "Principe de Asturias", Alcalá de Henares, Madrid, Spain
- Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - Anna Dastiridou
- Ophthalmology Department, University of Thessaly, Larissa, Greece.
| | | | - Miguel A Teus
- Hospital Universitario "Principe de Asturias", Alcalá de Henares, Madrid, Spain
- Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| |
Collapse
|
10
|
Lee A, Sung KR, Kim JM, Lee JY, Rim H. Rate of Retinal Nerve Fiber Layer Thinning in Glaucomatous Eyes With Optic Disc and Parapapillary Deep-Layer Microvasculature Loss. J Glaucoma 2023; 32:918-925. [PMID: 37523631 DOI: 10.1097/ijg.0000000000002270] [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: 03/20/2023] [Accepted: 07/08/2023] [Indexed: 08/02/2023]
Abstract
PRCIS Microvasculature dropout in the parapapillary choroidal layer was a more important biomarker of glaucomatous nerve fiber layer thinning when it presented with deep-layer microvasculature of the optic disc rather than when it presents by itself. PURPOSE To characterize open angle glaucoma eyes with optic nerve head deep-layer microvasculature dropout (MvD-D) and parapapillary choroidal layer microvasculature dropout (MvD-P) and compare their retinal nerve fiber layer (RNFL) thinning rate. MATERIAL AND METHODS This study included 122 open angle glaucoma eyes that underwent ≥5 serial spectral-domain optical coherence tomography scans during a mean follow-up of 5.4 years. Swept-source optical coherence tomography angiography was used to evaluate MvD-P and MvD-D. Subjects were classified into 3 groups according to the presence of MvD-P and MvD-D: (1) no dropout (n=37); (2) solely MvD-P (n=40), and (3) both MvD-P and MvD-D (n=45). The RNFL thinning rate was compared among the 3 groups, and the associated factors were assessed by Cox proportional hazard analysis. RESULTS RNFL thinning rates were highest in the group with both MvD-P and MvD-D, followed by the group with solely MvD-P and finally by the no dropout group (-0.24 vs. -0.65 vs. -1.20 μm/y, P <0.001). Thinner central corneal thickness [hazard ratio (HR)0.990, P =0.003], presence of disc hemorrhage (HR=1.802, P =0.035), and coexistence of MvD-P and MvD-D (HR=2.941, P <0.001) were the factors associated with RNFL thinning. CONCLUSIONS The coexistence of MvD-P and MvD-D was associated with faster RNFL thinning than MvD-P alone or no dropout, which suggested that observing the optic disc deep microvasculature along with parapapillary choroidal layer using Swept-source optical coherence tomography angiography may be clinically relevant in monitoring glaucoma progression.
Collapse
Affiliation(s)
- Anna Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine
| | - Kyung Rim Sung
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine
| | - Joon Mo Kim
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul
| | - Jin Yeong Lee
- Department of Ophthalmology, HanGil Eye Hospital, Incheon, Korea
| | - Hyunah Rim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine
| |
Collapse
|
11
|
Hollitt GL, Qassim A, Thomson D, Schmidt JM, Nguyen TT, Landers J, MacGregor S, Siggs OM, Souzeau E, Craig JE. Genetic Risk Assessment of Degenerative Eye Disease (GRADE): study protocol of a prospective assessment of polygenic risk scores to predict diagnosis of glaucoma and age-related macular degeneration. BMC Ophthalmol 2023; 23:431. [PMID: 37875865 PMCID: PMC10594830 DOI: 10.1186/s12886-023-03143-5] [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: 04/19/2023] [Accepted: 09/14/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Glaucoma and age-related macular degeneration (AMD) account for a substantial portion of global blindness. Both conditions are highly heritable, with recognised monogenic and polygenic inheritance patterns. Current screening guidelines lack decisive recommendations. Polygenic risk scores (PRS) allow for cost-effective broad population risk stratification for these conditions. The predictive potential of PRS could facilitate earlier diagnosis and treatment, and prevent unnecessary vision loss. METHODS The Genetic Risk Assessment of Degenerative Eye disease (GRADE) study is a prospective study designed to generate high-quality evidence about the feasibility of PRS to stratify individuals from the general population, enabling identification of those at highest risk of developing glaucoma or AMD. The targeted recruitment is 1000 individuals aged over 50 years, from which blood or saliva samples will be used for genotyping and an individual PRS for glaucoma and AMD will be derived. Individuals with PRS values in the bottom decile (n = 100), top decile (n = 100) and middle 80% (n = 100) for both glaucoma and AMD will undergo a detailed eye examination for glaucoma and/or AMD. DISCUSSION The primary objective will be to compare the prevalence of glaucoma and AMD cases between low, intermediate, and high PRS risk groups. We expect to find a higher prevalence of both diseases in the high PRS risk group, as compared to the middle and low risk groups. This prospective study will assess the clinical validity of a PRS for glaucoma and AMD in the general Australian population. Positive findings will support the implementation of PRS into clinical practice.
Collapse
Affiliation(s)
- Georgina L Hollitt
- Department of Ophthalmology, Flinders University, 1 Flinders Drive, 5042, Bedford Park, SA, Australia.
| | - Ayub Qassim
- Department of Ophthalmology, Flinders University, 1 Flinders Drive, 5042, Bedford Park, SA, Australia
| | - Daniel Thomson
- Department of Ophthalmology, Flinders University, 1 Flinders Drive, 5042, Bedford Park, SA, Australia
| | - Joshua M Schmidt
- Department of Ophthalmology, Flinders University, 1 Flinders Drive, 5042, Bedford Park, SA, Australia
| | - Thi Thi Nguyen
- Department of Ophthalmology, Flinders University, 1 Flinders Drive, 5042, Bedford Park, SA, Australia
| | - John Landers
- Department of Ophthalmology, Flinders University, 1 Flinders Drive, 5042, Bedford Park, SA, Australia
| | - Stuart MacGregor
- QIMR Berghofer Medical Research Institute, 4006, Herston, QLD, Australia
| | - Owen M Siggs
- Department of Ophthalmology, Flinders University, 1 Flinders Drive, 5042, Bedford Park, SA, Australia
- Garvan Institute of Medical Research, 2010, Darlinghurst, NSW, Australia
| | - Emmanuelle Souzeau
- Department of Ophthalmology, Flinders University, 1 Flinders Drive, 5042, Bedford Park, SA, Australia
| | - Jamie E Craig
- Department of Ophthalmology, Flinders University, 1 Flinders Drive, 5042, Bedford Park, SA, Australia
| |
Collapse
|
12
|
Yang Z, Wu B, Li Z, Yu M, Jiang J, Chen S, Xu S, Zeng J, Wang M, Yang X. Changes in Stress-Strain Index in School-Aged Children: A 3-Year Longitudinal Study. J Ophthalmol 2023; 2023:6680748. [PMID: 37868693 PMCID: PMC10590269 DOI: 10.1155/2023/6680748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 09/22/2023] [Accepted: 09/23/2023] [Indexed: 10/24/2023] Open
Abstract
Purpose To determine three-year change of the corneal biomechanical parameter stress-strain index (SSI) in schoolchildren aged 7- 9 years and their correlation with refractive error and axial length (AL). Methods This is a prospective cohort study. Data of the AL, refractive error, and corneal biomechanical parameter SSI were collected at baseline and a 3-year follow-up for 217 schoolchildren. SSI, AL, and refractive error were measured via corneal visualization Scheimpflug technology (Corvis ST), IOLMaster biometry, and cycloplegic refraction. Three years of changes in SSI and its association with refractive error and AL were analyzed. Participants were divided into persistent nonmyopia (PNM), newly developed myopia (NDM), and persistent myopia (PM). The three-year difference in SSI among the three groups was analyzed. Results After three years of follow-up, the corneal biomechanical parameter SSI decreased in all participants (P < 0.01). There was a negative correlation between the change in SSI and the change in AL (r = -0.205, P=0.002) and a positive correlation between the change in refractive error (r = 0.183, P=0.007). After three years of follow-up, there was a decrease in the SSI for the NDM, PM, and PNM participants, with a median change of -0.05 for PNM and -0.13 and -0.09 for the NDM and PM, respectively. There was a significant decrease in corneal biomechanical properties for NDM patients compared with PNM patients (P < 0.01). Conclusion In 7- to 9-year-old schoolchildren, SSI decreased after three years of the longitudinal study, and the change in SSI was correlated with the change in AL and refractive error. There was a rapid decrease in corneal biomechanical properties among newly developed myopic patients.
Collapse
Affiliation(s)
- Zhengfei Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Bo Wu
- South China Hospital, Shenzhen University, Shenzhen, China
| | - Zhouyue Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Mengting Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jinyun Jiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Shuyuan Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Shengsong Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Junwen Zeng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Mengyi Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xiao Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
13
|
Yuhas PT, McHugh-Morrison C, Canavan J, Jeyandran J, Mahmoud AM, Roberts CJ. Intereye Differences in the Clinical Assessment of Intraocular Pressure and Ocular Biomechanics. Optom Vis Sci 2023; 100:688-696. [PMID: 37639554 PMCID: PMC10662582 DOI: 10.1097/opx.0000000000002066] [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: 04/07/2023] [Accepted: 07/23/2023] [Indexed: 08/31/2023] Open
Abstract
SIGNIFICANCE Clinicians and researchers will have evidence whether intereye differences confound clinical measurements of intraocular pressure or of ocular biomechanical parameters. PURPOSE The purpose of this study was to determine whether intraocular pressure and biomechanical parameters, as measured by the Ocular Response Analyzer (ORA) and by Cornea Visualization with Scheimpflug Technology (CorVis ST), are different between the first and second eye measured. METHODS Intraocular pressure and biomechanical parameters were collected from both eyes of healthy participants (N = 139). The ORA measured corneal-compensated intraocular pressure, Goldmann-correlated intraocular pressure, and corneal hysteresis. The CorVis ST measured biomechanically corrected intraocular pressure, stiffness parameter at first applanation, and stiffness parameter at highest concavity. For each measurement, a paired t test compared the value of the first eye measured against that of the second eye measured. RESULTS For the ORA, Goldmann-correlated intraocular pressure was significantly higher ( P = .001) in the first eye (14.8 [3.45] mmHg) than in the second eye (14.3 [3.63] mmHg). For the CorVis ST, biomechanically corrected intraocular pressure was significantly higher ( P < .001) in the second eye (14.7 [2.14] mmHg) than in the first eye (14.3 [2.11] mmHg). Stiffness parameter at first applanation (intereye difference, 6.85 [9.54] mmHg/mm) was significantly ( P < .001) higher in the first eye than in the second eye. Stiffness parameter at highest concavity was significantly higher ( P = .01) in the second eye (14.3 [3.18] mmHg/mm) than in the first eye (14.0 [3.13] mmHg/mm). CONCLUSIONS Although there were statistically significant intereye differences in intraocular pressure and in biomechanical parameters for both devices, the variations were small and thus unlikely to affect clinical outcomes.
Collapse
Affiliation(s)
| | | | - Joshua Canavan
- College of Optometry, The Ohio State University, Columbus, Ohio
| | | | - Ashraf M. Mahmoud
- Department of Ophthalmology and Visual Sciences, College of Medicine, The Ohio State University, Columbus, Ohio
| | - Cynthia J. Roberts
- Department of Ophthalmology and Visual Sciences, College of Medicine, The Ohio State University, Columbus, Ohio
- Department of Biomedical Engineering, College of Engineering, The Ohio State University, Columbus, Ohio
| |
Collapse
|
14
|
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
|
15
|
Vinciguerra R, Ambrosio R, Wang Y, Zhang F, Zhou X, Bai J, Yu K, Chen S, Fang X, Vinciguerra P. Detection of Keratoconus With a New Corvis Biomechanical Index Optimized for Chinese Populations. Am J Ophthalmol 2023; 252:182-187. [PMID: 37059320 DOI: 10.1016/j.ajo.2023.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 04/01/2023] [Accepted: 04/05/2023] [Indexed: 04/16/2023]
Abstract
PURPOSE The aim of this study was to introduce an optimized version of the Corvis Biomechanical Index for Chinese populations (cCBI). DESIGN Retrospective, multicenter clinical validity enhancement study. METHODS Patients were included from 7 clinics in Beijing, Shenyang, Guangzhou, Shanghai, Wenzhou, Chongqing, and Tianjin, China. Logistic regression was used to optimize the values of the constants of the CBI, based on database 1 as the development dataset (6 of 7 clinics), to create a new version of the index named cCBI. The factors of the CBI (A1Velocity, ARTh, Stiffness Parameter-A, DARatio2mm, and Inverse Integrated Radius) and the cutoff value were kept the same (0.5). With the formation of cCBI determined, it was validated on database 2 (1 of the 7 clinics). RESULTS Two thousand four hundred seventy-three patients (healthy and keratoconus) were included. In database 2, the area under the curve of the cCBI was 0.985 with 93.4% specificity and 95.5% sensitivity. In the same dataset, the original CBI produced an area under the curve of 0.978 with 68.1% specificity and 97.7% sensitivity. There was a statistically significant difference between the receiver operating characteristic curve of cCBI and CBI (De Long P = .0009) CONCLUSION: The new cCBI for Chinese patients was shown to be statistically significantly better when compared with CBI to separate healthy from keratoconic eyes. The presence of an external validation dataset confirms this finding and suggests the use of cCBI in everyday clinical practice to aid in the diagnosis of keratoconus in patients who are of Chinese ethnicity.
Collapse
Affiliation(s)
| | - Renato Ambrosio
- Department of Ophthalmology (R.A.), the Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Yan Wang
- Tianjin Eye Hospital (Y.W.), Tianjin Key Laboratory of Ophthalmology and Visual Science, Nankai University Affiliated Eye Hospital; Clinical College of Ophthalmology (Y.W.), Tianjin Medical University, Tianjin, China
| | - Fengju Zhang
- Beijing Tongren Eye Center (F.Z.), Beijing Tongren Hospital, Beijing Ophthalmology and Visual Sciences Key Lab, Capital Medical University, Beijing, China
| | - Xingtao Zhou
- Eye and ENT Hospital of Fudan University (X.Z.), Shanghai, China
| | - Ji Bai
- BAI JI Ophthalmology (J.B.), Chongqing, China
| | - Keming Yu
- Zhongshan Ophthalmic Center (K.Y.), Sun Yat-Sen University, Guangzhou, China
| | - Shihao Chen
- Eye Hospital (S.C.), Wenzhou Medical University, Zhejiang, China
| | - Xuejun Fang
- Shenyang Aier Eye Hospital (X.F.), Shenyang, China
| | - Paolo Vinciguerra
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy
| |
Collapse
|
16
|
Wei Y, Cai Y, Bao C, Zhu Y, Pan Y. The role of corneal biomechanics in visual field progression of primary open-angle glaucoma with ocular normotension or hypertension: a prospective longitude study. Front Bioeng Biotechnol 2023; 11:1174419. [PMID: 37234476 PMCID: PMC10206210 DOI: 10.3389/fbioe.2023.1174419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 04/20/2023] [Indexed: 05/28/2023] Open
Abstract
Introduction: To analyze effects of dynamic corneal response parameters (DCRs) on visual field (VF) progression in normal-tension glaucoma (NTG) and hypertension glaucoma (HTG). Methods: This was a prospective cohort study. This study included 57 subjects with NTG and 54 with HTG, followed up for 4 years. The subjects were divided into progressive and nonprogressive groups according to VF progression. DCRs were evaluated by corneal visualization Scheimpflug technology. General linear models (GLMs) were used to compare DCRs between two groups, adjusting for age, axial length (AL), mean deviation (MD), etc. VF progression risk factors were evaluated by logistic regression and receiver operating characteristic (ROC) curves. Results: For NTG, first applanation deflection area (A1Area) was increased in progressive group and constituted an independent risk factor for VF progression. ROC curve of A1Area combined with other relevant factors (age, AL, MD, etc.) for NTG progression had an area under curve (AUC) of 0.813, similar to the ROC curve with A1area alone (AUC = 0.751, p = 0.232). ROC curve with MD had an AUC of 0.638, lower than A1Area-combined ROC curve (p = 0.036). There was no significant difference in DCRs between the two groups in HTG. Conclusion: Corneas in progressive NTG group were more deformable than nonprogressive group. A1Area may be an independent risk factor for NTG progression. It suggested that the eyes with more deformable corneas may also be less tolerant to pressure and accelerate VF progression. VF progression in HTG group was not related to DCRs. Its specific mechanism needs further studies.
Collapse
Affiliation(s)
| | - Yu Cai
- *Correspondence: Yu Cai, ; Yingzi Pan,
| | | | | | | |
Collapse
|
17
|
Brazuna R, Alonso RS, Salomão MQ, Fernandes BF, Ambrósio R. Ocular Biomechanics and Glaucoma. Vision (Basel) 2023; 7:vision7020036. [PMID: 37218954 DOI: 10.3390/vision7020036] [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: 03/14/2023] [Revised: 04/11/2023] [Accepted: 04/21/2023] [Indexed: 05/24/2023] Open
Abstract
Biomechanics is a branch of biophysics that deals with mechanics applied to biology. Corneal biomechanics have an important role in managing patients with glaucoma. While evidence suggests that patients with thin and stiffer corneas have a higher risk of developing glaucoma, it also influences the accurate measurement of intraocular pressure. We reviewed the pertinent literature to help increase our understanding of the biomechanics of the cornea and other ocular structures and how they can help optimize clinical and surgical treatments, taking into consideration individual variabilities, improve the diagnosis of suspected patients, and help monitor the response to treatment.
Collapse
Affiliation(s)
- Rodrigo Brazuna
- Department of Ophthalmology, Federal University of the State of Rio de Janeiro, Rio de Janeiro 22290-240, RJ, Brazil
| | - Ruiz S Alonso
- Department of Ophthalmology, Antonio Pedro University Hospital, Fluminense Federal University, Niterói 24033-900, RJ, Brazil
| | - Marcella Q Salomão
- Department of Ophthalmology, Federal University of São Paulo, São Paulo 04023-062, SP, Brazil
| | | | - Renato Ambrósio
- Department of Ophthalmology, Federal University of the State of Rio de Janeiro, Rio de Janeiro 22290-240, RJ, Brazil
| |
Collapse
|
18
|
Marshall HN, Mullany S, Han X, Qassim A, He W, Hassall MM, Schmidt J, Thomson D, Nguyen TT, Berry EC, Knight LS, Hollitt GL, Ridge B, Schulz A, Mills RA, Healey PR, Agar A, Galanopoulos A, Landers J, Graham SL, Hewitt AW, Casson RJ, MacGregor S, Siggs OM, Craig JE. High Polygenic Risk is Associated with Earlier Initiation and Escalation of Treatment in Early Primary Open Angle Glaucoma. Ophthalmology 2023:S0161-6420(23)00229-4. [PMID: 37044160 DOI: 10.1016/j.ophtha.2023.03.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/07/2023] [Accepted: 03/31/2023] [Indexed: 04/14/2023] Open
Abstract
PURPOSE To assess whether a glaucoma polygenic risk score (PRS) was associated with treatment commencement or escalation in early primary open angle glaucoma. DESIGN Prospective longitudinal observational cohort study. PARTICIPANTS Participants from the PROGRESSA study (Progression Risk of Glaucoma: RElevant SNPs with Significant Association) were divided into a cohort of glaucoma suspects who were treatment naive at enrolment, and early manifest and suspect glaucoma cases on treatment at enrolment. METHODS A per-allele weighted glaucoma PRS was calculated for 1,107 participants. Multivariable mixed effects Cox proportional regression analysis assessed the association between PRS and time to commencement of intraocular pressure (IOP) lowering therapy in 416 glaucoma suspects who were treatment naive at study enrolment. Secondary analysis evaluated the association between PRS and escalation of IOP lowering therapy amongst 691 suspect and early manifest glaucoma cases who were on IOP lowering therapy at enrolment. MAIN OUTCOME MEASURES Commencement or escalation of IOP lowering therapy. RESULTS A higher glaucoma PRS was associated with a greater risk of commencing IOP-lowering therapy within 5 years (HR: 1.45/Standard Deviation (SD) 95% Confidence Interval (CI) [1.27, 1.62] P<0.001). This finding persisted after adjustment for relevant demographic and clinical parameters (adjusted HR: 1.23/SD 95%CI [1.07, 1.43] P=0.005). Participants in the upper population-based quintile had a 3.3 times greater risk of commencing therapy by 5 years than the lowest quintile (HR: 3.30 95%CI [1.63, 6,70] P<0.001), and a 5.4 greater risk of commencing IOP lowering therapy by 2 years than the lowest quintile (HR: 5.45 95%CI [2.08, 14.25] P<0.001). A higher glaucoma PRS was associated with a greater risk of treatment escalation amongst cases on treatment at enrolment (HR: 1.19/SD 95%CI [1.09, 1.31] P<0.001). In combined analysis of treatment naive suspects and treated cases, participants in the top population-based quintile were at 2.3 times greater risk of requiring initiation or escalation of IOP lowering therapy than the lowest quintile (HR: 2.33 95%CI [1.75, 3.01] P<0.001). CONCLUSIONS This study demonstrates novel associations between glaucoma polygenic risk and risk of commencement or escalation of IOP lowering therapy, building upon previous work highlighting the potential clinical utility of genetic risk stratification in glaucoma.
Collapse
Affiliation(s)
- Henry N Marshall
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Sean Mullany
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Xikun Han
- QIMR Berghofer Medical Research Institute, Herston, Queensland
| | - Ayub Qassim
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Weixiong He
- QIMR Berghofer Medical Research Institute, Herston, Queensland
| | - Mark M Hassall
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Joshua Schmidt
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Daniel Thomson
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Thi Thi Nguyen
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Ella C Berry
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Lachlan Sw Knight
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Georgina L Hollitt
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Bronwyn Ridge
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Angela Schulz
- Faculty of Health and Medical Sciences, Macquarie University, Sydney, Australia
| | - Richard A Mills
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Paul R Healey
- Centre for Vision Research, University of Sydney, Sydney, Australia
| | - Ashish Agar
- Department of Ophthalmology, University of New South Wales, Sydney, Australia
| | - Anna Galanopoulos
- Discipline of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, South Australia
| | - John Landers
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Stuart L Graham
- Faculty of Health and Medical Sciences, Macquarie University, Sydney, Australia
| | - Alex W Hewitt
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | - Robert J Casson
- Discipline of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, South Australia
| | | | - Owen M Siggs
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia; Garvan Institute of Medical Research, Sydney, New South Wales
| | - Jamie E Craig
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| |
Collapse
|
19
|
Mohammadzadeh V, Moghimi S, Nishida T, Mahmoudinezhad G, Kamalipour A, Micheletti E, Zangwill L, Weinreb RN. Effect of Corneal Hysteresis on the Rates of Microvasculature Loss in Glaucoma. Ophthalmol Glaucoma 2023; 6:177-186. [PMID: 35995420 DOI: 10.1016/j.ogla.2022.08.010] [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: 04/15/2022] [Revised: 07/19/2022] [Accepted: 08/12/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the association between corneal hysteresis (CH) and rates of optic nerve head whole image capillary density (wiCD) loss over time in open-angle glaucoma (OAG). DESIGN Observational cohort. PARTICIPANTS One hundred seventy-four eyes (122 OAG and 52 glaucoma suspect eyes) from 112 patients over more than 2 years and 4 visits or more. METHODS Baseline CH measurements were acquired with the Ocular Response Analyzer. Linear mixed-effect models were designed to investigate the effect of CH, average intraocular pressure (IOP) during follow-up, and baseline visual field (VF) mean deviation (MD) on the rates of wiCD loss and circumpapillary retinal nerve fiber layer (cpRNFL) thinning over time, while adjusting for confounders. Interaction between CH or baseline MD and average IOP during follow-up were included in final models to evaluate the effect of baseline MD or average IOP during follow-up on structural changes for different values of CH. MAIN OUTCOME MEASURE Effect of CH, IOP, and baseline MD on the rates of wiCD loss and cpRNFL thinning over time. RESULTS The average follow-up time was 3.9 years. In the multivariable model, non-Black race, higher average IOP during follow-up, lower baseline CH, lower baseline VF MD, and higher numbers of IOP-lowering medications were associated with faster rates of wiCD loss over time. For CH values 6 mmHg and 12 mmHg, every 1-mmHg increase in average IOP during follow-up was associated with 0.23% per year faster and 0.07% per year slower rates of wiCD loss over time, respectively. While every 1-mmHg decrease in CH was associated with 1.89% per year faster rate of wiCD loss for MD of -12 dB, it was associated with 0.81% per year faster rate of wiCD loss for MD of -3 dB. CONCLUSION Lower CH values were significantly associated with faster rates of wiCD loss over time. In eyes with lower CH, both higher average IOP during follow-up and more severe glaucoma damage at baseline were associated with faster rates of wiCD loss and cpRNFL thinning. These results support CH as a useful parameter for risk assessment of glaucoma progression. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
Collapse
Affiliation(s)
- Vahid Mohammadzadeh
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Sasan Moghimi
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Takashi Nishida
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Golnoush Mahmoudinezhad
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Alireza Kamalipour
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Eleonora Micheletti
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Linda Zangwill
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California.
| |
Collapse
|
20
|
Liu MX, Zhou M, Li DL, Dong XX, Liang G, Pan CW. Corneal Biomechanics in Primary Open Angle Glaucoma and Ocular Hypertension: A Systematic Review and Meta-analysis. J Glaucoma 2023; 32:e24-e32. [PMID: 36583701 DOI: 10.1097/ijg.0000000000002170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 12/07/2022] [Indexed: 12/31/2022]
Abstract
PRCIS Normal tension glaucoma patients had softer corneas than normal controls, whereas high-tension glaucoma and ocular hypertension patients had stiffer corneas. PURPOSE To comprehensively identify the corneal biomechanical differences of patients with primary open angle glaucoma (POAG) and ocular hypertension (OHT) using the Ocular Response Analyzer or the Corvis ST. METHODS The electronic databases PubMed, Embase, and Web of Science were comprehensively searched for studies comparing corneal biomechanical differences between POAG and OHT patients with normal controls by Ocular Response Analyzer or Corvis ST. The weighted mean differences and 95% confidence intervals (CIs) were calculated. Subgroup analyses were performed according to the subtypes of POAG, including high-tension glaucoma (HTG) and normal tension glaucoma (NTG). RESULTS Thirty-one case-control studies were ultimately included, with 2462 POAG patients, 345 OHT patients, and 3281 normal controls. The corneal hysteresis (CH), corneal resistance factor (CRF), and highest concavity time (HC-t) were all lower in POAG patients than in normal controls. The CH, time at the second applanation (A2t), HC-t, highest concavity radius (HC-R), and deformation amplitude at the highest concavity (HC-DA) were lower in OHT patients, while the CRF, time at the first applanation (A1t), and stiffness parameter at the first applanation (SP-A1) were greater in OHT patients than in normal controls. The subgroup analyses showed that the CH, A2t, length at the second applanation (A2L), and HC-DA were lower in HTG, and the CH, CRF, A1t, and HC-t were lower in NTG patients than in normal controls. CONCLUSION The corneas of NTG patients are more deformable than normal controls, whereas the corneas of HTG and OHT patients are stiffer.
Collapse
Affiliation(s)
- Min-Xin Liu
- School of Public Health, Medical College of Soochow University, Suzhou
| | - Miao Zhou
- Department of Ophthalmology, Peking University People's Hospital, Beijing
| | - Dan-Lin Li
- School of Public Health, Medical College of Soochow University, Suzhou
| | - Xing-Xuan Dong
- School of Public Health, Medical College of Soochow University, Suzhou
| | - Gang Liang
- Department of Ophthalmology, The Affiliated Hospital of Yunnan University, Kunming
- Department of Ophthalmology, The Second People's Hospital of Yunnan Province, Kunming, China
| | - Chen-Wei Pan
- School of Public Health, Medical College of Soochow University, Suzhou
| |
Collapse
|
21
|
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
|
22
|
Abstract
Glaucoma is a progressive, age-related optic neuropathy, whereby the prevalence increases sharply over the age of 60 and is associated with increased systemic tissue stiffness. On a molecular basis, this is associated with increased deposition of collagen and loss of elastin structure, resulting in aberrant biomechanical compliance and reduced tissue elasticity. Increased tissue stiffness is a known driver of myofibroblast activation and persistence, especially in chronic cellular injuries via mechanotransduction pathways mediated by integrins and focal adhesion kinases. Evidence from histological and imaging studies plus force measurements of glaucomatous eyes show that several ocular tissues are stiffer than normal, healthy age-matched controls including the trabecular meshwork, Schlemm's canal, cornea, sclera and the lamina cribrosa. This is associated with increased extracellular matrix deposition and fibrosis. This review reports on the evidence to support the concept that glaucoma represents 'a stiff eye in a stiff body' and addresses potential mechanisms to attenuate this.
Collapse
Affiliation(s)
- Sarah Powell
- Department of Ophthalmology, Mater Misericordiae University Hospital, Dublin, Ireland.,Catherine McAuley Research Centre, University College Dublin, Dublin, Ireland
| | - Mustapha Irnaten
- Catherine McAuley Research Centre, University College Dublin, Dublin, Ireland
| | - Colm O'Brien
- Department of Ophthalmology, Mater Misericordiae University Hospital, Dublin, Ireland.,Catherine McAuley Research Centre, University College Dublin, Dublin, Ireland
| |
Collapse
|
23
|
Yuhas PT, Roberts CJ. Clinical Ocular Biomechanics: Where Are We after 20 Years of Progress? Curr Eye Res 2023; 48:89-104. [PMID: 36239188 DOI: 10.1080/02713683.2022.2125530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Purpose: Ocular biomechanics is an assessment of the response of the structures of the eye to forces that may lead to disease development and progression, or influence the response to surgical intervention. The goals of this review are (1) to introduce basic biomechanical principles and terminology, (2) to provide perspective on the progress made in the clinical study and assessment of ocular biomechanics, and (3) to highlight critical studies conducted in keratoconus, laser refractive surgery, and glaucoma in order to aid interpretation of biomechanical parameters in the laboratory and in the clinic.Methods: A literature review was first conducted of basic biomechanical studies related to ocular tissue. The subsequent review of ocular biomechanical studies was limited to those focusing on keratoconus, laser refractive surgery, or glaucoma using the only two commercially available devices that allow rapid assessment of biomechanical response in the clinic.Results: Foundational studies on ocular biomechanics used a combination of computer modeling and destructive forces on ex-vivo tissues. The knowledge gained from these studies could not be directly translated to clinical research and practice until the introduction of non-contact tonometers that quantified the deformation response of the cornea to an air puff, which represents a non-destructive, clinically appropriate load. The corneal response includes a contribution from the sclera which may limit corneal deformation. Two commercial devices are available, the Ocular Response Analyzer which produces viscoelastic parameters with a customized load for each eye, and the Corvis ST which produces elastic parameters with a consistent load for every eye. Neither device produces the classic biomechanical properties reported in basic studies, but rather biomechanical deformation response parameters which require careful interpretation.Conclusions: Research using clinical tools has enriched our understanding of how ocular disease alters ocular biomechanics, as well as how ocular biomechanics may influence the pathophysiology of ocular disease and response to surgical intervention.
Collapse
Affiliation(s)
- Phillip T Yuhas
- College of Optometry, The Ohio State University, Columbus, OH, USA
| | - Cynthia J Roberts
- Department of Ophthalmology and Visual Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA.,Department of Biomedical Engineering, College of Engineering, The Ohio State University, Columbus, OH, USA
| |
Collapse
|
24
|
Chou CC, Shih PJ, Jou TS, Hsu MY, Chen JP, Hsu RH, Lee NC, Chien YH, Hwu WL, Wang IJ. Corneal Biomechanical Characteristics in Osteogenesis Imperfecta With Collagen Defect. Transl Vis Sci Technol 2023; 12:14. [PMID: 36622688 PMCID: PMC9838590 DOI: 10.1167/tvst.12.1.14] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Purpose To identify the characteristic corneal biomechanical properties of osteogenesis imperfecta (OI), and to compare the corneal biomechanical properties between OI and keratoconus. Methods We included 46 eyes of 23 patients with OI, 188 eyes of 99 keratoconus patients, and 174 eyes of 92 normal controls to compare corneal biomechanical parameters between OI corneas, keratoconus, and normal controls by using Corneal Visualization Scheimpflug Technology (Corvis ST). Results Patients with OI had significantly higher Corvis biomechanical index (CBI) (P < 0.001), higher tomographic and biomechanical index (TBI) (P = 0.040), lower Corvis Biomechanical Factor (CBiF) (P = 0.034), and lower stiffness parameter at first applanation (SP-A1) (P < 0.001) compared with normal controls. In contrast, OI group showed lower CBI (P < 0.001), lower TBI (P < 0.001), higher CBiF (P < 0.001), and higher SP-A1 (P = 0.020) than keratoconus group. Notably, the stress-strain index (SSI) was not significantly different between the OI and normal controls (P = 1.000), whereas keratoconus showed the lowest SSI compared with OI group (P = 0.025) and normal controls (P < 0.001). Conclusions Although the corneal structures of OI patients are less stable and easier to deform as compared to those of the control group, there is no significant difference in material stiffness observed between the OI and normal controls. In contrast, the corneas of keratoconus showed not only lower structural stability and higher deformability but also lower material stiffness compared with those of OI cornea and normal controls. Translational Relevance The biomechanical alterations are different between OI corneas and keratoconus.
Collapse
Affiliation(s)
- Chien-Chih Chou
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan,Department of Ophthalmology, Taichung Veterans General Hospital, Taichung, Taiwan,Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Po-Jen Shih
- Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Tzuu-Shuh Jou
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan,Center of Precision Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Min-Yen Hsu
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan,Department of Ophthalmology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Jun-Peng Chen
- Biostatistics Task Force of Taichung Veterans General Hospital, Taichung, Taiwan
| | - Rai-Hseng Hsu
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan,Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Ni-Chung Lee
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan,Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Yin-Hsiu Chien
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan,Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Wuh-Liang Hwu
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan,Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - I-Jong Wang
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan,Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan,Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| |
Collapse
|
25
|
Aoki S, Asaoka R, Fujino Y, Nakakura S, Murata H, Kiuchi Y. Comparison of two analyzer measurements focusing on material stiffness among normal, treatment-naïve, and treated glaucoma eyes. Sci Rep 2023; 13:96. [PMID: 36596840 PMCID: PMC9810725 DOI: 10.1038/s41598-022-27346-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 12/30/2022] [Indexed: 01/04/2023] Open
Abstract
To investigate differences in biomechanical properties focusing on stiffness parameters between normal, treatment-naïve primary open-angle glaucoma (POAG), and treated POAG eyes. Retrospective case-control study, This study included 46 treatment-naïve POAG eyes, 46 POAG eyes treated with prostaglandin analogues, and 49 normal eyes used as controls; matched in terms of age and axial length. Corneal hysteresis (CH) and corneal resistance factor (CRF) were measured using an ocular response analyzer (ORA). Fifteen biomechanical parameters were measured with the Corneal Visualization Scheimpflug Technology (Corvis ST), including biomechanical glaucoma factor (BGF) and two stiffness parameters of 'SP A1' and 'stress-strain index (SSI)', which were compared among the three groups. Additionally, the area under the curve (AUC) values of the receiver-operating curve to discriminate control and treatment-naïve POAG eyes were calculated for BGF and CH. Treatment-naïve POAG eyes had higher 'SSI' than normal eyes even after controlling for IOP (p < 0.05, Tukey-Cramer test). Treated POAG eyes had significantly lower CRF, and higher BGF than treatment-naïve POAG eyes. There were also significant differences in CH or SP A1 among the three groups. BGF and CH had similar AUC values (0.61 and 0.59). Treatment-naïve POAG eyes had stiffer corneas compared to normal eyes, which seemed to result from the material/structure of the cornea rather than higher intraocular pressure. Antiglaucoma topical medication alters biomechanical properties measured with Corvis ST. These results are important for understanding the pathogenesis and improving the management of POAG.
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, 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, Hamamatsu City, Shizuoka, Japan
- Department of Ophthalmology, Faculty of Medicine, Shimane University, Matsue, Japan
| | - Shunsuke Nakakura
- Department of Ophthalmology, Saneikai Tsukazaki 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
|
26
|
Ramm L, Herber R, Lorenz G, Jasper CS, Pillunat LE, Pillunat KR. Evaluation of corneal biomechanical properties using the ocular response analyzer and the dynamic Scheimpflug-Analyzer Corvis ST in high pressure and normal pressure open-angle glaucoma patients. PLoS One 2023; 18:e0281017. [PMID: 36701409 PMCID: PMC9879466 DOI: 10.1371/journal.pone.0281017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 01/12/2023] [Indexed: 01/27/2023] Open
Abstract
PURPOSE To characterize differences in corneal biomechanics in high (HPG) and normal pressure (NPG) primary open-angle glaucoma, and its association to disease severity. METHODS Corneal biomechanical properties were measured using the Ocular Response Analyzer (ORA) and the dynamic Scheimpflug-Analyzer Corvis ST (CST). Disease severity was functionally assessed by automated perimetry (Humphrey field analyzer) and structurally with the Heidelberg Retina Tomograph. To avoid a possible falsification by intraocular pressure, central corneal thickness and age, which strongly influence ORA and CST measurements, group matching was performed. Linear mixed models and generalized estimating equations were used to consider inter-eye correlation. RESULTS Following group matching, 60 eyes of 38 HPG and 103 eyes of 60 NPG patients were included. ORA measurement revealed a higher CRF in HPG than in NPG (P < 0.001). Additionally, the CST parameter integrated radius (P < 0.001) was significantly different between HPG and NPG. The parameter SSI (P < 0.001) representing corneal stiffness was higher in HPG than in NPG. Furthermore, regression analysis revealed associations between biomechanical parameters and indicators of disease severity. In HPG, SSI correlated to RNFL thickness. In NPG, dependencies between biomechanical readings and rim area, MD, and PSD were shown. CONCLUSION Significant differences in corneal biomechanical properties were detectable between HPG and NPG patients which might indicate different pathophysiological mechanisms underlying in both entities. Moreover, biomechanical parameters correlated to functional and structural indices of diseases severity. A reduced corneal deformation measured by dynamic methods was associated to advanced glaucomatous damage.
Collapse
Affiliation(s)
- Lisa Ramm
- Department of Ophthalmology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Robert Herber
- Faculty of Medicine Carl Gustav Carus, Department of Ophthalmology, TU Dresden, Dresden, Germany
- * E-mail:
| | - Georg Lorenz
- Department of Ophthalmology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Carolin S. Jasper
- Department of Ophthalmology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Lutz E. Pillunat
- Department of Ophthalmology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Karin R. Pillunat
- Department of Ophthalmology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| |
Collapse
|
27
|
Correlations among Corneal Biomechanical Parameters, Stiffness, and Thickness Measured Using Corvis ST and Pentacam in Patients with Ocular Hypertension. J Ophthalmol 2022; 2022:7387581. [PMID: 36510627 PMCID: PMC9741532 DOI: 10.1155/2022/7387581] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 11/15/2022] [Accepted: 11/23/2022] [Indexed: 12/05/2022] Open
Abstract
Background To preliminary explore the correlations among corneal biomechanical parameters, stiffness, and thickness in patients with ocular hypertension (OHT) before and after treatment with topical antiglaucoma medications. Methods This was a retrospective study that included 35 eyes with newly diagnosed OHT. Axial length (AL), apical corneal thickness, and minimum corneal thickness were measured using Pentacam. The lengths, velocities, and times of the first and second corneal applanations (A1L, A1V, A1T, A2L, A2V, and A2T, respectively); the highest concavity radius; highest concavity peak distance (PDHC); highest concavity deformation amplitude (DAHC); highest concavity time (HCT); pachymetry (PACH); stress-strain index (SSI); stiffness parameter-A1 (SP-A1); deformation amplitude ratio (DA ratio); integrated radius (IR); Ambrosio's relational thickness horizontal (ARTh); corneal biomechanical index; noncorrected intraocular pressure (IOPnct); and biomechanically corrected IOP (bIOP) values were measured using the corneal visualization Scheimpflug technology (Corvis ST/CST). Results After 5 weeks of treatment, Goldman applanation tonometer-IOP, IOPnct, bIOP, PACH, A1T, A2V, SSI, SP-A1, and ARTh decreased, but A1V, A2T, PDHC, DAHC, DA ratio, and IR increased significantly (all p < 0.05). SP-A1 and A1T were positively associated with premedication IOP and IOP changes, whereas A1V, A2T, PDHC, and IR were negatively associated (all p < 0.05). DAHC and DA ratio had significantly negative correlations with IOP variations. PDHC was found to be positively correlated with AL (p < 0.05). A positive relationship was noted between SP-A1 and HCT before medication (p < 0.05). Conclusions SP-A1 was significantly and consistently associated with IOP. HCT might be correlated with SP-A1. SP-A1 and CST parameters could serve as potential biomarkers for evaluating OHT treatment efficacy.
Collapse
|
28
|
Chou CC, Shih PJ, Wang CY, Jou TS, Chen JP, Wang IJ. Corvis Biomechanical Factor Facilitates the Detection of Primary Angle Closure Glaucoma. Transl Vis Sci Technol 2022; 11:7. [PMID: 36180025 PMCID: PMC9547358 DOI: 10.1167/tvst.11.10.7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To characterize the corneal biomechanical properties of primary angle closure glaucoma (PACG) and to investigate the diagnostic performance of combining corneal biomechanical parameters and anterior segment parameters in detecting PACG. Methods This retrospective cross-sectional study evaluated 79 and 81 eyes of normal controls and patients with PACG, respectively. Corvis Biomechanical Factor (CBiF) and anterior chamber volume (ACV) were measured using the Corvis ST and Pentacam, respectively. We performed multivariable logistic regression, adjusted for age, sex, central corneal thickness, intraocular pressure, and ACV to evaluate the effect of CBiF on PACG. The area under the receiver operating curve (AUC) was calculated to compare the diagnostic performance of ACV, CBiF, and ACV-CBiF combination for detecting PACG. Results The median CBiF of the control and PACG groups was 6.61 (interquartile range [IQR], 6.39–6.88) and 6.20 (IQR, 5.93–6.48), respectively (P < 0.001). A lower CBiF, suggestive of decreased corneal biomechanical stability, increased the odds of PACG (odds ratio, 0.029; 95% confidence interval [CI], 0.003–0.266; P = 0.002) in the multivariable logistic regression model. The ACV–CBiF combination yielded the highest AUC (0.934; 95% CI, 0.882–0.968) compared with ACV alone (0.878; 95% CI, 0.823–0.928). The ACV-CBiF combination had significantly higher discriminatory ability than that of ACV alone (DeLong test, P = 0.004). Conclusions Lower CBiF and ACV may act as independent predictors for PACG. Combining ACV and CBiF may enhance detection of PACG. Translational Relevance The combination of corneal biomechanical parameters and anterior segment parameters enhances the detection of PACG.
Collapse
Affiliation(s)
- Chien-Chih Chou
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Ophthalmology, Taichung Veterans General Hospital, Taichung, Taiwan.,School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Po-Jen Shih
- Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Chun-Yuan Wang
- Department of Ophthalmology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Tzuu-Shuh Jou
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.,Center of Precision Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Jun-Peng Chen
- Biostatistics Task Force of Taichung Veterans General Hospital, Taichung, Taiwan
| | - I-Jong Wang
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.,Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| |
Collapse
|
29
|
Kamalipour A, Moghimi S, Eslani M, Nishida T, Mohammadzadeh V, Micheletti E, Girkin CA, Fazio MA, Liebmann JM, Zangwill LM, Weinreb RN. A Prospective Longitudinal Study to Investigate Corneal Hysteresis as a Risk Factor of Central Visual Field Progression in Glaucoma. Am J Ophthalmol 2022; 240:159-169. [PMID: 35278360 PMCID: PMC10249485 DOI: 10.1016/j.ajo.2022.02.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 02/07/2022] [Accepted: 02/27/2022] [Indexed: 11/22/2022]
Abstract
PURPOSE To evaluate the role of corneal hysteresis (CH) as a risk factor of central visual field (VF) progression in a cohort of glaucoma suspect and glaucoma patients. DESIGN Prospective cohort study. METHODS Two hundred forty-eight eyes of 143 subjects who were followed for an average of 4.8 years with a minimum of 5 visits with 10-2 and 24-2 VF tests were included. Univariable and multivariable linear mixed-effects models were used to identify characteristics associated with the rate of change over time in 10-2 and 24-2 mean deviation (MD). Mixed-effects logistic regression was used to evaluate characteristics associated with an increased likelihood of event-based 10-2 VF progression based on the clustered pointwise linear regression criterion. RESULTS CH was significantly associated with 10-2 and 24-2 VF progression in the univariable trend-based analysis. In multivariable trend-based analyses, lower CH was associated with a faster rate of decline in 10-2 MD (0.07 dB/y per 1 mm Hg, P < .001) but not with 24-2 MD (P = .490). In multivariable event-based analysis, lower CH was associated with an increased likelihood of 10-2 VF progression (odds ratio = 1.35 per 1 mm Hg lower, P = .025). Similar results were found in eyes with early glaucomatous damage at the baseline (baseline: 24-2 MD ≥ -6 dB). CONCLUSIONS Lower CH was associated with a statistically significant, but relatively small, increased risk of central VF progression on the 10-2 test grid. Given the substantial influence of central VF impairment on the quality of life, clinicians should consider using CH to assess the risk of progression in patients with primary open-angle glaucoma including those with early disease.
Collapse
Affiliation(s)
- Alireza Kamalipour
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California
| | - Sasan Moghimi
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California
| | - Medi Eslani
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California
| | - Takashi Nishida
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California
| | - Vahid Mohammadzadeh
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California
| | - Eleonora Micheletti
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California
| | | | - Massimo A Fazio
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California; Department of Ophthalmology and Visual Sciences, Heersink School of Medicine; Department of Biomedical Engineering, School of Engineering
| | - Jeffrey M Liebmann
- University of Alabama at Birmingham, Alabama, and Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York, USA
| | - Linda M Zangwill
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California.
| |
Collapse
|
30
|
Mullany S, Marshall H, Diaz-Torres S, Berry EC, Schmidt JM, Thomson D, Qassim A, To MS, Dimasi D, Kuot A, Knight LS, Hollitt G, Kolovos A, Schulz A, Lake S, Mills RA, Agar A, Galanopoulos A, Landers J, Mitchell P, Healey PR, Graham SL, Hewitt AW, Souzeau E, Hassall MM, Klebe S, MacGregor S, Gharahkhani P, Casson RJ, Siggs OM, Craig JE. The APOE E4 Allele Is Associated with Faster Rates of Neuroretinal Thinning in a Prospective Cohort Study of Suspect and Early Glaucoma. OPHTHALMOLOGY SCIENCE 2022; 2:100159. [PMID: 36249683 PMCID: PMC9560531 DOI: 10.1016/j.xops.2022.100159] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/08/2022] [Accepted: 04/08/2022] [Indexed: 11/24/2022]
Abstract
Purpose Design Participants Methods Main Outcome Measures Results Conclusions
Collapse
|
31
|
Wu N, Chen Y, Sun X. Association Between Ocular Biomechanics Measured With Corvis ST and Glaucoma Severity in Patients With Untreated Primary Open Angle Glaucoma. Transl Vis Sci Technol 2022; 11:10. [PMID: 35679036 PMCID: PMC9187943 DOI: 10.1167/tvst.11.6.10] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To compare the ocular biomechanical differences between normal controls and patients with untreated primary open angle glaucoma, including normal-tension glaucoma (NTG) and high-tension glaucoma (HTG), and to investigate the association between ocular biomechanics and glaucoma severity in each group. Methods One hundred fifty-three eyes of 153 subjects, including 51 controls, 47 NTG, and 55 HTG cases, were enrolled in this cross-sectional study. Each participant underwent biomechanical measurements by using the Corneal Visualization Scheimpflug Technology. Glaucoma severity was evaluated by mean deviation (MD), pattern standard deviation (PSD), ganglion cell complex (GCC), and retinal nerve fiber layer (RNFL) thickness. Results Deformation amplitude (P = 0.001) significantly increased, whereas first applanation time (P < 0.0001), highest concavity time (P = 0.001), stiffness parameter at first applanation (P = 0.009), and time of whole eye movement (WEM, P = 0.008) decreased significantly in NTG eyes compared with controls. Besides, NTG had the highest first applanation velocity than controls (P < 0.0001) and HTG (P = 0.044). Shorter time of WEM was independently correlated with worse MD (P = 0.02) and higher values of PSD (P = 0.03) in NTG. Axial length was positively related to PSD (P = 0.02) and negatively related to GCC (P < 0.0001) and RNFL (P < 0.0001) thickness in HTG. Conclusions NTG corneas are more deformable than healthy ones and HTG. Time of WEM, which relates to orbital compliance, is significantly associated with glaucomatous visual field defect in NTG, whereas axial length is correlated with glaucoma severity in HTG. Translational Relevance Ocular biomechanics may partly account for the differences of pathogenic mechanisms between NTG and HTG.
Collapse
Affiliation(s)
- Na Wu
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China
| | - Yuhong Chen
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China
| | - Xinghuai Sun
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China.,State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, China
| |
Collapse
|
32
|
Brazuna R, Salomão M, Esporcatte B, Macedo M, Esporcatte L, Colombini GNUI, Ambrósio R. Corneal biomechanics and glaucoma beyond the bidirectional impact of intraocular pressure and corneal deformation response. REVISTA BRASILEIRA DE OFTALMOLOGIA 2022. [DOI: 10.37039/1982.8551.20220036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
33
|
Glaukomverdacht: Parameter der Hornhautsteifigkeit sind prädiktiv für Glaukomprogression. AUGENHEILKUNDE UP2DATE 2022. [DOI: 10.1055/a-1740-1435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
34
|
Vinciguerra R, Herber R, Wang Y, Zhang F, Zhou X, Bai J, Yu K, Chen S, Fang X, Raiskup F, Vinciguerra P. Corneal Biomechanics Differences Between Chinese and Caucasian Healthy Subjects. Front Med (Lausanne) 2022; 9:834663. [PMID: 35280913 PMCID: PMC8914014 DOI: 10.3389/fmed.2022.834663] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 01/31/2022] [Indexed: 11/16/2022] Open
Abstract
Purpose The aim of this study was to evaluate the difference between Caucasian and Chinese healthy subjects with regards to Corvis ST dynamic corneal response parameters (DCRs). Methods Two thousand eight hundred and eighty-nine healthy Caucasian and Chinese subjects were included in this multicenter retrospective study. Subsequently, Chinese eyes were matched to Caucasians by age, intraocular pressure (IOP), and Corneal Thickness (CCT) using a case-control matching algorithm. The DCRs assessed were Deformation Amplitude (DA) Applanation 1 velocity (A1v), integrated radius (1/R), deformation amplitude ratio (DAratio), stiffness parameter at applanation 1 (SPA1), ARTh (Ambrósio's Relational Thickness to the horizontal profile), and the novel Stress Strain Index (SSI). Results After age-, CCT-, and IOP- matching, 503 Chinese were assigned to 452 Caucasians participants. Statistical analysis showed a statistical significant difference between Chinese and Caucasian Healthy subjects in the values of SPA1 (p = 0.008), Arth (p = 0.008), and SSI (p < 0.001). Conversely, DA, A1v, DAratio, and 1/R were not significantly different between the two ethnical groups (p > 0.05). Conclusion We found significant differences in the values of the DCRs provided by the Corvis ST between Chinese and Caucasian healthy subjects.
Collapse
Affiliation(s)
| | - Robert Herber
- Department of Ophthalmology, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Yan Wang
- Tianjin Eye Hospital, Tianjin Key Laboratory of Ophthalmology and Visual Science, Nankai University Affiliated Eye Hospital, Tianjin, China
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
| | - Fengju Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Sciences Key Lab, Capital Medical University, Beijing, China
| | - Xingtao Zhou
- EYE & ENT Hospital of Fudan University, Shanghai, China
| | - Ji Bai
- BAI JI Ophthalmology, Chongqing, China
| | - Keming Yu
- Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Shihao Chen
- Eye Hospital, Wenzhou Medical University, Zhejiang, China
| | | | - Frederik Raiskup
- Department of Ophthalmology, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Paolo Vinciguerra
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Humanitas Research Hospital, Rozzano, Italy
| |
Collapse
|
35
|
Glaukomverdacht: Parameter der Hornhautsteifigkeit sind prädiktiv für Glaukomprogression. Klin Monbl Augenheilkd 2021. [DOI: 10.1055/a-1548-1581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
36
|
Amin S, Jalilian E, Katz E, Frank C, Yazdanpanah G, Guaiquil VH, Rosenblatt MI, Djalilian AR. The Limbal Niche and Regenerative Strategies. Vision (Basel) 2021; 5:vision5040043. [PMID: 34698278 PMCID: PMC8544688 DOI: 10.3390/vision5040043] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 08/27/2021] [Accepted: 09/16/2021] [Indexed: 12/17/2022] Open
Abstract
The protective function and transparency provided by the corneal epithelium are dependent on and maintained by the regenerative capacity of limbal epithelial stem cells (LESCs). These LESCs are supported by the limbal niche, a specialized microenvironment consisting of cellular and non-cellular components. Disruption of the limbal niche, primarily from injuries or inflammatory processes, can negatively impact the regenerative ability of LESCs. Limbal stem cell deficiency (LSCD) directly hampers the regenerative ability of the corneal epithelium and allows the conjunctival epithelium to invade the cornea, which results in severe visual impairment. Treatment involves restoring the LESC population and functionality; however, few clinically practiced therapies currently exist. This review outlines the current understanding of the limbal niche, its pathology and the emerging approaches targeted at restoring the limbal niche. Most emerging approaches are in developmental phases but show promise for treating LSCD and accelerating corneal regeneration. Specifically, we examine cell-based therapies, bio-active extracellular matrices and soluble factor therapies in considerable depth.
Collapse
Affiliation(s)
- Sohil Amin
- Department of Ophthalmology and Visual Sciences, University of Illinois Chicago, Chicago, IL 60612, USA; (S.A.); (E.J.); (E.K.); (C.F.); (G.Y.); (V.H.G.); (M.I.R.)
| | - Elmira Jalilian
- Department of Ophthalmology and Visual Sciences, University of Illinois Chicago, Chicago, IL 60612, USA; (S.A.); (E.J.); (E.K.); (C.F.); (G.Y.); (V.H.G.); (M.I.R.)
| | - Eitan Katz
- Department of Ophthalmology and Visual Sciences, University of Illinois Chicago, Chicago, IL 60612, USA; (S.A.); (E.J.); (E.K.); (C.F.); (G.Y.); (V.H.G.); (M.I.R.)
| | - Charlie Frank
- Department of Ophthalmology and Visual Sciences, University of Illinois Chicago, Chicago, IL 60612, USA; (S.A.); (E.J.); (E.K.); (C.F.); (G.Y.); (V.H.G.); (M.I.R.)
| | - Ghasem Yazdanpanah
- Department of Ophthalmology and Visual Sciences, University of Illinois Chicago, Chicago, IL 60612, USA; (S.A.); (E.J.); (E.K.); (C.F.); (G.Y.); (V.H.G.); (M.I.R.)
- Richard and Loan Hill Department of Bioengineering, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Victor H. Guaiquil
- Department of Ophthalmology and Visual Sciences, University of Illinois Chicago, Chicago, IL 60612, USA; (S.A.); (E.J.); (E.K.); (C.F.); (G.Y.); (V.H.G.); (M.I.R.)
| | - Mark I. Rosenblatt
- Department of Ophthalmology and Visual Sciences, University of Illinois Chicago, Chicago, IL 60612, USA; (S.A.); (E.J.); (E.K.); (C.F.); (G.Y.); (V.H.G.); (M.I.R.)
| | - Ali R. Djalilian
- Department of Ophthalmology and Visual Sciences, University of Illinois Chicago, Chicago, IL 60612, USA; (S.A.); (E.J.); (E.K.); (C.F.); (G.Y.); (V.H.G.); (M.I.R.)
- Correspondence:
| |
Collapse
|
37
|
Qassim A, Mullany S, Knight LSW, Siggs OM, Craig JE. Reply. Ophthalmology 2021; 128:e31-e32. [PMID: 33832780 DOI: 10.1016/j.ophtha.2021.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 01/26/2021] [Accepted: 01/28/2021] [Indexed: 10/21/2022] Open
Affiliation(s)
- Ayub Qassim
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia.
| | - Sean Mullany
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Lachlan S W Knight
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Owen M Siggs
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Jamie E Craig
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| |
Collapse
|
38
|
Roy AS, Tejwani S, Matalia J. Re: Qassim et al.: Corneal stiffness parameters are predictive of structural and functional progression in glaucoma suspects (Ophthalmology. 2020 Nov 25;S0161-6420(20)31116-7. doi: 10.1016/j.ophtha.2020.11.021. Online ahead of print). Ophthalmology 2021; 128:e31. [PMID: 33832779 DOI: 10.1016/j.ophtha.2021.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 12/06/2020] [Accepted: 01/22/2021] [Indexed: 10/21/2022] Open
Affiliation(s)
- Abhijit Sinha Roy
- Imaging, Biomechanical and Mathematical Modelling Solutions, Narayan Nethralaya Foundation, Health City, Bommasandra, Bangalore, India.
| | - Sushma Tejwani
- Glaucoma Services, Narayan Nethralaya Eye Hospital, Health City, Bommasandra, Bangalore, India
| | - Jyoti Matalia
- Pediatric Ophthalmology Services, Narayan Nethralaya Eye Hospital, Bommasandra, Bangalore, India
| |
Collapse
|