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Asrani SG, McGlumphy EJ, Al-Aswad LA, Chaya CJ, Lin S, Musch DC, Pitha I, Robin AL, Wirostko B, Johnson TV. The relationship between intraocular pressure and glaucoma: An evolving concept. Prog Retin Eye Res 2024; 103:101303. [PMID: 39303763 DOI: 10.1016/j.preteyeres.2024.101303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 09/17/2024] [Accepted: 09/18/2024] [Indexed: 09/22/2024]
Abstract
Intraocular pressure (IOP) is the most important modifiable risk factor for glaucoma and fluctuates considerably within patients over short and long time periods. Our field's understanding of IOP has evolved considerably in recent years, driven by tonometric technologies with increasing accuracy, reproducibility, and temporal resolution that have refined our knowledge regarding the relationship between IOP and glaucoma risk and pathogenesis. The goal of this article is to review the published literature pertinent to the following points: 1) the factors that determine IOP in physiologic and pathologic states; 2) technologies for measuring IOP; 3) scientific and clinical rationale for measuring diverse IOP metrics in patients with glaucoma; 4) the impact and shortcomings of current standard-of-care IOP monitoring approaches; 5) recommendations for approaches to IOP monitoring that could improve patient outcomes; and 6) research questions that must be answered to improve our understanding of how IOP contributes to disease progression. Retrospective and prospective data, including that from landmark clinical trials, document greater IOP fluctuations in glaucomatous than healthy eyes, tendencies for maximal daily IOP to occur outside of office hours, and, in addition to mean and maximal IOP, an association between IOP fluctuation and glaucoma progression that is independent of mean in-office IOP. Ambulatory IOP monitoring, measuring IOP outside of office hours and at different times of day and night, provides clinicians with discrete data that could improve patient outcomes. Eye care clinicians treating glaucoma based on isolated in-office IOP measurements may make treatment decisions without fully capturing the entire IOP profile of an individual. Data linking home blood pressure monitors and home glucose sensors to dramatically improved outcomes for patients with systemic hypertension and diabetes and will be reviewed as they pertain to the question of whether ambulatory tonometry is positioned to do the same for glaucoma management. Prospective randomized controlled studies are warranted to determine whether remote tonometry-based glaucoma management might reduce vision loss and improve patient outcomes.
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Affiliation(s)
- Sanjay G Asrani
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, USA
| | | | - Lama A Al-Aswad
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA, USA
| | - Craig J Chaya
- John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA
| | - Shan Lin
- Glaucoma Center of San Francisco, San Francisco, CA, USA
| | - David C Musch
- Department of Ophthalmology & Visual Sciences and Department of Epidemiology, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, USA
| | - Ian Pitha
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alan L Robin
- Department of Ophthalmology & Visual Sciences and Department of Epidemiology, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, USA; Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Barbara Wirostko
- John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA.
| | - Thomas V Johnson
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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2
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Shao Y, Hu B, Liu X, Ni Z, Shu Y, Zhang X, Shen J, Liang L, Zhou L, Liu J, Li X, Zhang J, Ma L, Di Z, Mei Y, Li R, Bi Y, Song E. Multi-functional, conformal systems with ultrathin crystalline-silicon-based bioelectronics for characterization of intraocular pressure and ocular surface temperature. Biosens Bioelectron 2024; 267:116786. [PMID: 39326320 DOI: 10.1016/j.bios.2024.116786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 05/28/2024] [Accepted: 09/15/2024] [Indexed: 09/28/2024]
Abstract
Technologies that established in vivo evaluations of soft-tissue biomechanics and temperature are essential to biological research and clinical diagnostics, particularly for a wide range of eye-related diseases such as glaucoma. Of importance are advanced bioelectronic devices for high-precise monitoring of intraocular pressure (IOP) and various ocular temperatures, as clinically proven uses for glaucoma diagnosis. Existing characterization methods are temporary, single point, and lack microscale resolution, failing to measure continuous IOP fluctuation across the long-term period. Here, this work presents a multi-functional smart contact lens, capable of rapidly capturing IOP fluctuation and ocular surface temperature (OST) for assistance for clinical use. The microscale device design is programmable and determined by finite element analysis simulation, with detailed experiments of ex vivo porcine eyeballs. Such compact bioelectronics can provide high-precise measurement with sensitivity of 0.03% mmHg-1 and 1.2 Ω °C-1 in the range of Δ2∼50 mmHg and 30-50 °C, respectively. In vivo tests of bio-integration with a living rabbit can evaluate real-time IOP fluctuation and OST, as of biocompatibility assessments verified through cellular and animal experiments. The resultant bioelectronic devices for continuous precise characterization of living eyeballs can offer broad utility for hospital diagnosis of a wide range of eye-related disorders.
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Affiliation(s)
- Yuting Shao
- Department of Ophthalmology, Tongji Eye Institute, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, People's Republic of China; Shanghai Frontiers Science Research Base of Intelligent Optoelectronics and Perception, Institute of Optoelectronics, Fudan University, Shanghai, 200438, People's Republic of China; State Key Laboratory of Integrated Chips and Systems, Frontier Institute of Chip and System, Fudan University, Shanghai, 200438, People's Republic of China
| | - Bofan Hu
- Department of Materials Science & State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai, 200438, People's Republic of China
| | - Xin Liu
- Department of Ophthalmology, Guizhou Provincial People's Hospital, Guiyang, 550000, People's Republic of China
| | - Zhuofan Ni
- School of Mechanics and Aerospace Engineering, State Key Laboratory of Structural Analysis, Optimization and CAE Software for Industrial Equipment, and International Research Center for Computational Mechanics, Dalian University of Technology, Dalian, 116024, People's Republic of China
| | - Yiyang Shu
- Department of Ophthalmology, Tongji Eye Institute, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, People's Republic of China
| | - Xiruo Zhang
- Department of Ophthalmology, Tongji Eye Institute, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, People's Republic of China
| | - Jiaqi Shen
- Department of Ophthalmology, Tongji Eye Institute, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, People's Republic of China
| | - Li Liang
- School of Mechanics and Aerospace Engineering, State Key Laboratory of Structural Analysis, Optimization and CAE Software for Industrial Equipment, and International Research Center for Computational Mechanics, Dalian University of Technology, Dalian, 116024, People's Republic of China
| | - Lianjie Zhou
- Shanghai Frontiers Science Research Base of Intelligent Optoelectronics and Perception, Institute of Optoelectronics, Fudan University, Shanghai, 200438, People's Republic of China
| | - Junhan Liu
- Department of Materials Science & State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai, 200438, People's Republic of China
| | - Xiao Li
- School of Biomedical Sciences, Heart and Vascular Institute and Li Ka Shing Institute of Health Science, Faculty of Medicine, The Chinese University of Hong Kong, People's Republic of China
| | - Juan Zhang
- Department of Ophthalmology, Tongji Eye Institute, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, People's Republic of China
| | - Lichao Ma
- Shanghai Frontiers Science Research Base of Intelligent Optoelectronics and Perception, Institute of Optoelectronics, Fudan University, Shanghai, 200438, People's Republic of China
| | - Zengfeng Di
- Shanghai Institute of Microsystem and Information Technology (CAS), Shanghai, 201800, People's Republic of China
| | - Yongfeng Mei
- Shanghai Frontiers Science Research Base of Intelligent Optoelectronics and Perception, Institute of Optoelectronics, Fudan University, Shanghai, 200438, People's Republic of China; Department of Materials Science & State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai, 200438, People's Republic of China
| | - Rui Li
- School of Mechanics and Aerospace Engineering, State Key Laboratory of Structural Analysis, Optimization and CAE Software for Industrial Equipment, and International Research Center for Computational Mechanics, Dalian University of Technology, Dalian, 116024, People's Republic of China.
| | - Yanlong Bi
- Department of Ophthalmology, Tongji Eye Institute, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, People's Republic of China.
| | - Enming Song
- Department of Ophthalmology, Tongji Eye Institute, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, People's Republic of China; Shanghai Frontiers Science Research Base of Intelligent Optoelectronics and Perception, Institute of Optoelectronics, Fudan University, Shanghai, 200438, People's Republic of China; Department of Materials Science & State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai, 200438, People's Republic of China; State Key Laboratory of Integrated Chips and Systems, Frontier Institute of Chip and System, Fudan University, Shanghai, 200438, People's Republic of China.
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3
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Liu W, Du Z, Duan Z, Li L, Shen G. Neuroprosthetic contact lens enabled sensorimotor system for point-of-care monitoring and feedback of intraocular pressure. Nat Commun 2024; 15:5635. [PMID: 38965218 PMCID: PMC11224243 DOI: 10.1038/s41467-024-49907-5] [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: 02/07/2024] [Accepted: 06/24/2024] [Indexed: 07/06/2024] Open
Abstract
The wearable contact lens that continuously monitors intraocular pressure (IOP) facilitates prompt and early-state medical treatments of oculopathies such as glaucoma, postoperative myopia, etc. However, either taking drugs for pre-treatment or delaying the treatment process in the absence of a neural feedback component cannot realize accurate diagnosis or effective treatment. Herein, a neuroprosthetic contact lens enabled sensorimotor system is reported, which consists of a smart contact lens with Ti3C2Tx Wheatstone bridge structured IOP strain sensor, a Ti3C2Tx temperature sensor and an IOP point-of-care monitoring/display system. The point-of-care IOP monitoring and warning can be realized due to the high sensitivity of 12.52 mV mmHg-1 of the neuroprosthetic contact lens. In vivo experiments on rabbit eyes demonstrate the excellent wearability and biocompatibility of the neuroprosthetic contact lens. Further experiments on a living rate in vitro successfully mimic the biological sensorimotor loop. The leg twitching (larger or smaller angles) of the living rat was demonstrated under the command of motor cortex controlled by somatosensory cortex when the IOP is away from the normal range (higher or lower).
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Affiliation(s)
- Weijia Liu
- School of Integrated Circuits and Electronics, Beijing Institute of Technology, 100081, Beijing, China
| | - Zhijian Du
- School of Integrated Circuits and Electronics, Beijing Institute of Technology, 100081, Beijing, China
| | - Zhongyi Duan
- School of Integrated Circuits and Electronics, Beijing Institute of Technology, 100081, Beijing, China
| | - La Li
- School of Integrated Circuits and Electronics, Beijing Institute of Technology, 100081, Beijing, China.
| | - Guozhen Shen
- School of Integrated Circuits and Electronics, Beijing Institute of Technology, 100081, Beijing, China.
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4
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Duan Z, Yuan M, Liu Z, Pei W, Jiang K, Li L, Shen G. An Ultrasensitive Ti 3C 2T x MXene-based Soft Contact Lens for Continuous and Nondestructive Intraocular Pressure Monitoring. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024; 20:e2309785. [PMID: 38377279 DOI: 10.1002/smll.202309785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/08/2024] [Indexed: 02/22/2024]
Abstract
Wearable soft contact lens sensors for continuous and nondestructive intraocular pressure (IOP) monitoring are highly desired as glaucoma and postoperative myopia patients grow, especially as the eyestrain crowd increases. Herein, a smart closed-loop system is presented that combines a Ti3C2Tx MXene-based soft contact lens (MX-CLS) sensor, wireless data transmission units, display, and warning components to realize continuous and nondestructive IOP monitoring/real-time display. The fabricated MX-CLS device exhibits an extremely high sensitivity of 7.483 mV mmHg-1, good linearity on silicone eyeballs, excellent stability under long-term pressure-release measurement, sufficient transparency with 67.8% transmittance under visible illumination, and superior biocompatibility with no discomfort when putting the MX-CLS sensor onto the Rabbit eyes. After integrating with the wireless module, users can realize real-time monitoring and warning of IOP via smartphones, the demonstrated MX-CLS device together with the IOP monitoring/display system opens up promising platforms for Ti3C2Tx materials as the base for multifunctional contact lens-based sensors and continuous and nondestructive IOP measurement system.
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Affiliation(s)
- Zhongyi Duan
- School of Integrated Circuits and Electronics, Beijing Institute of Technology, Beijing, 100081, P. R. China
| | - Miao Yuan
- State Key Laboratory of Integrated Optoelectronics Institute of Semiconductors, Chinese Academy of Sciences, Beijing, 100083, P. R. China
| | - Zhiduo Liu
- School of Physics, Beijing Institute of Technology, Beijing, 100081, P. R. China
| | - Weihua Pei
- State Key Laboratory of Integrated Optoelectronics Institute of Semiconductors, Chinese Academy of Sciences, Beijing, 100083, P. R. China
| | - Kai Jiang
- Faculty of Hepato-Pancreato-Biliary Surgery, Chinese PLA General Hospital, Institute of Hepatobiliary Surgery of Chinese PLA & Key Laboratory of Digital Hepatobiliary Surgery, Beijing, 100853, P. R. China
| | - La Li
- School of Integrated Circuits and Electronics, Beijing Institute of Technology, Beijing, 100081, P. R. China
| | - Guozhen Shen
- School of Integrated Circuits and Electronics, Beijing Institute of Technology, Beijing, 100081, P. R. China
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5
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Bhatia A, Hanna J, Stuart T, Kasper KA, Clausen DM, Gutruf P. Wireless Battery-free and Fully Implantable Organ Interfaces. Chem Rev 2024; 124:2205-2280. [PMID: 38382030 DOI: 10.1021/acs.chemrev.3c00425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Advances in soft materials, miniaturized electronics, sensors, stimulators, radios, and battery-free power supplies are resulting in a new generation of fully implantable organ interfaces that leverage volumetric reduction and soft mechanics by eliminating electrochemical power storage. This device class offers the ability to provide high-fidelity readouts of physiological processes, enables stimulation, and allows control over organs to realize new therapeutic and diagnostic paradigms. Driven by seamless integration with connected infrastructure, these devices enable personalized digital medicine. Key to advances are carefully designed material, electrophysical, electrochemical, and electromagnetic systems that form implantables with mechanical properties closely matched to the target organ to deliver functionality that supports high-fidelity sensors and stimulators. The elimination of electrochemical power supplies enables control over device operation, anywhere from acute, to lifetimes matching the target subject with physical dimensions that supports imperceptible operation. This review provides a comprehensive overview of the basic building blocks of battery-free organ interfaces and related topics such as implantation, delivery, sterilization, and user acceptance. State of the art examples categorized by organ system and an outlook of interconnection and advanced strategies for computation leveraging the consistent power influx to elevate functionality of this device class over current battery-powered strategies is highlighted.
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Affiliation(s)
- Aman Bhatia
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
| | - Jessica Hanna
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
| | - Tucker Stuart
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
| | - Kevin Albert Kasper
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
| | - David Marshall Clausen
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
| | - Philipp Gutruf
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
- Department of Electrical and Computer Engineering, The University of Arizona, Tucson, Arizona 85721, United States
- Bio5 Institute, The University of Arizona, Tucson, Arizona 85721, United States
- Neuroscience Graduate Interdisciplinary Program (GIDP), The University of Arizona, Tucson, Arizona 85721, United States
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6
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Liu X, Ye Y, Ge Y, Qu J, Liedberg B, Zhang Q, Wang Y. Smart Contact Lenses for Healthcare Monitoring and Therapy. ACS NANO 2024; 18:6817-6844. [PMID: 38407063 DOI: 10.1021/acsnano.3c12072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
The eye contains a wealth of physiological information and offers a suitable environment for noninvasive monitoring of diseases via smart contact lens sensors. Although extensive research efforts recently have been undertaken to develop smart contact lens sensors, they are still in an early stage of being utilized as an intelligent wearable sensing platform for monitoring various biophysical/chemical conditions. In this review, we provide a general introduction to smart contact lenses that have been developed for disease monitoring and therapy. First, different disease biomarkers available from the ocular environment are summarized, including both physical and chemical biomarkers, followed by the commonly used materials, manufacturing processes, and characteristics of contact lenses. Smart contact lenses for eye-drug delivery with advancing technologies to achieve more efficient treatments are then introduced as well as the latest developments for disease diagnosis. Finally, sensor communication technologies and smart contact lenses for antimicrobial and other emerging bioapplications are also discussed as well as the challenges and prospects of the future development of smart contact lenses.
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Affiliation(s)
- Xiaohu Liu
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou 325001, China
| | - Ying Ye
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou 325001, China
| | - Yuancai Ge
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou 325001, China
| | - Jia Qu
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou 325001, China
| | - Bo Liedberg
- School of Materials Science and Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore 639798, Singapore
| | - Qingwen Zhang
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou 325001, China
- Engineering Research Center of Clinical Functional Materials and Diagnosis & Treatment Devices of Zhejiang Province, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou 325001, China
| | - Yi Wang
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou 325001, China
- Engineering Research Center of Clinical Functional Materials and Diagnosis & Treatment Devices of Zhejiang Province, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou 325001, China
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7
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Karthikeyan SK, Sundaram SM, Ve RS, Souza DD, Biswas S, Shetty MU. Design and development of a noninvasive ocular pressure estimator. Optom Vis Sci 2024; 101:164-172. [PMID: 38546758 DOI: 10.1097/opx.0000000000002114] [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: 04/11/2024] Open
Abstract
SIGNIFICANCE A snapshot intraocular pressure (IOP) is ineffective in identifying the IOP peak and fluctuation, especially during sleep. Because IOP variability plays a significant role in the progression of glaucoma, monitoring the IOP, especially during sleep, is essential to capture the dynamic nature of IOP. PURPOSE We aimed to design an ocular pressure estimator (OPE) that can reliably and accurately measure the IOP noninvasively over closed-eyelid condition. METHODS Ocular pressure estimator works on the principle that the external pressure applied by raising the IOP of the eyeball is transmitted through a compressible septum to the pressure sensor, thus recording the IOP. A fluid-filled pouch with a pressure sensor was placed over a rubber glove mimicking the eyelid (septum), covering the cornea of enucleated goat eyeballs. A pressure-controlled setup was connected to a goat cadaver eye, which was validated by a rebound tonometer. Cannulation of eyeballs through the lower limbus had the least difference from the control setup values documented using rebound tonometer, compared with cannulation through the optic nerve. Intraocular pressures ranging from 3 to 30 mmHg was induced, and the outputs recorded using OPE were amplified and recorded for 10 minutes (n = 10 eyes). We stratified the randomization of the number of times and the induced pressures. RESULTS The measurements recorded were found to be linear when measured against an IOP range of 3 to 30 mmHg. The device has excellent reliability (intraclass correlation coefficient, 0.998). The repeatability coefficient and coefficient of variations were 4.24 (3.60 to 4.87) and 8.61% (7.33 to 9.90), respectively. The overall mean difference ± SD between induced IOP and the OPE was 0.22 ± 3.50 (95% confidence interval, -0.35 to 0.79) mmHg across all IOP ranges. CONCLUSIONS Ocular pressure estimator offers a promising approach for reliably and accurately measuring IOP and its fluctuation noninvasively under a condition mimicking a closed eye.
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Affiliation(s)
- Siddharth K Karthikeyan
- Department of Optometry, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Swaminathan M Sundaram
- Department of Instrumentation and Control Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Ramesh S Ve
- Department of Optometry, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Donson D Souza
- Blackfrog Technologies Pvt Ltd, Manipal, Karnataka, India
| | - Sayantan Biswas
- Department of Optometry, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, United Kingdom
| | - Mayur U Shetty
- Blackfrog Technologies Pvt Ltd, Manipal, Karnataka, India
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8
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Raveendran R, Prabakaran L, Senthil R, Yesudhason BV, Dharmalingam S, Sathyaraj WV, Atchudan R. Current Innovations in Intraocular Pressure Monitoring Biosensors for Diagnosis and Treatment of Glaucoma-Novel Strategies and Future Perspectives. BIOSENSORS 2023; 13:663. [PMID: 37367028 DOI: 10.3390/bios13060663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/11/2023] [Accepted: 06/14/2023] [Indexed: 06/28/2023]
Abstract
Biosensors are devices that quantify biologically significant information required for diverse applications, such as disease diagnosis, food safety, drug discovery and detection of environmental pollutants. Recent advancements in microfluidics, nanotechnology and electronics have led to the development of novel implantable and wearable biosensors for the expedient monitoring of diseases such as diabetes, glaucoma and cancer. Glaucoma is an ocular disease which ranks as the second leading cause for loss of vision. It is characterized by the increase in intraocular pressure (IOP) in human eyes, which results in irreversible blindness. Currently, the reduction of IOP is the only treatment used to manage glaucoma. However, the success rate of medicines used to treat glaucoma is quite minimal due to their curbed bioavailability and reduced therapeutic efficacy. The drugs must pass through various barriers to reach the intraocular space, which in turn serves as a major challenge in glaucoma treatment. Rapid progress has been observed in nano-drug delivery systems for the early diagnosis and prompt therapy of ocular diseases. This review gives a deep insight into the current advancements in the field of nanotechnology for detecting and treating glaucoma, as well as for the continuous monitoring of IOP. Various nanotechnology-based achievements, such as nanoparticle/nanofiber-based contact lenses and biosensors that can efficiently monitor IOP for the efficient detection of glaucoma, are also discussed.
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Affiliation(s)
- Rubiya Raveendran
- Faculty of Allied Health Sciences, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam 603103, Tamil Nadu, India
| | - Lokesh Prabakaran
- Faculty of Allied Health Sciences, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam 603103, Tamil Nadu, India
| | - Rethinam Senthil
- Department of Pharmacology, Saveetha Dental College and Hospitals, SIMATS, Chennai 600077, Tamil Nadu, India
| | - Beryl Vedha Yesudhason
- Regeneration and Stem Cell Biology Lab, Centre for Molecular and Nanomedical Sciences, International Research Centre, Sathyabama Institute of Science and Technology, Chennai 600119, Tamil Nadu, India
| | - Sankari Dharmalingam
- Department of Biotechnology, College of Science and Humanities, SRM Institute of Science and Technology, Kattankulathur 603203, Tamil Nadu, India
| | - Weslen Vedakumari Sathyaraj
- Faculty of Allied Health Sciences, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam 603103, Tamil Nadu, India
| | - Raji Atchudan
- School of Chemical Engineering, Yeungnam University, Gyeongsan 38541, Republic of Korea
- Department of Chemistry, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences, Chennai 602105, Tamil Nadu, India
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9
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Ren X, Zhou Y, Lu F, Zhai L, Wu H, Chen Z, Wang C, Zhu X, Xie Y, Cai P, Xu J, Tang X, Li J, Yao J, Jiang Q, Hu B. Contact Lens Sensor with Anti-jamming Capability and High Sensitivity for Intraocular Pressure Monitoring. ACS Sens 2023. [PMID: 37262351 DOI: 10.1021/acssensors.3c00542] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Contact lens sensors provide a noninvasive approach for intraocular pressure (IOP) monitoring in patients with glaucoma. Accurate measurement of this imperceptible pressure variation requires highly sensitive sensors in the absence of simultaneously amplifying IOP signal and blinking-induced noise. However, current noise-reduction methods rely on external filter circuits, which thicken contact lenses and reduce signal quality. Here, we introduce a contact lens strain sensor with an anti-jamming ability by utilizing a self-lubricating layer to reduce the coefficient of friction (COF) to remove the interference from the tangential force. The sensor achieves exceptionally high sensitivity due to the strain concentration layout and the confined occurrence of sympatric microcracks. The animal tests prove our lens can accurately detect IOP safely and reliably.
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Affiliation(s)
- Xueyang Ren
- Department of Neuro-Psychiatric Institute, the Affiliated Brain Hospital with Nanjing Medical University, Nanjing 210029, China
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing 211166, China
- State Key Laboratory of Bioelectronics and Jiangsu Key Laboratory of Biomaterials and Devices, School of Biological Science and Medical Engineering, Southeast University, Nanjing 210096, China
| | - Yunfan Zhou
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing 211166, China
- The Affiliated Eye Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Fangzhou Lu
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing 211166, China
| | - Leili Zhai
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing 211166, China
| | - Hao Wu
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing 211166, China
| | - Zhongda Chen
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing 211166, China
| | - Changxian Wang
- Innovative Center for Flexible Devices (iFLEX), Max Planck-NTU Joint Lab for Artificial Senses, School of Materials Science and Engineering, Nanyang Technological University, Singapore 639798, Singapore
| | - Xuefei Zhu
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing 211166, China
- The Affiliated Eye Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yandong Xie
- Department of Neuro-Psychiatric Institute, the Affiliated Brain Hospital with Nanjing Medical University, Nanjing 210029, China
| | - Pingqiang Cai
- Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing 210093, China
| | - Juan Xu
- Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing 210093, China
| | - Xianglong Tang
- Department of Neuro-Psychiatric Institute, the Affiliated Brain Hospital with Nanjing Medical University, Nanjing 210029, China
| | - Jianqing Li
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing 211166, China
- School of Instrument Science and Engineering, Southeast University, Nanjing 210096, China
| | - Jin Yao
- The Affiliated Eye Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Qin Jiang
- The Affiliated Eye Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Benhui Hu
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing 211166, China
- State Key Laboratory of Bioelectronics and Jiangsu Key Laboratory of Biomaterials and Devices, School of Biological Science and Medical Engineering, Southeast University, Nanjing 210096, China
- The Affiliated Eye Hospital of Nanjing Medical University, Nanjing 210029, China
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10
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Yaïci R, Geerling G. [Tonometry: Review and Perspectives]. Klin Monbl Augenheilkd 2023. [PMID: 36827998 DOI: 10.1055/a-2022-0624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
Reliable and repeated IOP measurement are essential in the diagnosis and treatment of glaucoma. In this second part, the other contact tonometry and non-contact tonometry are presented. The clinical value of the different methods and the value of multimodality in tonometry will be discussed based on a review of the literature, and the latest innovations with telemetric IOP sensors will be introduced.
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11
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Abstract
ZusammenfassungIn 2. Teil des Beitrags werden die sonstigen Kontakttonometer und die Nonkontakttonometrie präsentiert. Es wird anhand einer Revue der Literatur über den klinischen Wert der verschiedenen Methoden und den Wert der Multimodalität in der Tonometrie diskutiert; ferner werden die letzten Innovationen mit den telemetrischen IOD-Sensoren eingeführt.
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12
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Biswas S, Biswas P. Relationship between Diurnal Variation in Intraocular Pressure and Central Corneal Power. Optom Vis Sci 2023; 100:96-104. [PMID: 36705719 DOI: 10.1097/opx.0000000000001974] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
SIGNIFICANCE Relationship between intraocular pressure (IOP) change and central corneal curvature is complicated by measurement techniques and corneal biomechanical parameters. Findings from this study indicate that it is worthwhile to observe the association between diurnal change in IOP and corneal power. PURPOSE This study aimed to investigate the relationship between the diurnal change in IOP and central corneal power among eyes with and without myopia. METHODS Sixty healthy eyes of 24 emmetropes and 36 myopes were recruited for this cross-sectional study. Both anterior and posterior central corneal powers of the steep (Ks), flat (Kf), mean meridian (Km), best-fit spheres, and central corneal thickness were recorded followed by the IOP (Goldmann-correlated IOP [IOPg] and corneal-compensated IOP) and corneal biomechanics (corneal hysteresis and corneal resistance factor). Measurements were obtained every 3 hours from 9.30 am to 6.30 pm . Linear-mixed model was used to determine the relationship between the change in IOP and the associated change in corneal measurements (adjusted for age, sex, refractive error, central corneal thickness, and biomechanics) among the myopic and nonmyopic eyes. RESULTS Group mean, amplitude of change, and the diurnal change in IOPg were (mean ± standard deviation) 15.14 ± 2.50, 3.33 ± 1.44, and 1.81 ± 1.25 mmHg, respectively. Overall, an IOP increase was associated with a decrease in the adjusted anterior corneal powers. Myopic eyes were associated with a decrease of 0.04 D (95% confidence interval [CI], 0.07 to 0.01 D; P = .02) in Ks and 0.03 D (95% CI, 0.06 to 0.001 D; P = .047) in Kf per mmHg increase in IOP, whereas for emmetropes, per mmHg increase in IOP only flattened the Kf by 0.03 D (95% CI, 0.06 to 0.004 D; P = .02). CONCLUSIONS Change in anterior corneal power was inversely related to the change in IOPg, with myopic and nonmyopic eyes reporting a significant but differential impact of IOP. Clinicians must keep in mind the impact of large IOP fluctuation on the anterior corneal power.
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13
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Kim TY, Mok JW, Hong SH, Jeong SH, Choi H, Shin S, Joo CK, Hahn SK. Wireless theranostic smart contact lens for monitoring and control of intraocular pressure in glaucoma. Nat Commun 2022; 13:6801. [PMID: 36357417 PMCID: PMC9649789 DOI: 10.1038/s41467-022-34597-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 10/31/2022] [Indexed: 11/12/2022] Open
Abstract
Glaucoma is one of the irreversible ocular diseases that can cause vision loss in some serious cases. Although Triggerfish has been commercialized for monitoring intraocular pressure in glaucoma, there is no smart contact lens to monitor intraocular pressure and take appropriate drug treatment in response to the intraocular pressure levels. Here, we report a precisely integrated theranostic smart contact lens with a sensitive gold hollow nanowire based intraocular pressure sensor, a flexible drug delivery system, wireless power and communication systems and an application specific integrated circuit chip for both monitoring and control of intraocular pressure in glaucoma. The gold hollow nanowire based intraocular pressure sensor shows high ocular strain sensitivity, chemical stability and biocompatibility. Furthermore, the flexible drug delivery system can be used for on-demand delivery of timolol for intraocular pressure control. Taken together, the intraocular pressure levels can be successfully monitored and controlled by the theranostic smart contact lens in glaucoma induced rabbits. This theranostic smart contact lens would be harnessed as a futuristic personal healthcare platform for glaucoma and other ocular diseases.
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Affiliation(s)
- Tae Yeon Kim
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk, 37673, Korea
| | - Jee Won Mok
- CK St. Mary's Eye Center, CK building, 559, Gangnam-daero, Seocho-gu, Seoul, 06531, Korea
| | - Sang Hoon Hong
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk, 37673, Korea
| | - Sang Hoon Jeong
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk, 37673, Korea
| | - Hyunsik Choi
- PHI BIOMED Co., 168, Yeoksam-ro, Gangnam-gu, Seoul, 06248, Korea
| | - Sangbaie Shin
- PHI BIOMED Co., 168, Yeoksam-ro, Gangnam-gu, Seoul, 06248, Korea
| | - Choun-Ki Joo
- CK St. Mary's Eye Center, CK building, 559, Gangnam-daero, Seocho-gu, Seoul, 06531, Korea
| | - Sei Kwang Hahn
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk, 37673, Korea.
- PHI BIOMED Co., 168, Yeoksam-ro, Gangnam-gu, Seoul, 06248, Korea.
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14
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Association of Ultra-Short-Term Intraocular Pressure Fluctuation With Disease Progression in Primary Angle Closure Glaucoma: The CUPAL Study. J Glaucoma 2022; 31:874-880. [PMID: 35980863 DOI: 10.1097/ijg.0000000000002103] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 07/23/2022] [Indexed: 02/04/2023]
Abstract
PRCIS This study demonstrated significant differences in ultra-short-term IOP fluctuations, measured by a contact lens sensor between progressive and stable PACG eyes, during the first one hour after falling asleep. PURPOSE To identify the most sensitive period for detecting significant ultra-short-term intraocular pressure (IOP) fluctuation associated with disease progression in primary angle closure glaucoma (PACG). MATERIALS AND METHODS PACG eyes, which had been followed up for over 2 years under the CUHK PACG Longitudinal (CUPAL) Study, were recruited. Eyes with or without functional or structural glaucomatous progression were classified into 'progressive' or 'stable' groups on the basis of serial visual field and retinal nerve fiber layer (RNFL) thickness documentations, respectively. Ultra-short-term IOP fluctuations were recorded by Sensimed Triggerfish sensors (Sensimed AG, Lausanne, Switzerland) with 288 readings over 30 seconds, at 5-minute intervals, over a 24-hour period. In each of 7 activity-related 1-hour periods during the examining day, the mean value of the amplitude-frequency profiles of the signal fluctuations in twelve 30-second intervals was calculated by semivariogram/semi-variance. The 'progressive' and 'stable' groups were compared by permutation tests on functional t-statistics. RESULTS Among the 25 recruited PACG eyes, 16 eyes were classified as RNFL 'progressive' group (the mean rate of change in global RNFL thickness: -0.199 ±0.128 μm/mo). Higher signal fluctuations, in terms of amplitude-frequency, were found during the first 1-hour period of sleeping in the RNFL 'progressive' group compared with the RNFL 'stable' group ( P =0.028). CONCLUSIONS Between RNFL 'progressive' and 'stable' PACG eyes, significant differences in ultra-short-term IOP fluctuation at the 1-hour period after falling asleep were identified. The first hour of sleeping may be the most sensitive period for detecting significant ultra-short-term IOP fluctuation in PACG eyes.
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15
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Zhu H, Yang H, Zhan L, Chen Y, Wang J, Xu F. Hydrogel-Based Smart Contact Lens for Highly Sensitive Wireless Intraocular Pressure Monitoring. ACS Sens 2022; 7:3014-3022. [PMID: 36260093 DOI: 10.1021/acssensors.2c01299] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Real-time intraocular pressure (IOP) monitoring plays a crucial role in glaucoma diagnosis and treatment. The wireless smart contact lens based on a flexible inductor-capacitor-resistor (LCR) sensor is chip-free and battery-free, demonstrating excellent application potential for physiological signal monitoring. To promote the use of LCR contact lenses for clinical IOP monitoring, reliable, comfortable contact lens materials should be used and excellent sensitivity needs to be realized. Here, we propose a method for producing hydrogel-based smart contact lenses for wireless IOP monitoring that uses the conformal stacking technique, solving the problems of swelling of the hydrogel and spherical integration of the pyramid-microstructured dielectric elastomer. The IOP of the in vitro porcine eye is successfully monitored owing to the high sensitivity of the spherical pyramid-microstructured capacitive pressure sensor and the hydrogel substrate. In addition, a glasses-integrated impedance-matching tunable reader for remote signal measurement is realized by enhancing the signal amplitude and increasing the reading distance, improving the portability of the signal measurement equipment. With the above improved designs, the wireless contact lens system has application potential for clinical IOP monitoring and shows substantial promise for next-generation daily ocular health management.
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Affiliation(s)
- Hengtian Zhu
- College of Engineering and Applied Sciences and Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing210023, China
| | - Huan Yang
- College of Engineering and Applied Sciences and Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing210023, China
| | - Liuwei Zhan
- College of Engineering and Applied Sciences and Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing210023, China
| | - Ye Chen
- College of Engineering and Applied Sciences and Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing210023, China
| | - Junming Wang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan430030, China
| | - Fei Xu
- College of Engineering and Applied Sciences and Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing210023, China
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16
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Twenty Four Hour Intraocular Pressure Indicators Distinguish Normal Tension Glaucoma from Healthy Eyes Measured with a Contact Lens Sensor. J Glaucoma 2022; 31:639-644. [PMID: 35766388 DOI: 10.1097/ijg.0000000000002071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 06/12/2022] [Indexed: 11/26/2022]
Abstract
PRCIS The cut-off values of CLS. PURPOSE We conducted the present study to determine (1) the best factor for distinguishing normal tension glaucoma (NTG) and non-glaucoma subjects based on the intraocular pressure (IOP) values measured by a contact lens sensor (CLS) and (2) the optimal cut-off values of that factor. SUBJECTS AND METHODS The eyes of 18 non-glaucoma subjects and 26 NTG patients were examined. We evaluated five indicators: maximum IOP value, standard deviation (SD), IOP fluctuation range, the cosine-fit curve amplitude, and the amplitude of dual-harmonic regression values. We determined the indicators' cut-off values to distinguish between non-glaucoma subjects and NTG patients with the area under the curve (AUC). RESULTS The mean IOP values were 12.3±2.7 mmHg in the non-glaucoma eyes and 12.5±3.1 mmHg in the NTG eyes (P=0.824). All five indicators were significantly higher in the NTG group. The best factor to distinguish the non-glaucoma subjects and NTG patients was the IOP fluctuation range (P<0.0001, AUC=0.844); the cut-off level value was 436.5 millivolt equivalents. CONCLUSIONS 24 hour IOP measurements with a CLS showed that among IOP indicators studied, the range of IOP fluctuation was most important and significantly larger in NTG eyes compared to non-glaucoma eyes.
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17
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Zhu Y, Li S, Li J, Falcone N, Cui Q, Shah S, Hartel MC, Yu N, Young P, de Barros NR, Wu Z, Haghniaz R, Ermis M, Wang C, Kang H, Lee J, Karamikamkar S, Ahadian S, Jucaud V, Dokmeci MR, Kim HJ, Khademhosseini A. Lab-on-a-Contact Lens: Recent Advances and Future Opportunities in Diagnostics and Therapeutics. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2022; 34:e2108389. [PMID: 35130584 PMCID: PMC9233032 DOI: 10.1002/adma.202108389] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/27/2022] [Indexed: 05/09/2023]
Abstract
The eye is one of the most complex organs in the human body, containing rich and critical physiological information (e.g., intraocular pressure, corneal temperature, and pH) as well as a library of metabolite biomarkers (e.g., glucose, proteins, and specific ions). Smart contact lenses (SCLs) can serve as a wearable intelligent ocular prosthetic device capable of noninvasive and continuous monitoring of various essential physical/biochemical parameters and drug loading/delivery for the treatment of ocular diseases. Advances in SCL technologies and the growing public interest in personalized health are accelerating SCL research more than ever before. Here, the current status and potential of SCL development through a comprehensive review from fabrication to applications to commercialization are discussed. First, the material, fabrication, and platform designs of the SCLs for the diagnostic and therapeutic applications are discussed. Then, the latest advances in diagnostic and therapeutic SCLs for clinical translation are reviewed. Later, the established techniques for wearable power transfer and wireless data transmission applied to current SCL devices are summarized. An outlook, future opportunities, and challenges for developing next-generation SCL devices are also provided. With the rise in interest of SCL development, this comprehensive and essential review can serve as a new paradigm for the SCL devices.
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Affiliation(s)
- Yangzhi Zhu
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
| | - Shaopei Li
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
| | - Jinghang Li
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
- School of Engineering, Westlake University, Hangzhou, Zhejiang Province, 310024, China
- School of Materials Science and Engineering, Wuhan Institute of Technology, Wuhan, Hubei Province, 430205, China
| | - Natashya Falcone
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
| | - Qingyu Cui
- Department of Medicine, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, 90095, USA
| | - Shilp Shah
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
- Department of Bioengineering, University of California-Los Angeles, Los Angeles, CA, 90095, USA
| | - Martin C Hartel
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
- Department of Bioengineering, University of California-Los Angeles, Los Angeles, CA, 90095, USA
| | - Ning Yu
- Department of Chemical and Environmental Engineering, University of California-Riverside, Riverside, CA, 92521, USA
| | - Patric Young
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
| | | | - Zhuohong Wu
- Department of Nanoengineering, University of California-San Diego, San Diego, CA, 92093, USA
| | - Reihaneh Haghniaz
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
| | - Menekse Ermis
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
| | - Canran Wang
- Andrew and Peggy Cherng Department of Medical Engineering, Division of Engineering and Applied Science, California Institute of Technology, Pasadena, CA, 91125, USA
| | - Heemin Kang
- Department of Materials Science and Engineering, Korea University, Seoul, 02841, Republic of Korea
| | - Junmin Lee
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), Pohang, 37673, Republic of Korea
| | | | - Samad Ahadian
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
| | - Vadim Jucaud
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
| | - Mehmet R Dokmeci
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
| | - Han-Jun Kim
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
| | - Ali Khademhosseini
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, USA
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Hosseinian H, Hosseini S, Martinez-Chapa SO, Sher M. A Meta-Analysis of Wearable Contact Lenses for Medical Applications: Role of Electrospun Fiber for Drug Delivery. Polymers (Basel) 2022; 14:185. [PMID: 35012207 PMCID: PMC8747307 DOI: 10.3390/polym14010185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 12/18/2021] [Accepted: 12/20/2021] [Indexed: 01/14/2023] Open
Abstract
In recent years, wearable contact lenses for medical applications have attracted significant attention, as they enable continuous real-time recording of physiological information via active and noninvasive measurements. These devices play a vital role in continuous monitoring of intraocular pressure (IOP), noninvasive glucose monitoring in diabetes patients, drug delivery for the treatment of ocular illnesses, and colorblindness treatment. In specific, this class of medical devices is rapidly advancing in the area of drug loading and ocular drug release through incorporation of electrospun fibers. The electrospun fiber matrices offer a high surface area, controlled morphology, wettability, biocompatibility, and tunable porosity, which are highly desirable for controlled drug release. This article provides an overview of the advances of contact lens devices in medical applications with a focus on four main applications of these soft wearable devices: (i) IOP measurement and monitoring, (ii) glucose detection, (iii) ocular drug delivery, and (iv) colorblindness treatment. For each category and application, significant challenges and shortcomings of the current devices are thoroughly discussed, and new areas of opportunity are suggested. We also emphasize the role of electrospun fibers, their fabrication methods along with their characteristics, and the integration of diverse fiber types within the structure of the wearable contact lenses for efficient drug loading, in addition to controlled and sustained drug release. This review article also presents relevant statistics on the evolution of medical contact lenses over the last two decades, their strengths, and the future avenues for making the essential transition from clinical trials to real-world applications.
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Affiliation(s)
- Hamed Hosseinian
- School of Engineering and Sciences, Tecnologico de Monterrey, Ave. Eugenio Garza Sada 2501, Monterrey 64849, Mexico; (H.H.); (S.O.M.-C.)
| | - Samira Hosseini
- School of Engineering and Sciences, Tecnologico de Monterrey, Ave. Eugenio Garza Sada 2501, Monterrey 64849, Mexico; (H.H.); (S.O.M.-C.)
- Writing Lab, Institute for the Future of Education, Tecnologico de Monterrey, Monterrey 64849, Mexico
| | - Sergio O. Martinez-Chapa
- School of Engineering and Sciences, Tecnologico de Monterrey, Ave. Eugenio Garza Sada 2501, Monterrey 64849, Mexico; (H.H.); (S.O.M.-C.)
| | - Mazhar Sher
- Department of Mechanical Engineering and Applied Mechanics, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA 19104, USA
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19
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Affiliation(s)
- Huixin Liu
- Shanghai Environmental Protection Key Laboratory for Environmental Standard and Risk Management of Chemical Pollutants School of Resources & Environmental Engineering East China University of Science & Technology Shanghai 200237 PR China
- State Environmental Protection Key Lab of Environmental Risk Assessment and Control on Chemical Processes School of Resources & Environmental Engineering East China University of Science & Technology Shanghai 200237 PR China
| | - Xiaomei Yan
- Department of Chemistry Technical University of Denmark Kongens Lyngby 2800 Denmark
| | - Zhen Gu
- Department of Automation School of Information Science and Engineering East China University of Science & Technology Shanghai 200237 PR China
| | - Guangli Xiu
- Shanghai Environmental Protection Key Laboratory for Environmental Standard and Risk Management of Chemical Pollutants School of Resources & Environmental Engineering East China University of Science & Technology Shanghai 200237 PR China
- State Environmental Protection Key Lab of Environmental Risk Assessment and Control on Chemical Processes School of Resources & Environmental Engineering East China University of Science & Technology Shanghai 200237 PR China
| | - Xinxin Xiao
- Department of Chemistry Technical University of Denmark Kongens Lyngby 2800 Denmark
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20
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Pajic B, Resan M, Pajic-Eggspuehler B, Massa H, Cvejic Z. Triggerfish Recording of IOP Patterns in Combined HFDS Minimally Invasive Glaucoma and Cataract Surgery: A Prospective Study. J Clin Med 2021; 10:3472. [PMID: 34441768 PMCID: PMC8396965 DOI: 10.3390/jcm10163472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 07/30/2021] [Accepted: 08/04/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The aim of the study is to investigate whether the circadian IOP rhythm can be influenced by combined cataract surgery with high frequency deep sclerotomy (HFDS) and whether intraocular pressure (IOP) can be significantly reduced by HFDS. METHODS In our study 10 patients were included, in whom 24 h IOP monitoring was installed before and after HFDS/cataract surgery using a Triggerfish. HFDS is a minimally invasive glaucoma surgery (MIGS). RESULTS After performed HFDS combined with cataract surgery, the IOP was reduced from 27.7 ± 2.11 mmHg to 14.4 ± 2.59 mmHg, which is highly significant (p < 0.001). The contact lens sensor (CLS) cosinor analysis pre- and postoperatively showed that the circadian rhythm is not influenced by the surgery, i.e., the circadian IOP rhythm did not show significant differences before and after surgery. CONCLUSIONS HFDS combined with cataract surgery is a potent surgical method that can significantly reduce the IOP. However, the circadian rhythm cannot be changed by the surgery. The acrophase remained during the night in all patients.
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Affiliation(s)
- Bojan Pajic
- Eye Clinic Orasis, Swiss Eye Research Foundation, 5734 Reinach AG, Switzerland;
- Department of Physics, Faculty of Sciences, University of Novi Sad, Trg Dositeja Obradovica 4, 21000 Novi Sad, Serbia;
- Department of Clinical Neurosciences, Division of Ophthalmology, Geneva University Hospitals, 1205 Geneva, Switzerland;
- Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland
- Faculty of Medicine of the Military Medical Academy, University of Defense, 11000 Belgrade, Serbia;
| | - Mirko Resan
- Faculty of Medicine of the Military Medical Academy, University of Defense, 11000 Belgrade, Serbia;
| | | | - Horace Massa
- Department of Clinical Neurosciences, Division of Ophthalmology, Geneva University Hospitals, 1205 Geneva, Switzerland;
| | - Zeljka Cvejic
- Department of Physics, Faculty of Sciences, University of Novi Sad, Trg Dositeja Obradovica 4, 21000 Novi Sad, Serbia;
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21
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Ko J, Kang HJ, Ahn J, Zhao ZJ, Jeong Y, Hwang SH, Bok M, Jeon S, Gu J, Ha JH, Rho J, Jeong JH, Park I. Biocompatible Nanotransfer Printing Based on Water Bridge Formation in Hyaluronic Acid and Its Application to Smart Contact Lenses. ACS APPLIED MATERIALS & INTERFACES 2021; 13:35069-35078. [PMID: 34282875 DOI: 10.1021/acsami.1c06225] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Many conventional micropatterning and nanopatterning techniques employ toxic chemicals, rendering them nonbiocompatible and unsuited for biodevice production. Herein the formation of water bridges on the surface of hyaluronic acid (HA) films is exploited to develop a transfer-based nanopatterning method applicable to diverse structures and materials. The HA film surface, made deformable via water bridge generation, is brought into contact with a functional material and subjected to thermal treatment, which results in film shrinkage, allowing a robust pattern transfer. The proposed biocompatible method, which avoids the use of extra chemicals, enables the transfer of nanoscale, microscale, and thin-film structures as well as functional materials such as metals and metal oxides. A nanopatterned HA film is transferred onto a moisture-containing contact lens to fabricate smart contact lenses with unique optical characteristics of rationally designed optical nanopatterns. These lenses demonstrated binocular parallax-induced stereoscopy via nanoline array polarization and acted as cutoff filters, with nanodot arrays, capable of treating Irlen syndrome.
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Affiliation(s)
- Jiwoo Ko
- Department of Mechanical Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Yuseong-gu, Daejeon, 34141, South Korea
- Department of Nano Manufacturing Technology, Korea Institute of Machinery and Materials (KIMM), 156 Gajeongbuk-Ro, Yuseong-gu, Daejeon, 34103, South Korea
| | - Hyeok Joong Kang
- Department of Nano Manufacturing Technology, Korea Institute of Machinery and Materials (KIMM), 156 Gajeongbuk-Ro, Yuseong-gu, Daejeon, 34103, South Korea
| | - Junseong Ahn
- Department of Mechanical Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Yuseong-gu, Daejeon, 34141, South Korea
- Department of Nano Manufacturing Technology, Korea Institute of Machinery and Materials (KIMM), 156 Gajeongbuk-Ro, Yuseong-gu, Daejeon, 34103, South Korea
| | - Zhi-Jun Zhao
- Department of Nano Manufacturing Technology, Korea Institute of Machinery and Materials (KIMM), 156 Gajeongbuk-Ro, Yuseong-gu, Daejeon, 34103, South Korea
| | - Yongrok Jeong
- Department of Nano Manufacturing Technology, Korea Institute of Machinery and Materials (KIMM), 156 Gajeongbuk-Ro, Yuseong-gu, Daejeon, 34103, South Korea
| | - Soon Hyoung Hwang
- Department of Nano Manufacturing Technology, Korea Institute of Machinery and Materials (KIMM), 156 Gajeongbuk-Ro, Yuseong-gu, Daejeon, 34103, South Korea
| | - Moonjeong Bok
- Department of Nano Manufacturing Technology, Korea Institute of Machinery and Materials (KIMM), 156 Gajeongbuk-Ro, Yuseong-gu, Daejeon, 34103, South Korea
| | - Sohee Jeon
- Department of Nano Manufacturing Technology, Korea Institute of Machinery and Materials (KIMM), 156 Gajeongbuk-Ro, Yuseong-gu, Daejeon, 34103, South Korea
| | - Jimin Gu
- Department of Mechanical Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Yuseong-gu, Daejeon, 34141, South Korea
| | - Ji-Hwan Ha
- Department of Mechanical Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Yuseong-gu, Daejeon, 34141, South Korea
- Department of Nano Manufacturing Technology, Korea Institute of Machinery and Materials (KIMM), 156 Gajeongbuk-Ro, Yuseong-gu, Daejeon, 34103, South Korea
| | - Junsuk Rho
- Department of Chemical Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang-si, Gyeongsangbuk-do 37673, South Korea
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang-si, Gyeongsangbuk-do 37673, South Korea
| | - Jun-Ho Jeong
- Department of Nano Manufacturing Technology, Korea Institute of Machinery and Materials (KIMM), 156 Gajeongbuk-Ro, Yuseong-gu, Daejeon, 34103, South Korea
| | - Inkyu Park
- Department of Mechanical Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Yuseong-gu, Daejeon, 34141, South Korea
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22
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A soft and transparent contact lens for the wireless quantitative monitoring of intraocular pressure. Nat Biomed Eng 2021; 5:772-782. [PMID: 33941897 DOI: 10.1038/s41551-021-00719-8] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 03/22/2021] [Indexed: 02/02/2023]
Abstract
Continuous detection of raised intraocular pressure (IOP) could benefit the monitoring of patients with glaucoma. Current contact lenses with embedded sensors for measuring IOP are rigid, bulky, partially block vision or are insufficiently sensitive. Here, we report the design and testing in volunteers of a soft and transparent contact lens for the quantitative monitoring of IOP in real time using a smartphone. The contact lens incorporates a strain sensor, a wireless antenna, capacitors, resistors, stretchable metal interconnects and an integrated circuit for wireless communication. In rabbits, the lens provided measurements that match those of a commercial tonometer. In ten human participants, the lens proved to be safe, and reliably provided accurate quantitative measurements of IOP without inducing inflammation.
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Dennyson Savariraj A, Salih A, Alam F, Elsherif M, AlQattan B, Khan AA, Yetisen AK, Butt H. Ophthalmic Sensors and Drug Delivery. ACS Sens 2021; 6:2046-2076. [PMID: 34043907 PMCID: PMC8294612 DOI: 10.1021/acssensors.1c00370] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 05/17/2021] [Indexed: 12/15/2022]
Abstract
Advances in multifunctional materials and technologies have allowed contact lenses to serve as wearable devices for continuous monitoring of physiological parameters and delivering drugs for ocular diseases. Since the tear fluids comprise a library of biomarkers, direct measurement of different parameters such as concentration of glucose, urea, proteins, nitrite, and chloride ions, intraocular pressure (IOP), corneal temperature, and pH can be carried out non-invasively using contact lens sensors. Microfluidic contact lens sensor based colorimetric sensing and liquid control mechanisms enable the wearers to perform self-examinations at home using smartphones. Furthermore, drug-laden contact lenses have emerged as delivery platforms using a low dosage of drugs with extended residence time and increased ocular bioavailability. This review provides an overview of contact lenses for ocular diagnostics and drug delivery applications. The designs, working principles, and sensing mechanisms of sensors and drug delivery systems are reviewed. The potential applications of contact lenses in point-of-care diagnostics and personalized medicine, along with the significance of integrating multiplexed sensing units together with drug delivery systems, have also been discussed.
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Affiliation(s)
| | - Ahmed Salih
- Department
of Mechanical Engineering, Khalifa University
of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Fahad Alam
- Department
of Mechanical Engineering, Khalifa University
of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Mohamed Elsherif
- Department
of Mechanical Engineering, Khalifa University
of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Bader AlQattan
- Department
of Mechanical Engineering, Khalifa University
of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Ammar A. Khan
- Department
of Chemical Engineering, Imperial College
London, London SW7 2AZ, United Kingdom
| | - Ali K. Yetisen
- Department
of Physics, Lahore University of Management
Sciences, Lahore Cantonment 54792, Lahore, Pakistan
| | - Haider Butt
- Department
of Mechanical Engineering, Khalifa University
of Science and Technology, Abu Dhabi, United Arab Emirates
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Kim TY, Shin S, Choi H, Jeong SH, Myung D, Hahn SK. Smart Contact Lenses with a Transparent Silver Nanowire Strain Sensor for Continuous Intraocular Pressure Monitoring. ACS APPLIED BIO MATERIALS 2021; 4:4532-4541. [PMID: 35006789 PMCID: PMC10867858 DOI: 10.1021/acsabm.1c00267] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Continuous intraocular pressure (IOP) monitoring can provide a paradigm shift in the management of patients with glaucoma as a facile alternative to conventional diagnostic methods. However, the low sensitivity and functional instability of current IOP sensors have limited their clinical utility in the management of glaucoma. Here, we have developed a smart contact lens integrated with a transparent silver nanowire IOP strain sensor and wireless circuits for noninvasive, continuous IOP monitoring. After confirming the robust stability of the IOP sensor within the smart contact lens in the presence of tears and repeated eyelid blink model cycles, we were able to monitor IOP changes on polydimethylsiloxane model eyes in vitro. In vivo tests demonstrated that our fully integrated wireless smart contact lens could successfully monitor the change in IOP in living rabbit eyes, which was clearly validated by the conventional invasive tonometer IOP test. Taken together, we could confirm the feasibility of our smart contact lens as a noninvasive platform for continuous IOP monitoring of glaucoma patients.
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Affiliation(s)
- Tae Yeon Kim
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk 37673, Korea
| | - Sangbaie Shin
- PHI BIOMED Co., 168 Yeoksam-ro, Gangnam-gu, Seoul 06248, South Korea
| | - Hyunsik Choi
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk 37673, Korea
| | - Sang Hoon Jeong
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk 37673, Korea
| | - David Myung
- Department of Ophthalmology and Chemical Engineering, Stanford University, 443 Via Ortega, Stanford, California 94305, United States
| | - Sei Kwang Hahn
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk 37673, Korea
- PHI BIOMED Co., 168 Yeoksam-ro, Gangnam-gu, Seoul 06248, South Korea
- Department of Ophthalmology and Chemical Engineering, Stanford University, 443 Via Ortega, Stanford, California 94305, United States
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Toris CB, Gagrani M, Ghate D. Current methods and new approaches to assess aqueous humor dynamics. EXPERT REVIEW OF OPHTHALMOLOGY 2021. [DOI: 10.1080/17469899.2021.1902308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Carol B. Toris
- Dept. Of Ophthalmology and Visual Science, University of Nebraska Medical Center, Omaha, NE, USA
- Dept. Of Ophthalmology and Visual Science, Case Western Reserve University, Cleveland, OH USA
| | - Meghal Gagrani
- Dept. Of Ophthalmology and Visual Science, University of Nebraska Medical Center, Omaha, NE, USA
| | - Deepta Ghate
- Dept. Of Ophthalmology and Visual Science, University of Nebraska Medical Center, Omaha, NE, USA
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Kim YH, Lin MC, Radke CJ. Central-to-peripheral corneal edema during wear of embedded-component contact lenses. Cont Lens Anterior Eye 2021; 45:101443. [PMID: 33846087 DOI: 10.1016/j.clae.2021.101443] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/12/2021] [Accepted: 04/01/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE With active investigation underway for embedded-circuit contact lenses, safe oxygen supply of these novel lenses remains a question. Central-to-peripheral corneal edema for healthy eyes during wear of soft contact (SCL) and scleral lenses (SL) with embedding components is assessed. METHODS Various 2-dimensional (2D) designs of SL and SCL with embedded components are constructed on Comsol Multiphysics 5.5. Local corneal swelling associated with the designed lenses is determined by a recently developed 2D metabolic-swelling model. Settled central post-lens tear-film thicknesses (PoLTFs) are set at 400 μm and 3 μm for SL and SCL designs, respectively. Each lens design has an axisymmetric central and an axisymmetric peripheral embedment. Oxygen permeability (Dk) of the lens and the embedments ranges from 0 to 200 Barrer. Dimensions and location of the embedments are varied to assess optimal-design configurations to minimize central-to-peripheral corneal edema. RESULTS By adjusting oxygen Dk of the central embedment, the peripheral embedment, or the lens matrix polymer, corneal swelling is reduced by up to 2.5 %, 1.5 %, or 1.4 % of the baseline corneal thickness, respectively, while keeping all other parameters constant. A decrease in PoLTF thickness from 400 μm to 3 μm decreases corneal edema by up to 1.8 % of the baseline corneal thickness. Shifting the peripheral embedment farther out towards the periphery and towards the anterior lens surface reduces peak edema by up to 1.3 % and 0.6 % of the baseline corneal thickness, respectively. CONCLUSIONS To minimize central-to-peripheral corneal edema, embedments should be placed anteriorly and far into the periphery to allow maximal limbal metabolic support and oxygen transport in the polar direction (i.e., the θ-direction in spherical coordinates). High-oxygen transmissibility for all components and thinner PoLTF thickness are recommended to minimize corneal edema. Depending on design specifications, less than 1 % swelling over the entire cornea is achievable even with oxygen-impermeable embedments.
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Affiliation(s)
- Young Hyun Kim
- Vision Science Group, University of California, Berkeley, CA, 94720, United States; Chemical and Biomolecular Engineering Department, University of California, Berkeley, CA, 94720, United States; Clinical Research Center, School of Optometry, University of California, Berkeley, CA, 94720, United States
| | - Meng C Lin
- Vision Science Group, University of California, Berkeley, CA, 94720, United States; Clinical Research Center, School of Optometry, University of California, Berkeley, CA, 94720, United States
| | - Clayton J Radke
- Vision Science Group, University of California, Berkeley, CA, 94720, United States; Chemical and Biomolecular Engineering Department, University of California, Berkeley, CA, 94720, United States.
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Shin H, Seo H, Chung WG, Joo BJ, Jang J, Park JU. Recent progress on wearable point-of-care devices for ocular systems. LAB ON A CHIP 2021; 21:1269-1286. [PMID: 33704299 DOI: 10.1039/d0lc01317j] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
The eye is a complex sensory organ that contains abundant information for specific diseases and pathological responses. It has emerged as a facile biological interface for wearable healthcare platforms because of its excellent accessibility. Recent advances in electronic devices have led to the extensive research of point-of-care (POC) systems for diagnosing and monitoring diseases by detecting the biomarkers within the eye. Among these systems, contact lenses, which make direct contact with the ocular surfaces, have been utilized as one of the promising candidates for non-invasive POC testing of various diseases. The continuous and long-term measurement from the sensor allows the patients to manage their symptoms in an effective and convenient way. Herein, we review the progress of contact lens sensors in terms of the materials, methodologies, device designs, and target biomarkers. The anatomical structure and biological mechanisms of the eye are also discussed to provide a comprehensive understanding of the principles of contact lens sensors. Intraocular pressure and glucose, which are the representative biomarkers found in the eyes, can be measured with the biosensors integrated with contact lenses for the diagnosis of glaucoma and diabetes. Furthermore, contact lens sensors for various general pathologies as well as other ocular diseases are also considered, thereby providing the prospects for further developments of smart contact lenses as a future POC system.
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Affiliation(s)
- Haein Shin
- Nano Science Technology Institute, Department of Materials Science and Engineering, Yonsei University, Seoul, 03722, Republic of Korea.
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Muniesa MJ, Benítez I, Ezpeleta J, Sánchez de la Torre M, Pazos M, Millà E, Barbé F. Effect of CPAP Therapy on 24-Hour Intraocular Pressure-Related Pattern From Contact Lens Sensors in Obstructive Sleep Apnea Syndrome. Transl Vis Sci Technol 2021; 10:10. [PMID: 34003989 PMCID: PMC8054618 DOI: 10.1167/tvst.10.4.10] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 02/19/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the effect of continuous positive airway pressure (CPAP) therapy on 24-hour intraocular pressure (IOP)-related pattern from contact lens sensors (CLS) in obstructive sleep apnea syndrome (OSAS). Methods Prospective, observational, case series study. Twenty-two eyes of 22 newly diagnosed patients with severe OSAS were included. A first 24-hour CLS measurement was performed before CPAP therapy was started, and a second 24-hour CLS monitoring was performed after beginning CPAP. We analyzed the amplitude and the maximum and minimum IOP-related values (m Veq). We also analyzed IOP-related measurements at five-minute intervals throughout the first hour of nocturnal acrophase, starting from when the patient fell asleep. Results The baseline measurements showed significant fluctuations in the IOP, with the highest IOP readings being recorded at night (nocturnal acrophase) in 17 of 22 patients (77.27%). Nocturnal acrophase began when the patients laid down to sleep. During CPAP therapy, the patients showed a more marked increase in IOP in the initial phase of nocturnal acrophase, with significant differences at 20, 25, 30, and 55 minutes (P < 0.05). Conclusions Most of patients with severe OSAS exhibited a nocturnal acrophase and the highest IOP readings at night. CPAP was associated with additional increase in IOP-related pattern for at least the first hour of CPAP use. Translational Relevance Our results suggest that CPAP was associated with additional increase in IOP during the initial phase of nocturnal acrophase. This effect could be important in the management of patients with OSAS and glaucomatous progression.
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Affiliation(s)
- María Jesús Muniesa
- Institut Clínic d'Oftalmologia, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca Biomèdica de Lleida (IRBLleida)—Group of Translational Research in Respiratory Medicine, Lleida, Spain
| | - Iván Benítez
- Institut de Recerca Biomèdica de Lleida (IRBLleida)—Group of Translational Research in Respiratory Medicine, Lleida, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Juan Ezpeleta
- Ophthalmology Department, Arnau de Vilanova University Hospital, IRBLleida, Catalonia, Spain
| | - Manuel Sánchez de la Torre
- Institut de Recerca Biomèdica de Lleida (IRBLleida)—Group of Translational Research in Respiratory Medicine, Lleida, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Marta Pazos
- Institut Clínic d'Oftalmologia, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Elena Millà
- Institut Clínic d'Oftalmologia, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Ferrán Barbé
- Institut de Recerca Biomèdica de Lleida (IRBLleida)—Group of Translational Research in Respiratory Medicine, Lleida, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
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29
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Next-generation contact lenses: Towards bioresponsive drug delivery and smart technologies in ocular therapeutics. Eur J Pharm Biopharm 2021; 161:80-99. [DOI: 10.1016/j.ejpb.2021.02.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 12/25/2020] [Accepted: 02/09/2021] [Indexed: 12/11/2022]
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30
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Jones L, Hui A, Phan CM, Read ML, Azar D, Buch J, Ciolino JB, Naroo SA, Pall B, Romond K, Sankaridurg P, Schnider CM, Terry L, Willcox M. CLEAR - Contact lens technologies of the future. Cont Lens Anterior Eye 2021; 44:398-430. [PMID: 33775384 DOI: 10.1016/j.clae.2021.02.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 02/01/2021] [Indexed: 12/20/2022]
Abstract
Contact lenses in the future will likely have functions other than correction of refractive error. Lenses designed to control the development of myopia are already commercially available. Contact lenses as drug delivery devices and powered through advancements in nanotechnology will open up further opportunities for unique uses of contact lenses. This review examines the use, or potential use, of contact lenses aside from their role to correct refractive error. Contact lenses can be used to detect systemic and ocular surface diseases, treat and manage various ocular conditions and as devices that can correct presbyopia, control the development of myopia or be used for augmented vision. There is also discussion of new developments in contact lens packaging and storage cases. The use of contact lenses as devices to detect systemic disease has mostly focussed on detecting changes to glucose levels in tears for monitoring diabetic control. Glucose can be detected using changes in colour, fluorescence or generation of electric signals by embedded sensors such as boronic acid, concanavalin A or glucose oxidase. Contact lenses that have gained regulatory approval can measure changes in intraocular pressure to monitor glaucoma by measuring small changes in corneal shape. Challenges include integrating sensors into contact lenses and detecting the signals generated. Various techniques are used to optimise uptake and release of the drugs to the ocular surface to treat diseases such as dry eye, glaucoma, infection and allergy. Contact lenses that either mechanically or electronically change their shape are being investigated for the management of presbyopia. Contact lenses that slow the development of myopia are based upon incorporating concentric rings of plus power, peripheral optical zone(s) with add power or non-monotonic variations in power. Various forms of these lenses have shown a reduction in myopia in clinical trials and are available in various markets.
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Affiliation(s)
- Lyndon Jones
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada; Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong.
| | - Alex Hui
- School of Optometry and Vision Science, UNSW Sydney, Sydney, NSW, Australia
| | - Chau-Minh Phan
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada; Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong
| | - Michael L Read
- Eurolens Research, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Dimitri Azar
- Department of Ophthalmology and Visual Sciences, University of Illinois College of Medicine, Chicago, IL, USA; Verily Life Sciences, San Francisco, CA, USA
| | - John Buch
- Johnson & Johnson Vision Care, Jacksonville, FL, USA
| | - Joseph B Ciolino
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - Shehzad A Naroo
- College of Health and Life Sciences, Aston University, Birmingham B4 7ET, UK
| | - Brian Pall
- Johnson & Johnson Vision Care, Jacksonville, FL, USA
| | - Kathleen Romond
- Department of Ophthalmology and Visual Sciences, University of Illinois College of Medicine, Chicago, IL, USA
| | - Padmaja Sankaridurg
- School of Optometry and Vision Science, UNSW Sydney, Sydney, NSW, Australia; Brien Holden Vision Institute, Sydney, Australia
| | | | - Louise Terry
- School of Optometry and Vision Sciences, Cardiff University, UK
| | - Mark Willcox
- School of Optometry and Vision Science, UNSW Sydney, Sydney, NSW, Australia
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Yang C, Huang X, Li X, Yang C, Zhang T, Wu Q, liu D, Lin H, Chen W, Hu N, Xie X. Wearable and Implantable Intraocular Pressure Biosensors: Recent Progress and Future Prospects. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2021; 8:2002971. [PMID: 33747725 PMCID: PMC7967055 DOI: 10.1002/advs.202002971] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/24/2020] [Indexed: 05/09/2023]
Abstract
Biosensors worn on or implanted in eyes have been garnering substantial attention since being proven to be an effective means to acquire critical biomarkers for monitoring the states of ophthalmic disease, diabetes. Among these disorders, glaucoma, the second leading cause of blindness globally, usually results in irreversible blindness. Continuous intraocular pressure (IOP) monitoring is considered as an effective measure, which provides a comprehensive view of IOP changes that is beyond reach for the "snapshots" measurements by clinical tonometry. However, to satisfy the applications in ophthalmology, the development of IOP sensors are required to be prepared with biocompatible, miniature, transparent, wireless and battery-free features, which are still challenging with many current fabrication processes. In this work, the recent advances in this field are reviewed by categorizing these devices into wearable and implantable IOP sensors. The materials and structures exploited for engineering these IOP devices are presented. Additionally, their working principle, performance, and the potential risk that materials and device architectures may pose to ocular tissue are discussed. This review should be valuable for preferable structure design, device fabrication, performance optimization, and reducing potential risk of these devices. It is significant for the development of future practical IOP sensors.
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Affiliation(s)
- Cheng Yang
- State Key Laboratory of Optoelectronic Materials and TechnologiesGuangdong Province Key Laboratory of Display Material and TechnologySchool of Electronics and Information TechnologyThe First Affiliated Hospital of Sun Yat‐Sen UniversitySun Yat‐Sen UniversityGuangzhou510006China
| | - Xinshuo Huang
- State Key Laboratory of Optoelectronic Materials and TechnologiesGuangdong Province Key Laboratory of Display Material and TechnologySchool of Electronics and Information TechnologyThe First Affiliated Hospital of Sun Yat‐Sen UniversitySun Yat‐Sen UniversityGuangzhou510006China
| | - Xiangling Li
- State Key Laboratory of Optoelectronic Materials and TechnologiesGuangdong Province Key Laboratory of Display Material and TechnologySchool of Electronics and Information TechnologyThe First Affiliated Hospital of Sun Yat‐Sen UniversitySun Yat‐Sen UniversityGuangzhou510006China
- School of Biomedical EngineeringSun Yat‐Sen UniversityGuangzhou510006China
| | - Chengduan Yang
- State Key Laboratory of Optoelectronic Materials and TechnologiesGuangdong Province Key Laboratory of Display Material and TechnologySchool of Electronics and Information TechnologyThe First Affiliated Hospital of Sun Yat‐Sen UniversitySun Yat‐Sen UniversityGuangzhou510006China
| | - Tao Zhang
- State Key Laboratory of Optoelectronic Materials and TechnologiesGuangdong Province Key Laboratory of Display Material and TechnologySchool of Electronics and Information TechnologyThe First Affiliated Hospital of Sun Yat‐Sen UniversitySun Yat‐Sen UniversityGuangzhou510006China
- School of Biomedical EngineeringSun Yat‐Sen UniversityGuangzhou510006China
| | - Qianni Wu
- State Key Laboratory of OphthalmologyZhongshan Ophthalmic CenterSun Yat‐Sen UniversityGuangzhou510060China
| | - Dong liu
- State Key Laboratory of OphthalmologyZhongshan Ophthalmic CenterSun Yat‐Sen UniversityGuangzhou510060China
| | - Haotian Lin
- State Key Laboratory of OphthalmologyZhongshan Ophthalmic CenterSun Yat‐Sen UniversityGuangzhou510060China
| | - Weirong Chen
- State Key Laboratory of OphthalmologyZhongshan Ophthalmic CenterSun Yat‐Sen UniversityGuangzhou510060China
| | - Ning Hu
- State Key Laboratory of Optoelectronic Materials and TechnologiesGuangdong Province Key Laboratory of Display Material and TechnologySchool of Electronics and Information TechnologyThe First Affiliated Hospital of Sun Yat‐Sen UniversitySun Yat‐Sen UniversityGuangzhou510006China
| | - Xi Xie
- State Key Laboratory of Optoelectronic Materials and TechnologiesGuangdong Province Key Laboratory of Display Material and TechnologySchool of Electronics and Information TechnologyThe First Affiliated Hospital of Sun Yat‐Sen UniversitySun Yat‐Sen UniversityGuangzhou510006China
- State Key Laboratory of OphthalmologyZhongshan Ophthalmic CenterSun Yat‐Sen UniversityGuangzhou510060China
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Li P, Lee GH, Kim SY, Kwon SY, Kim HR, Park S. From Diagnosis to Treatment: Recent Advances in Patient-Friendly Biosensors and Implantable Devices. ACS NANO 2021; 15:1960-2004. [PMID: 33534541 DOI: 10.1021/acsnano.0c06688] [Citation(s) in RCA: 108] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Patient-friendly medical diagnostics and treatments have been receiving a great deal of interest due to their rapid and cost-effective health care applications with minimized risk of infection, which has the potential to replace conventional hospital-based medical procedures. In particular, the integration of recently developed materials into health care devices allows the rapid development of point-of-care (POC) sensing platforms and implantable devices with special functionalities. In this review, the recent advances in biosensors for patient-friendly diagnosis and implantable devices for patient-friendly treatment are discussed. Comprehensive analysis of portable and wearable biosensing platforms for patient-friendly health monitoring and disease diagnosis is provided, including topics such as materials selection, device structure and integration, and biomarker detection strategies. Moreover, specific challenges related to each biological fluid for wearable biosensor-based POC applications are presented. Also, advances in implantable devices, including recent materials development and wireless communication strategies, are discussed. Furthermore, various patient-friendly surgical and treatment approaches are reviewed, such as minimally invasive insertion and mounting, in vivo electrical and optical modulations, and post-operation health monitoring. Finally, the challenges and future perspectives toward the development of the patient-friendly diagnosis and treatment are provided.
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Affiliation(s)
- Pei Li
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, Republic of Korea
| | - Gun-Hee Lee
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, Republic of Korea
- School of Electrical Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, Republic of Korea
| | - Su Yeong Kim
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, Republic of Korea
| | - Se Young Kwon
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, Republic of Korea
| | - Hyung-Ryong Kim
- College of Dentistry and Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan 330-714, Republic of Korea
| | - Steve Park
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, Republic of Korea
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Dou Z, Tang J, Liu Z, Sun Q, Wang Y, Li Y, Yuan M, Wu H, Wang Y, Pei W, Chen H. Wearable Contact Lens Sensor for Non-invasive Continuous Monitoring of Intraocular Pressure. MICROMACHINES 2021; 12:108. [PMID: 33499080 PMCID: PMC7910926 DOI: 10.3390/mi12020108] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 02/06/2023]
Abstract
Intraocular pressure (IOP) is an essential indicator of the diagnosis and treatment of glaucoma. IOP has an apparent physiological rhythm, and it often reaches its peak value at night. To avoid missing the peak value at night and sample the entire rhythm cycle, the continuous monitoring of IOP is urgently needed. A wearable contact lens IOP sensor based on a platinum (Pt) strain gauge is fabricated by the micro-electro-mechanical (MEMS) process. The structure and parameters of the strain gauge are optimized to improve the sensitivity and temperature stability. Tests on an eyeball model indicate that the IOP sensor has a high sensitivity of 289.5 μV/mmHg and excellent dynamic cycling performance at different speeds of IOP variation. The temperature drift coefficient of the sensor is 33.4 μV/°C. The non-invasive IOP sensor proposed in this report exhibits high sensitivity and satisfactory stability, promising a potential in continuous IOP monitoring.
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Affiliation(s)
- Zhiqiang Dou
- The State Key Laboratory on Integrated Optoelectronics, Institute of Semiconductors, Chinese Academy of Sciences, Beijing 100083, China; (Z.D.); (J.T.); (Z.L.); (Q.S.); (Y.W.); (Y.L.); (M.Y.); (Y.W.); (H.C.)
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jun Tang
- The State Key Laboratory on Integrated Optoelectronics, Institute of Semiconductors, Chinese Academy of Sciences, Beijing 100083, China; (Z.D.); (J.T.); (Z.L.); (Q.S.); (Y.W.); (Y.L.); (M.Y.); (Y.W.); (H.C.)
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zhiduo Liu
- The State Key Laboratory on Integrated Optoelectronics, Institute of Semiconductors, Chinese Academy of Sciences, Beijing 100083, China; (Z.D.); (J.T.); (Z.L.); (Q.S.); (Y.W.); (Y.L.); (M.Y.); (Y.W.); (H.C.)
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Qigong Sun
- The State Key Laboratory on Integrated Optoelectronics, Institute of Semiconductors, Chinese Academy of Sciences, Beijing 100083, China; (Z.D.); (J.T.); (Z.L.); (Q.S.); (Y.W.); (Y.L.); (M.Y.); (Y.W.); (H.C.)
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yang Wang
- The State Key Laboratory on Integrated Optoelectronics, Institute of Semiconductors, Chinese Academy of Sciences, Beijing 100083, China; (Z.D.); (J.T.); (Z.L.); (Q.S.); (Y.W.); (Y.L.); (M.Y.); (Y.W.); (H.C.)
| | - Yamin Li
- The State Key Laboratory on Integrated Optoelectronics, Institute of Semiconductors, Chinese Academy of Sciences, Beijing 100083, China; (Z.D.); (J.T.); (Z.L.); (Q.S.); (Y.W.); (Y.L.); (M.Y.); (Y.W.); (H.C.)
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Miao Yuan
- The State Key Laboratory on Integrated Optoelectronics, Institute of Semiconductors, Chinese Academy of Sciences, Beijing 100083, China; (Z.D.); (J.T.); (Z.L.); (Q.S.); (Y.W.); (Y.L.); (M.Y.); (Y.W.); (H.C.)
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Huijuan Wu
- Department of Ophthalmology, Peking University People’s Hospital, Beijing 100044, China;
| | - Yijun Wang
- The State Key Laboratory on Integrated Optoelectronics, Institute of Semiconductors, Chinese Academy of Sciences, Beijing 100083, China; (Z.D.); (J.T.); (Z.L.); (Q.S.); (Y.W.); (Y.L.); (M.Y.); (Y.W.); (H.C.)
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Weihua Pei
- The State Key Laboratory on Integrated Optoelectronics, Institute of Semiconductors, Chinese Academy of Sciences, Beijing 100083, China; (Z.D.); (J.T.); (Z.L.); (Q.S.); (Y.W.); (Y.L.); (M.Y.); (Y.W.); (H.C.)
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Hongda Chen
- The State Key Laboratory on Integrated Optoelectronics, Institute of Semiconductors, Chinese Academy of Sciences, Beijing 100083, China; (Z.D.); (J.T.); (Z.L.); (Q.S.); (Y.W.); (Y.L.); (M.Y.); (Y.W.); (H.C.)
- University of Chinese Academy of Sciences, Beijing 100049, China
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Chen X, Wu X, Lin X, Wang J, Xu W. Outcome, influence factor and development of CLS measurement in continuous IOP monitoring: A narrative review. Cont Lens Anterior Eye 2020; 44:101376. [PMID: 33092960 DOI: 10.1016/j.clae.2020.10.006] [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: 07/08/2020] [Revised: 09/25/2020] [Accepted: 10/08/2020] [Indexed: 10/23/2022]
Abstract
A large fluctuation in intraocular pressure (IOP) and a high peak IOP remain the risk factors for progressive visual field loss in patients with glaucoma, which is a leading cause of irreversible blindness. However, IOP measurements during working time cannot provide sufficient information on IOP to guide clinicians in setting IOP target values. Contact lenses are extensively used in ophthalmology to correct the refractive error, and recently, they are serving as platforms for detection and drug delivery. Contact lens sensor (CLS) is a feasible and promising approach to continuously monitor IOP, with superior tolerance, non-invasiveness, and without sleep disturbance. The present work reviewed the associations between progressive course and Triggerfish® CLS outputs as well as the relationship between treatments and Triggerfish® CLS outputs. Moreover, it further summarized state-of-the-art CLS devices of the past decade.
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Affiliation(s)
- Xiang Chen
- The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China
| | - Xingdi Wu
- The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China
| | - Xueqi Lin
- The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China
| | - Jingwen Wang
- The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China
| | - Wen Xu
- The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China.
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Artificial iris performance for smart contact lens vision correction applications. Sci Rep 2020; 10:14641. [PMID: 32887927 PMCID: PMC7474060 DOI: 10.1038/s41598-020-71376-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 08/11/2020] [Indexed: 12/14/2022] Open
Abstract
This paper presents the simulated performance assessment of an artificial iris embedded on a scleral contact lens using real data from an aniridia patient. The artificial iris is based on guest–host liquid crystal cells (GH-LCD) in order to actively modify the transmittance of the lens and effective pupil size. Experimental validation of the GH-LCD spectrum and iris contrast (determined to be 1:2.1) enabled the development of optical models that include the effect of a small pupil on image quality and visual quality on an optical system with aniridia characteristics. Visual simulations at different light conditions (high/low photopic and mesopic) demonstrated the theoretical capacity of the customized artificial iris smart contact lens to expand the depth-of-focus and decrease the optical aberrations (in particular, the spherical aberration). The visual modelling suggests a maximum depth-of-focus value for a 2-mm pupil diameter for both eyes as follows: 3D (1,000 cd/m2), 2D (10 cd/m2) and 0.75D (1 cd/m2). This work demonstrates the beneficial optical effects of an active artificial iris, based on visual simulations in response to different light levels, and enables further experimental investigation on patients to validate the dynamic light attenuation and visual performance of smart contact lenses with GH-LCD.
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Kwon S, Kim SH, Khang D, Lee JY. Potential Therapeutic Usage of Nanomedicine for Glaucoma Treatment. Int J Nanomedicine 2020; 15:5745-5765. [PMID: 32821099 PMCID: PMC7418176 DOI: 10.2147/ijn.s254792] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 06/05/2020] [Indexed: 12/20/2022] Open
Abstract
Glaucoma is a group of diseases characterized by progressive degeneration of retinal ganglion cells, leading to irreversible blindness. Currently, intraocular pressure reduction is the only established treatment available for glaucoma. With this treatment, the progression of the disease can only be delayed and there is no recovery. In addition, the commercially available eye drops have the disadvantage of low compliance and short therapeutic time, while glaucoma surgery always has the risk of failure due to wound fibrosis. Nanotechnology can overcome the limitations of the current treatment through the encapsulation and conjugation of drugs used for lowering intraocular pressure and antifibrotic agents using biodegradable or biocompatible nanoparticles for the sustained release of the drugs to protect the damaged ocular cells. Furthermore, using nanotechnology, treatment can be administered in various forms, including eye drops, contact lens, and ocular inserts, according to the convenience of the patients. Despite the promising results of delaying the progression of glaucoma, the regeneration of damaged ocular cells, including trabecular meshwork and retinal ganglion cells, is another critical hurdle to overcome. Bone marrow-derived mesenchymal stem cells and Müller glia cells can secrete neurogenic factors that trigger the regeneration of associated cells, including trabecular meshwork and retinal ganglion cells. In conclusion, this review highlights the potential therapeutic applications of nanotechnology- and stem cell-based methods that can be employed for the protection and regeneration of ocular cells.
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Affiliation(s)
- Song Kwon
- Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon 21999, South Korea
| | - Sung Hyun Kim
- Department of Ophthalmology, Gil Medical Center, Gachon University, College of Medicine, Incheon 21565, South Korea
| | - Dongwoo Khang
- Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon 21999, South Korea.,Department of Gachon Advanced Institute for Health Science & Technology (GAIHST), Gachon University, Incheon 21999, South Korea.,Department of Physiology, School of Medicine, Gachon University, Incheon 21999, South Korea
| | - Jong Yeon Lee
- Department of Ophthalmology, Gil Medical Center, Gachon University, College of Medicine, Incheon 21565, South Korea
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Maeng B, Chang HK, Park J. Photonic crystal-based smart contact lens for continuous intraocular pressure monitoring. LAB ON A CHIP 2020; 20:1740-1750. [PMID: 32347844 DOI: 10.1039/c9lc01268k] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Glaucoma is a very common disease after cataracts and is dangerous enough to cause irreversible blindness. However, often the main symptom of glaucoma is difficult to recognize because it may be absent or appear late, so the risk of blindness is greater. Intraocular pressure (IOP) is a well-known primary factor indicating glaucoma. In this study, we demonstrate a smart IOP sensor embedded in a contact lens that works through visual color changes without an external power source such as a battery or RF-based wireless power transfer. A microhydraulic amplification mechanism is adopted to enhance the range of color change from a photonic crystal (PC)-based flexible membrane whose lattice distance between nanostructures varies according to the morphology changes of an eyeball caused by IOP. The performance of the sensor is quantitatively demonstrated using an artificial silicone eye model for in vitro evaluation and a porcine eyeball for ex vivo verification. It has a limit of detection (LOD) of 3.2 and 5.12 mmHg, which was measured and evaluated using a spectrometer and a smartphone camera, respectively. The results prove that our sensor embedded in the contact lens can continuously monitor the IOP change using color change, and a smartphone camera can be used as a quantitative IOP measurement system in a noninvasive manner without an expensive optical spectrometer.
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Affiliation(s)
- Bohee Maeng
- Department of Mechanical Engineering, Sogang University, 35 Baekbeom-ro, Mapo-gu, Seoul 04107, Republic of Korea.
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Esen F, Eraslan M, Cerman E, Celiker H, Kazokoglu H. Diurnal Spikes of Intraocular Pressure in Uveitic Glaucoma: A 24-hour Intraocular Pressure Monitoring Study. Semin Ophthalmol 2020; 35:246-251. [PMID: 32881589 DOI: 10.1080/08820538.2020.1809683] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE The aim of this study was to document diurnal changes in intraocular pressure (IOP) in uveitic glaucoma (UG) and compare it with primary open angle glaucoma (POAG) patients. METHODS Eight patients with UG and seven patients with POAG were included in this study. The patients were matched for age, gender, and glaucoma medications. None of the patients experienced angle closure, uveitis attack, and ocular surgery, and were not under steroid or immunomodulatory therapy within the last three months. The 24-hour IOP fluctuations were recorded with the help of a contact lens sensor (Sensimed Triggerfish ®, Switzerland). The diurnal IOP fluctuations were modeled with best-fit lines and statistical comparisons between the longitudinal responses of the two groups were determined with nonlinear regression. RESULTS The comparison of mean 24-hour contact lens sensor (CLS) amplitudes revealed a significant difference between the fluctuation levels of UG and POAG groups (213 ± 160 millivolt equivalents (mVeq) vs. 162 ± 168 mVeq, respectively p = .003). The top level of the best-fit curves was significantly higher in the UG group (266 ± 143 mVeq) compared to the POAG group (159 ± 162 mVeq, p < .001). Both curves had their top levels between 5:00 PM and 8:00 AM. The longitudinal regression analysis revealed that the amplitudes of the 24-hour fluctuation waves were significantly different (p = .041). CONCLUSIONS This study demonstrated for the first time that the diurnal variation in IOP was significantly higher in UG patients. This difference was also more distinct between 5:00 PM and 8:00 AM clock-hours. The uveitis and glaucoma specialists should consider this potential for higher IOP fluctuations, while tailoring the glaucoma treatment in uveitic patients.
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Affiliation(s)
- Fehim Esen
- Department of Ophthalmology, Istanbul Medeniyet University School of Medicine , Istanbul, Turkey
| | - Muhsin Eraslan
- Department of Ophthalmology, Marmara University School of Medicine , Istanbul, Turkey
| | - Eren Cerman
- Department of Ophthalmology, Marmara University School of Medicine , Istanbul, Turkey
| | - Hande Celiker
- Department of Ophthalmology, Marmara University School of Medicine , Istanbul, Turkey
| | - Haluk Kazokoglu
- Department of Ophthalmology, Marmara University School of Medicine , Istanbul, Turkey
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Xu J, Cui T, Hirtz T, Qiao Y, Li X, Zhong F, Han X, Yang Y, Zhang S, Ren TL. Highly Transparent and Sensitive Graphene Sensors for Continuous and Non-invasive Intraocular Pressure Monitoring. ACS APPLIED MATERIALS & INTERFACES 2020; 12:18375-18384. [PMID: 32223262 DOI: 10.1021/acsami.0c02991] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Intraocular pressure (IOP) is the prime indicator for the diagnosis and treatment of glaucoma. IOP has circadian rhythm changes and is dependent on body gestures; therefore, a single measurement in the clinic can be misleading for diagnosis. Herein, few-layer graphene is utilized to develop non-invasive sensors with high transparency, sensitivity, linearity, and biocompatibility for 24 h continuous IOP monitoring. The graphene Wheatstone bridge consisting of two strain gauges and two compensating resistors is designed to improve the sensitivity and accuracy of IOP measurement. Testing results on a silicone eyeball indicate that the output voltage of the sensor is proportional to the IOP fluctuation. Under the various ranges and speeds of IOP fluctuation, the sensor exhibits excellent performance of dynamic cycles and step responses with an average sensitivity of 150 μV/mmHg. With the linear relationship, the average relative error between the calibrated IOP and the standard pressure is maintained at about 5%. More than 100 cycles and interval time measurements illustrate that the sensor possesses significant stability, durability, and reliability. Furthermore, a wireless system is designed for the sensor to realize IOP monitoring using a mobile phone. This sensor, with the average transparency of 85% and its ease of fabrication, as well as its portability for continuous IOP monitoring, brings new promise to the diagnosis and treatment of glaucoma.
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Affiliation(s)
- Jiandong Xu
- Institute of Microelectronics, Tsinghua University, Beijing 100084, P. R. China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, P. R. China
| | - Tianrui Cui
- Institute of Microelectronics, Tsinghua University, Beijing 100084, P. R. China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, P. R. China
| | - Thomas Hirtz
- Institute of Microelectronics, Tsinghua University, Beijing 100084, P. R. China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, P. R. China
| | - Yancong Qiao
- Institute of Microelectronics, Tsinghua University, Beijing 100084, P. R. China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, P. R. China
| | - Xiaoshi Li
- Institute of Microelectronics, Tsinghua University, Beijing 100084, P. R. China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, P. R. China
| | - Fanhui Zhong
- Institute of Microelectronics, Tsinghua University, Beijing 100084, P. R. China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, P. R. China
| | - Xiaolin Han
- Institute of Microelectronics, Tsinghua University, Beijing 100084, P. R. China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, P. R. China
| | - Yi Yang
- Institute of Microelectronics, Tsinghua University, Beijing 100084, P. R. China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, P. R. China
| | - Sheng Zhang
- Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, P. R. China
| | - Tian-Ling Ren
- Institute of Microelectronics, Tsinghua University, Beijing 100084, P. R. China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, P. R. China
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Kim K, Kim B, Lee CH. Printing Flexible and Hybrid Electronics for Human Skin and Eye-Interfaced Health Monitoring Systems. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2020; 32:e1902051. [PMID: 31298450 DOI: 10.1002/adma.201902051] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 05/02/2019] [Indexed: 05/27/2023]
Abstract
Advances in printing materials and techniques for flexible and hybrid electronics in the domain of connected healthcare have enabled rapid development of innovative body-interfaced health monitoring systems at a tremendous pace. Thin, flexible, and stretchable biosensors that are printed on a biocompatible soft substrate provide the ability to noninvasively and unobtrusively integrate with the human body for continuous monitoring and early detection of diseases and other conditions affecting health and well being. Hybrid integration of such biosensors with extremely well-established silicon-based microcircuit chips offers a viable route for in-sensor data processing and wireless transmission in many medical and clinical settings. Here, a set of advanced and hybrid printing techniques is summarized, covering diverse aspects ranging from active electronic materials to process capability, for their use in human skin and eye-interfaced health monitoring systems with different levels of complexity. Essential components of the devices, including constituent biomaterials, structural layouts, assembly methods, and power and data processing configurations, are outlined and discussed in a categorized manner tailored to specific clinical needs. Perspectives on the benefits and challenges of these systems in basic and applied biomedical research are presented and discussed.
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Affiliation(s)
- Kyunghun Kim
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, 47907, USA
| | - Bongjoong Kim
- School of Mechanical Engineering, Purdue University, West Lafayette, IN, 47907, USA
| | - Chi Hwan Lee
- Weldon School of Biomedical Engineering, School of Mechanical Engineering, Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN, 47907, USA
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Qian W, Qian C. Remote characterization of resonance frequency with a wirelessly powered parametric oscillator. IEEE TRANSACTIONS ON INSTRUMENTATION AND MEASUREMENT 2020; 69:1690-1697. [PMID: 32655185 PMCID: PMC7351332 DOI: 10.1109/tim.2019.2916242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
It is of both fundamental importance and practical value to measure the frequency of an LC resonator beyond the near-field region, especially when the resonator is used as a standalone capacitive sensor embedded inside a closed environment. To improve the coupling efficiency between the resonator and the external sniffer loop, we propose a novel method to integrate the LC resonator with a wirelessly-powered parametric resonator whose oscillation signal can be remotely identified in a noisy background. By measuring the minimum power level that is required for oscillation at different pumping frequencies, the resonator can be indirectly characterized by the frequency response curve. Starting from the basic principle of parametric oscillation, we will predict the measurable extremities in the frequency-dependent power curve under various circumstances that are classified based on the relative ratio between the lower and higher resonance frequencies. Our analytical models are validated by on-bench measurements performed on several parametric resonators with different circuit topologies. Their ability for remote characterization will make parametric resonators useful in structural health sensors or biomedical implants.
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Affiliation(s)
- Wei Qian
- Department of Electrical and Computer Engineering, Michigan State University, East Lansing, MI, 48824, USA
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Tang H, Alqattan B, Jackson T, Pikramenou Z, Sun XW, Wang K, Butt H. Cost-Efficient Printing of Graphene Nanostructures on Smart Contact Lenses. ACS APPLIED MATERIALS & INTERFACES 2020; 12:10820-10828. [PMID: 32039575 DOI: 10.1021/acsami.9b21300] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Smart contact lenses have been put forward for years, but there is still no commercial product in the market; the high cost due to expensive fabrication techniques could be one of the reasons. In this paper, first, a cost-efficient and reliable route to fabricate graphene grating on contact lens was designed and demonstrated based on the direct laser interference patterning graphene film on commercial contact lenses using an Nd:YAG laser. The thickness of the film and the interference angle have been taken into consideration. Optical characterization and simulation have been applied to evaluate the quality of our final achieved grating patterns with a grating size from 0.92 to 3.04 μm. Two-dimensional (2D) patterns could also be obtained through double-time laser interference. Contact angles for samples with different interference angles were presented considering the service environment of smart contact lenses. Of course, the conductivity of the samples was evaluated using a four-probe method. The most conductive sample had the sheet resistance lower than 30 Ω/sq. This research study highlighted the possibility of patterning graphene with the laser ablation method and provided a candidate solution for the fabrication of smart contact lenses under controlled cost.
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Affiliation(s)
- Haodong Tang
- Department of Mechanical Engineering, University of Birmingham, Birmingham B15 2TT, U.K
- Shenzhen Key Laboratory for Advanced Quantum Dot Displays and Lighting, Southern University of Science and Technology, Shenzhen 518055, China
| | - Bader Alqattan
- Department of Mechanical Engineering, University of Birmingham, Birmingham B15 2TT, U.K
| | - Tim Jackson
- Department of Electronic, Electrical and Systems Engineering, University of Birmingham, Birmingham B15 2TT, U.K
| | - Zoe Pikramenou
- Department of Chemistry, University of Birmingham, Birmingham B15 2TT, U.K
| | - Xiao Wei Sun
- Shenzhen Key Laboratory for Advanced Quantum Dot Displays and Lighting, Southern University of Science and Technology, Shenzhen 518055, China
| | - Kai Wang
- Shenzhen Key Laboratory for Advanced Quantum Dot Displays and Lighting, Southern University of Science and Technology, Shenzhen 518055, China
| | - Haider Butt
- Department of Mechanical Engineering, Khalifa University of Science and Technology, P.O. Box 127788, Abu Dhabi, United Arab Emirates
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Continuous intraocular pressure monitoring in patients with obstructive sleep apnea syndrome using a contact lens sensor. PLoS One 2020; 15:e0229856. [PMID: 32126130 PMCID: PMC7053760 DOI: 10.1371/journal.pone.0229856] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 02/16/2020] [Indexed: 01/12/2023] Open
Abstract
Purpose To analyse nocturnal intraocular pressure (IOP) fluctuations in patients with obstructive sleep apnea syndrome (OSAS) using a contact lens sensor (CLS) and to identify associations between the OSAS parameters determined by polysomnographic study (PSG) and IOP changes. Method Prospective, observational study. Twenty participants suspected of having OSAS were recruited. During PSG study, IOP was monitored using a CLS placed in the eye of the patient. The patients were classified according to the apnea-hypopnea index (AHI) in two categories, severe (>30) or mild/moderate (<30) OSAS. We evaluated several parameters determined by the IOP curves, including nocturnal elevations (acrophase) and plateau times in acrophase (PTs) defined by mathematical and visual methods. Results The IOP curves exhibited a nocturnal acrophase followed by PTs of varying extents at which the IOP remained higher than daytime measurement with small variations. We found significant differences in the length of the PTs in patients with severe OSAS compared to those with mild/moderate disease (P = 0.032/P = 0.028). We found a positive correlation between PTs and OSAS severity measured by the total number of apneic events (r = 0.681/0.751 P = 0.004/0.001) and AHI (r = 0.674/0.710, P = 0.004/0.002). Respiratory-related arousal and oxygen saturation also were associated significantly with the IOP PT length. Conclusions Periods of nocturnal IOP elevation lasted longer in severe OSAS patients than those with mild/moderate OSAS and correlate with the severity of the disease. The length of the nocturnal PT is also associated to respiratory parameters altered in patients with OSAS.
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Review of the measurement and management of 24-hour intraocular pressure in patients with glaucoma. Surv Ophthalmol 2020; 65:171-186. [DOI: 10.1016/j.survophthal.2019.09.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 09/23/2019] [Accepted: 09/25/2019] [Indexed: 02/06/2023]
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Transient changes in refractive error and corneal tomography after 24-h continuous monitoring of intraocular pressure patterns with a contact lens sensor. Jpn J Ophthalmol 2020; 64:127-133. [PMID: 32056036 DOI: 10.1007/s10384-020-00723-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 12/27/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE To evaluate changes in refractive error and corneal tomographic measurements after 24-h monitoring of intraocular pressure patterns with a contact lens sensor (CLS). STUDY DESIGN Prospective, longitudinal, observational study. PATIENTS AND METHODS Fourteen eyes of 14 consecutive patients who underwent 24-h CLS monitoring were enrolled. The objective spherical equivalent (SE) refractive error was measured using automated refraction and keratometry. The axial power, instantaneous power, and corneal thickness at the central, paracentral, midperipheral, and peripheral cornea were measured with swept-source anterior-segment optical coherence tomography. Measurements were performed at baseline, immediately after monitoring, and at follow-up visits 2-4 days after monitoring. RESULTS The myopic SE increased significantly (P < 0.001) from - 5.1 ± 4.2 to - 6.0 ± 4.0, D after 24-h monitoring with a CLS and returned to the premonitoring level at the second visit (- 5.3 ± 4.4 D, P = 0.315). Decreases in the midperipheral and peripheral axial powers and the paracentral instantaneous power and increases in the central instantaneous power and peripheral corneal thickness occurred after CLS monitoring. CONCLUSION Twenty-four-hour monitoring with a CLS resulted in significant increases in the myopic refractive error and corneal central steepening and midperipheral flattening. Although these changes are transient and do not negate the clinical merits of the CLS, clinicians should be aware of these potential adverse events. Three-dimensional evaluation of corneal deformation with anterior segment optical coherence tomography is a powerful tool for assessing and improving the safety, tolerability, and accuracy of CLS devices.
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Lee GH, Moon H, Kim H, Lee GH, Kwon W, Yoo S, Myung D, Yun SH, Bao Z, Hahn SK. Multifunctional materials for implantable and wearable photonic healthcare devices. NATURE REVIEWS. MATERIALS 2020; 5:149-165. [PMID: 32728478 PMCID: PMC7388681 DOI: 10.1038/s41578-019-0167-3] [Citation(s) in RCA: 205] [Impact Index Per Article: 51.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/28/2019] [Indexed: 05/20/2023]
Abstract
Numerous light-based diagnostic and therapeutic devices are routinely used in the clinic. These devices have a familiar look as items plugged in the wall or placed at patients' bedsides, but recently, many new ideas have been proposed for the realization of implantable or wearable functional devices. Many advances are being fuelled by the development of multifunctional materials for photonic healthcare devices. However, the finite depth of light penetration in the body is still a serious constraint for their clinical applications. In this Review, we discuss the basic concepts and some examples of state-of-the-art implantable and wearable photonic healthcare devices for diagnostic and therapeutic applications. First, we describe emerging multifunctional materials critical to the advent of next-generation implantable and wearable photonic healthcare devices and discuss the path for their clinical translation. Then, we examine implantable photonic healthcare devices in terms of their properties and diagnostic and therapeutic functions. We next describe exemplary cases of noninvasive, wearable photonic healthcare devices across different anatomical applications. Finally, we discuss the future research directions for the field, in particular regarding mobile healthcare and personalized medicine.
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Affiliation(s)
- Geon-Hui Lee
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), Pohang, South Korea
- Department of Chemical Engineering, Stanford University, Stanford, CA, USA
- These authors contributed equally: Geon-Hui Lee, Hanul Moon, Hyemin Kim
| | - Hanul Moon
- Department of Chemical Engineering, Stanford University, Stanford, CA, USA
- School of Electrical Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea
- These authors contributed equally: Geon-Hui Lee, Hanul Moon, Hyemin Kim
| | - Hyemin Kim
- PHI Biomed Co., Seoul, South Korea
- These authors contributed equally: Geon-Hui Lee, Hanul Moon, Hyemin Kim
| | - Gae Hwang Lee
- Department of Chemical Engineering, Stanford University, Stanford, CA, USA
- Samsung Advanced Institute of Technology (SAIT), Samsung Electronics, Suwon, South Korea
| | - Woosung Kwon
- Department of Chemical and Biological Engineering, Sookmyung Women’s University, Seoul, South Korea
| | - Seunghyup Yoo
- School of Electrical Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea
| | - David Myung
- Department of Chemical Engineering, Stanford University, Stanford, CA, USA
- Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Seok Hyun Yun
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Zhenan Bao
- Department of Chemical Engineering, Stanford University, Stanford, CA, USA
| | - Sei Kwang Hahn
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), Pohang, South Korea
- Department of Chemical Engineering, Stanford University, Stanford, CA, USA
- PHI Biomed Co., Seoul, South Korea
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47
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M Kouhani MH, Wu J, Tavakoli A, Weber AJ, Li W. Wireless, passive strain sensor in a doughnut-shaped contact lens for continuous non-invasive self-monitoring of intraocular pressure. LAB ON A CHIP 2020; 20:332-342. [PMID: 31825423 DOI: 10.1039/c9lc00735k] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
After cataract, glaucoma is the second leading cause of blindness worldwide and real-time monitoring of intraocular pressure (IOP) is of great demand. We present a wireless, passive sensor sitting inside a customized, planar and circular doughnut-shaped contact lens capable of continuous monitoring of the change in the curvature of cornea caused by IOP fluctuations. The sensor consists of a constant capacitor and a variable inductor in the form of a stretchable, closed-loop, serpentine wire that serves as both the sensor and the antenna. Results show a pressure responsivity of 523 kHz per 1% axial strain on a pressurized polydimethylsiloxane membrane and 35.1 kHz per 1 mmHg change in the IOP of a canine eye. The sensor is tested for stability and shows unvaried characteristics after repeated cycles and parasitic movements. Predictable influences of temperature and humidity on the sensor response are also verified experimentally, which can be canceled out using real-time calibration with temperature and humidity sensors to integrate with a reader device. The design reported here has numerous advantages, such as design simplicity, component reliability, high responsivity, and low cost, thereby opening up potential opportunities for the translation of this non-invasive, continuous IOP monitoring technique into clinical applications.
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Affiliation(s)
- M Hossein M Kouhani
- Electrical and Computer Engineering Department, Michigan State University, East Lansing, MI, USA.
| | - Jiajia Wu
- Electrical and Computer Engineering Department, Michigan State University, East Lansing, MI, USA.
| | - Arman Tavakoli
- Department of Mathematics, Michigan State University, East Lansing, MI, USA
| | - Arthur J Weber
- Department of Physiology, Michigan State University, East Lansing, MI, USA
| | - Wen Li
- Electrical and Computer Engineering Department, Michigan State University, East Lansing, MI, USA.
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48
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Can a contact lens sensor predict the success of trabectome surgery? Graefes Arch Clin Exp Ophthalmol 2020; 258:843-850. [PMID: 31900641 DOI: 10.1007/s00417-019-04576-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 11/25/2019] [Accepted: 12/18/2019] [Indexed: 10/25/2022] Open
Abstract
PURPOSE We examined whether a contact lens sensor (CLS) is useful for the postoperative evaluation of trabectome surgery. We investigated the correlations between the outcomes of trabectome surgery and the output of a CLS. METHODS We examined 24 consecutive eyes of patients with pseudo-exfoliation glaucoma. In each eye, the intraocular pressure (IOP) fluctuations over 24 h were measured with the SENSIMED Triggerfish CLS before and at 3 months after the trabectome surgery. We divided the patients into success (n = 12 eyes) and failure (n = 12 eyes) groups; success was defined as a postoperative IOP level ≤ 21 mmHg plus an IOP reduction ≥ 20% relative to the preoperative IOP value with or without anti-glaucoma medications. We investigated CLS parameters that correlate with surgical outcomes by performing a Cox hazard regression analysis. We determined the maximum value, minimum value, and range of IOP fluctuation as CLS parameters. RESULTS The mean follow-up period was 38.0 ± 3.0 months. The success rate was 50%. The postoperative range of IOP fluctuation during the nocturnal period with the CLS was significantly correlated with the surgical results (p = 0.024). CONCLUSIONS A smaller range of IOP fluctuation was significantly correlated with better surgical outcomes. We were able to predict the surgical success after trabectome surgery at 3 months using the CLS. Thus, CLS results could be a new surgical evaluation parameter.
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49
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Liu Z, Wang G, Pei W, Wei C, Wu X, Dou Z, Li Y, Wang Y, Chen H. Application of graphene nanowalls in an intraocular pressure sensor. J Mater Chem B 2020; 8:8794-8802. [DOI: 10.1039/d0tb01687j] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Combining crack mechanism in GNWs with the stretchability of PDMS, a contact lens sensor exhibits excellent sensitivity to intraocular pressure.
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Affiliation(s)
- Zhiduo Liu
- State Key Laboratory of Integrated Optoelectronics
- Institute of Semiconductors
- Chinese Academy of Sciences
- Beijing 100083
- China
| | - Gang Wang
- Department of Microelectronic Science and Engineering
- School of Physical Science and Technology
- Ningbo University
- Ningbo 315211
- China
| | - Weihua Pei
- State Key Laboratory of Integrated Optoelectronics
- Institute of Semiconductors
- Chinese Academy of Sciences
- Beijing 100083
- China
| | - Chunrong Wei
- State Key Laboratory of Integrated Optoelectronics
- Institute of Semiconductors
- Chinese Academy of Sciences
- Beijing 100083
- China
| | - Xiaoting Wu
- State Key Laboratory of Integrated Optoelectronics
- Institute of Semiconductors
- Chinese Academy of Sciences
- Beijing 100083
- China
| | - Zhiqiang Dou
- State Key Laboratory of Integrated Optoelectronics
- Institute of Semiconductors
- Chinese Academy of Sciences
- Beijing 100083
- China
| | - Yamin Li
- State Key Laboratory of Integrated Optoelectronics
- Institute of Semiconductors
- Chinese Academy of Sciences
- Beijing 100083
- China
| | - Yijun Wang
- State Key Laboratory of Integrated Optoelectronics
- Institute of Semiconductors
- Chinese Academy of Sciences
- Beijing 100083
- China
| | - Hongda Chen
- State Key Laboratory of Integrated Optoelectronics
- Institute of Semiconductors
- Chinese Academy of Sciences
- Beijing 100083
- China
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50
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A Low-Cost Strain Gauge Displacement Sensor Fabricated via Shadow Mask Printing. SENSORS 2019; 19:s19214713. [PMID: 31671560 PMCID: PMC6864542 DOI: 10.3390/s19214713] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 10/26/2019] [Accepted: 10/29/2019] [Indexed: 11/17/2022]
Abstract
This work presents a cost-effective shadow mask printing approach to fabricate flexible sensors. The liquid-state sensing material can be directly brushed on a flexible substrate through a shadow mask. The ink leakage issue which often occurs in printed electronics is addressed with a custom taping scheme. A simple thermal compression bonding approach is also proposed to package the functional area of the sensor. To verify the feasibility and robustness of the proposed fabrication approach, a prototyped strain gauge displacement sensor is fabricated using carbon ink as the sensing material and a flexible polyimide (PI) film as the substrate. Once the substrate is deformed, cracks in the solidified ink layer can cause an increased resistance in the conductive path, thus achieving function of stable displacement/strain sensing. As a demonstration for displacement sensing application, this sensor is evaluated by studying its real-time resistance response under both static and dynamic mechanical loading. The fabricated sensor shows a comparable performance (with a gauge factor of ~17.6) to those fabricated using costly lithography or inkjet printing schemes, while with a significantly lower production cost.
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