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Fantaci B, Calvo B, Rodríguez JF. Modeling biological growth of human keratoconus: On the effect of tissue degradation, location and size. Comput Biol Med 2024; 180:108976. [PMID: 39116714 DOI: 10.1016/j.compbiomed.2024.108976] [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: 05/20/2024] [Revised: 07/17/2024] [Accepted: 07/30/2024] [Indexed: 08/10/2024]
Abstract
Keratoconus is a non-inflammatory bilateral disease, that usually occurs in the inferior-temporal region, where the cornea bulges out and becomes thinner, due to the gradual loss of structural organization in corneal tissue. Degenerated extracellular matrix and fibers breakage have been observed in keratoconic corneas, that may promote the progression of the pathology. While keratoconus histopathology has been widely described in literature, its etiology is still not clear. Being able to fully understand keratoconus growing process could be crucial to detect its development and improve prevention strategies. This work proposes a novel continuum-based keratoconus growth model. The proposed framework accounts for the structural changes occurring in the underlying tissue during the progression of the disease, as indicated in experiments. The developed formulation is able to replicate the typical bulging and thinning of keratoconic corneas, as well as different forms in terms of shape, as they are commonly classified in clinics (nipple, oval and globus cones). The cone that is obtained constitutes a permanent deformed state, not pressure dependent. The resulting model may help to better understand the etiology of the behavior of this disease with the aim of improving the diagnosis and the treatment of the pathology.
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Affiliation(s)
- Benedetta Fantaci
- Aragon Institute of Research Engineering (I3A), Universidad de Zaragoza, Zaragoza, Spain.
| | - Begoña Calvo
- Aragon Institute of Research Engineering (I3A), Universidad de Zaragoza, Zaragoza, Spain; Bioengineering, Biomaterials and Nanomedicine Networking Biomedical Research Centre (CIBER-BBN), Universidad de Zaragoza, Zaragoza, Spain
| | - José Félix Rodríguez
- LaBS, Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Milan, Italy
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Itoi M, Itoi M. Association Between Family History and the Corneal Characteristics of Keratoconus in Japan. Eye Contact Lens 2024; 50:357-360. [PMID: 38861231 DOI: 10.1097/icl.0000000000001106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2024] [Indexed: 06/12/2024]
Abstract
PURPOSE The aim of this study was to determine the association between family history and corneal characteristics of keratoconus in Japan. METHODS The clinical records of patients with keratoconus who were interviewed regarding family history of keratoconus were retrospectively reviewed. Corneal indices derived from anterior segment optical coherence tomography were compared between the positive and negative family history groups using multiple linear regression analysis adjusted with age, sex, and history of atopy and eye rubbing. RESULTS A total of 2,701 eyes, including 122 eyes with positive family history, were enrolled. Based on the adjusted multiple linear regression analysis, no significant differences were found between groups with and without a family history except for paracentral and mid-peripheral corneal thickness. The adjusted mean differences in paracentral and mid-peripheral corneal thicknesses between the two groups were -10.33 (95% confidence interval -20.29 to -0.37 P -value <0.05) and -9.78 (95% confidence interval -16.70 to -2.85, P -value <0.01), respectively. CONCLUSIONS There was no significant association between family history and corneal indices in Japanese patients with keratoconus, except for paracentral and mid-peripheral corneal thicknesses. A Japanese patient with keratoconus who had a family history showed significantly lower paracentral and mid-peripheral corneal thicknesses than those with no family history.
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Affiliation(s)
- Motohiro Itoi
- Dougenzaka Itoi Eye Clinic (M.I.), Tokyo, Japan; and School of Optometry and Vision Science (M.I.), University of New South Wales, Sydney, Australia
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Jaskiewicz K, Maleszka-Kurpiel M, Matuszewska E, Kabza M, Rydzanicz M, Malinowski R, Ploski R, Matysiak J, Gajecka M. The Impaired Wound Healing Process Is a Major Factor in Remodeling of the Corneal Epithelium in Adult and Adolescent Patients With Keratoconus. Invest Ophthalmol Vis Sci 2023; 64:22. [PMID: 36811882 PMCID: PMC9970004 DOI: 10.1167/iovs.64.2.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
Purpose Keratoconus (KTCN) is the most common corneal ectasia, characterized by pathological cone formation. Here, to provide an insight into the remodeling of the corneal epithelium (CE) during the course of the disease, we evaluated topographic regions of the CE of adult and adolescent patients with KTCN. Methods The CE samples from 17 adult and 6 adolescent patients with KTCN, and 5 control CE samples were obtained during the CXL and PRK procedures, respectively. Three topographic regions, central, middle, and peripheral, were separated toward RNA sequencing and MALDI-TOF/TOF Tandem Mass Spectrometry. Data from transcriptomic and proteomic investigations were consolidated with the morphological and clinical findings. Results The critical elements of the wound healing process, epithelial-mesenchymal transition, cell-cell communications, and cell-extracellular matrix interactions were altered in the particular corneal topographic regions. Abnormalities in pathways of neutrophils degranulation, extracellular matrix processing, apical junctions, IL, and IFN signaling were revealed to cooperatively disorganize the epithelial healing. Deregulation of the epithelial healing, G2M checkpoints, apoptosis, and DNA repair pathways in the middle CE topographic region in KTCN explains the presence of morphological changes in the corresponding doughnut pattern (a thin cone center surrounded by a thickened annulus). Despite similar morphological characteristics of CE samples in adolescents and adults with KTCN, their transcriptomic features were different. Values of the posterior corneal elevation differentiated adults with KTCN from adolescents with KTCN and correlated with the expression of TCHP, SPATA13, CNOT3, WNK1, TGFB2, and KRT12 genes. Conclusions Identified molecular, morphological, and clinical features indicate the effect of impaired wound healing on corneal remodeling in KTCN CE.
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Affiliation(s)
| | - Magdalena Maleszka-Kurpiel
- Optegra Eye Health Care Clinic in Poznan, Poznan, Poland,Department of Optometry, Chair of Ophthalmology and Optometry, Poznan University of Medical Sciences, Poznan, Poland
| | - Eliza Matuszewska
- Chair and Department of Inorganic and Analytical Chemistry, Poznan University of Medical Sciences, Poznan, Poland
| | - Michał Kabza
- Chair and Department of Genetics and Pharmaceutical Microbiology, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Robert Malinowski
- Institute of Plant Genetics, Polish Academy of Sciences, Poznan, Poland
| | - Rafal Ploski
- Department of Medical Genetics, Medical University of Warsaw, Warsaw, Poland
| | - Jan Matysiak
- Chair and Department of Inorganic and Analytical Chemistry, Poznan University of Medical Sciences, Poznan, Poland
| | - Marzena Gajecka
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland,Chair and Department of Genetics and Pharmaceutical Microbiology, Poznan University of Medical Sciences, Poznan, Poland
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Biomechanics of keratoconus: Two numerical studies. PLoS One 2023; 18:e0278455. [PMID: 36730305 PMCID: PMC9894483 DOI: 10.1371/journal.pone.0278455] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 11/16/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The steep cornea in keratoconus can greatly impair eyesight. The etiology of keratoconus remains unclear but early injury that weakens the corneal stromal architecture has been implicated. To explore keratoconus mechanics, we conducted two numerical simulation studies. METHODS A finite-element model describing the five corneal layers and the heterogeneous mechanical behaviors of the ground substance and lamellar collagen-fiber architecture in the anterior and posterior stroma was developed using the Holzapfel-Gasser-Ogden constitutive model. The geometry was from a healthy subject. Its stroma was divided into anterior, middle, and posterior layers to assess the effect of changing regional mechanical parameters on corneal displacement and maximum principal stress under intraocular pressure. Specifically, the effect of softening an inferocentral corneal button, the collagen-based tissues throughout the whole cornea, or specific stromal layers in the button was examined. The effect of simply disorganizing the orthogonally-oriented posterior stromal fibers in the button was also assessed. The healthy cornea was also subjected to eye rubbing-like loading to identify the corneal layer(s) that experienced the most tensional stress. RESULTS Conical deformation and corneal thinning emerged when the corneal button or the mid-posterior stroma of the button underwent gradual softening or when the collagen fibers in the mid-posterior stroma of the button were dispersed. Softening the anterior layers of the button or the whole cornea did not evoke conical deformation. Button softening greatly increased and disrupted the stress on Bowman's membrane while mid-posterior stromal softening increased stress in the anterior layers. Eye rubbing profoundly stressed the deep posterior stroma while other layers were negligibly affected. DISCUSSION These observations suggest that keratoconus could be initiated, at least partly, by mechanical instability/damage in the mid-posterior stroma that then imposes stress on the anterior layers. This may explain why subclinical keratoconus is marked by posterior but not anterior elevation on videokeratoscopy.
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Identification of Treatment Protocols for Effective Cross-Linking of the Peripheral Cornea: An Experimental Study. Ophthalmol Ther 2022; 11:2057-2066. [PMID: 36066843 DOI: 10.1007/s40123-022-00564-1] [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: 07/15/2022] [Accepted: 08/24/2022] [Indexed: 10/14/2022] Open
Abstract
INTRODUCTION This study aimed to test and evaluate modified corneal cross-linking (CXL) protocols regarding improved treatment effects on the peripheral cornea in terms of tissue stability and cellular response. METHODS Peripheral CXL (pCXL) was performed within a ring of 9-11 mm of 36 human donor corneas with variations in applied energy (5.4, 7.2, and 10 J/cm2) at 9 mW/cm2 irradiance. Each energy level was additionally modulated regarding the oxygen level surrounding the cornea during treatment (21%; 100%). Stress-strain tests with endpoints at 12% strain and collagenase A-assisted digestions to complete digestion were performed to evaluate the rigidity and resistance of treated and control tissue. Further, corneas were processed histologically via TUNEL assay and H&E staining to demonstrate the effects on stromal cells during treatment under varying CXL conditions. RESULTS Increases in energy dosage achieved significant increases in resistance to stress in all variations except when comparing protocols A and B under normoxic conditions. Supplemental oxygen significantly increased rigidity in protocols B (p < 0.01) and C (p = 0.018). Hyperoxic conditions significantly increased resistance to digestion in all protocols. The number of DNA strand breaks in TUNEL assay staining showed significant increases in all increases in energy as well as with oxygen supplementation. CONCLUSIONS Increases in energy and supplemental oxygen improved the effect of CXL, though endothelial safety could not be verified with confidence in high-fluence CXL with supplemental oxygen. Results suggest that CXL protocols using 7.2 J/cm2 with 100% O2 or 10 J/cm2 without supplemental oxygen prove most effective without anticipated risk of endothelial damage.
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Chang L, Zhang L, Cheng Z, Zhang N, Wang C, Wang Y, Liu W. Effectiveness of collagen cross-linking induced by two-photon absorption properties of a femtosecond laser in ex vivo human corneal stroma. BIOMEDICAL OPTICS EXPRESS 2022; 13:5067-5081. [PMID: 36187250 PMCID: PMC9484424 DOI: 10.1364/boe.468593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/20/2022] [Accepted: 08/22/2022] [Indexed: 06/16/2023]
Abstract
This study aimed to investigate the effectiveness of two-photon induced collagen cross-linking (CXL) using femtosecond lasers in human corneal stroma. An 800-nm femtosecond laser optical path for CXL was established. Corneal samples that received two-photon induced CXL and ultraviolet-A (UVA) CXL underwent uniaxial stretching experiments, proteolytic resistance assays and observation of collagen fiber structure changes. Two-photon induced CXL can achieve corneal stiffening effects comparable to UVA CXL and showed better advantages at low strains. The cornea after two-photon induced CXL exhibited high enzymatic resistance and tight collagen fiber arrangement. Two-photon induced CXL promises to be a new option for keratoconus.
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Affiliation(s)
- Le Chang
- Clinical College of Ophthalmology, Tianjin Medical University, No. 22 Meteorological Terrace Road, Heping District, Tianjin 300070, China
| | - Lin Zhang
- Clinical College of Ophthalmology, Tianjin Medical University, No. 22 Meteorological Terrace Road, Heping District, Tianjin 300070, China
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin Eye Institute, Nankai University Affiliated Eye Hospital, Nankai University, No. 4 Gansu Road, Heping District, Tianjin 300020, China
| | - Zhenzhou Cheng
- Institute of Modern Optics, Nankai University, No. 94 Weijin Road, Nankai District, Tianjin 300071, China
- Tianjin Key Laboratory of Micro-scale Optical Information Science and Technology, No. 94 Weijin Road, Nankai District, Tianjin 300071, China
| | - Nan Zhang
- Institute of Modern Optics, Nankai University, No. 94 Weijin Road, Nankai District, Tianjin 300071, China
- Tianjin Key Laboratory of Micro-scale Optical Information Science and Technology, No. 94 Weijin Road, Nankai District, Tianjin 300071, China
| | - Congzheng Wang
- Department of Mechanics, School of Mechanical Engineering, Tianjin University, No. 92 Weijin Road, Nankai District, Tianjin 300072, China
| | - Yan Wang
- Clinical College of Ophthalmology, Tianjin Medical University, No. 22 Meteorological Terrace Road, Heping District, Tianjin 300070, China
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin Eye Institute, Nankai University Affiliated Eye Hospital, Nankai University, No. 4 Gansu Road, Heping District, Tianjin 300020, China
| | - Weiwei Liu
- Institute of Modern Optics, Nankai University, No. 94 Weijin Road, Nankai District, Tianjin 300071, China
- Tianjin Key Laboratory of Micro-scale Optical Information Science and Technology, No. 94 Weijin Road, Nankai District, Tianjin 300071, China
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Effect of Ultraviolet-A and Riboflavin treatment on the architecture of the center and periphery of normal rat cornea: 7 days post treatment. Exp Eye Res 2022; 219:109064. [PMID: 35385757 DOI: 10.1016/j.exer.2022.109064] [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: 12/10/2021] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 11/22/2022]
Abstract
Corneal collagen cross-linking (CXL) is a treatment that is widely applied to halt the progression of ectatic diseases such as keratoconus by creating biomechanical strength in the cornea. Most of the studies assessed the effect of the CXL on the cornea without any differentiation of its effect between periphery and the center of the untreated control cornea especially after the 7 days of CXL application. We investigate the ultrastructural changes in the architecture of the center and periphery of rat corneas, 7 days after standard CXL application. Five Wistar rats (10 corneas) were used in the present study. The left eye corneas (5 mm area) were de-epithelialized and irradiated with standard CXL application using riboflavin and Ultraviolet-A (UVA) (3 mW/cm2 for 30 min). The right eye corneas were used as a control. The sclera-cornea button was removed and processed for electron microscopy. Digital images were captured with a bottom mounted Quemesa camera and analyzed using the iTEM software. The ultrastructure of epithelium, hemi-desmosomes, Bowman's layer and stroma were organized in both untreated control and CXL rat cornea in both untreated control and CXL rat cornea. Within the same CXL cornea, both the collagen fibril (CF) diameter and interfibrillar spacing at the center were significantly smaller compared to the peripheral diameter and spacing of the cornea. When comparing the untreated control and CXL cornea, the central interfibrillar spacing of the CXL cornea was significantly smaller than the central spacing the untreated control cornea. In the CXL cornea the peripheral spacing was significantly higher compared to the peripheral interfibrillar spacing of the untreated control cornea. Within the CXL cornea, the proteoglycans (PGs) area and density of the periphery was significantly higher compared to the area and density of the center of the cornea. It suggests that CXL was more effective at the periphery of the cornea. This could be due to the higher amount of leucine rich PG lumican and higher diffusion of oxygen and riboflavin at the periphery cornea.
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[Histological changes in keratoconus and wound healing after corneal cross-linking]. Ophthalmologe 2021; 119:342-349. [PMID: 34874483 DOI: 10.1007/s00347-021-01537-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Keratoconus is classified as a corneal ectasia and is a multifactorial disease. In those affected, mostly adolescent patients visual deterioration occurs due to the development of irregular astigmatism. Treatment by corneal cross-linking (CXL) has been indicated in progressive disease for several years. OBJECTIVE To present the pathophysiology and histological changes in keratoconus as well as wound healing processes after CXL and their potential complications. MATERIAL AND METHODS Histological changes in keratoconus as well as wound healing processes after CXL and their potential complications are presented based on histological examination of corneal specimens with keratoconus with and without a condition after CXL. Relevant literature and own data are analyzed and discussed. RESULTS Besides inflammatory processes, atopic and genetic dispositions play a role in the development of keratoconus. The histological characteristics of keratoconus include changes in the epithelium, Bowman's layer and stroma. Wound healing processes after CXL include healing of the surface epithelium and transient loss of keratocytes and nerve fibers. CONCLUSION Keratoconus shows characteristic histopathological changes, such as epithelial irregularities, stromal thinning and breaks of Bowman's layer, whereas the endothelium and Descemet's membrane remain unchanged (apart from cases of corneal hydrops). After CXL wound healing processes can be followed primarily in vivo by confocal microscopy. Complications after CXL are rare. Persistent loss of keratocytes can be clinically manifested as a visually relevant scar.
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Raoux C, Schmeltz M, Bied M, Alnawaiseh M, Hansen U, Latour G, Schanne-Klein MC. Quantitative structural imaging of keratoconic corneas using polarization-resolved SHG microscopy. BIOMEDICAL OPTICS EXPRESS 2021; 12:4163-4178. [PMID: 34457406 PMCID: PMC8367248 DOI: 10.1364/boe.426145] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/29/2021] [Accepted: 05/22/2021] [Indexed: 05/20/2023]
Abstract
The human cornea is mainly composed of collagen fibrils aligned together within stacked lamellae. This lamellar structure can be affected in pathologies such as keratoconus, which is characterized by progressive corneal thinning and local steepening. In this study, we use polarization-resolved second harmonic generation (P-SHG) microscopy to characterize 8 control and 6 keratoconic human corneas. Automated processing of P-SHG images of transverse sections provides the collagen orientation in every pixel with sub-micrometer resolution. Series of P-SHG images recorded in the most anterior region of the stroma evidence sutural lamellae inclined at 22° ± 5° to the corneal surface, but show no significant difference between control and keratoconic corneas. In contrast, series of P-SHG images acquired along the full thickness of the stroma show a loss of order in the lamellar structure of keratoconic corneas, in agreement with their defective mechanical properties. This structural difference is analyzed quantitatively by computing the entropy and the orientation index of the collagen orientation distribution and significant differences are obtained along the full thickness of the stroma. This study shows that P-SHG is an effective tool for automatic quantitative analysis of structural defects of human corneas and should be applied to other collagen-rich tissues.
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Affiliation(s)
- Clothilde Raoux
- Laboratory for Optics and Biosciences, Ecole polytechnique, CNRS, INSERM, Institut Polytechnique de Paris, 91128 Palaiseau, France
- These authors contributed equally
| | - Margaux Schmeltz
- Laboratory for Optics and Biosciences, Ecole polytechnique, CNRS, INSERM, Institut Polytechnique de Paris, 91128 Palaiseau, France
- These authors contributed equally
| | - Marion Bied
- Laboratory for Optics and Biosciences, Ecole polytechnique, CNRS, INSERM, Institut Polytechnique de Paris, 91128 Palaiseau, France
| | - Maged Alnawaiseh
- Department of Ophthalmology, Hospital Fulda, University of Marburg, Campus Fulda, 36043 Fulda, Germany
| | - Uwe Hansen
- Institute for Musculoskeletal Medicine, University Hospital Münster, 48149 Münster, Germany
| | - Gaël Latour
- Laboratory for Optics and Biosciences, Ecole polytechnique, CNRS, INSERM, Institut Polytechnique de Paris, 91128 Palaiseau, France
- Université Paris-Saclay, 91190 Saint-Aubin, France
| | - Marie-Claire Schanne-Klein
- Laboratory for Optics and Biosciences, Ecole polytechnique, CNRS, INSERM, Institut Polytechnique de Paris, 91128 Palaiseau, France
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Alkanaan A, Barsotti R, Kirat O, Khan A, Almubrad T, Akhtar S. Collagen fibrils and proteoglycans of peripheral and central stroma of the keratoconus cornea - Ultrastructure and 3D transmission electron tomography. Sci Rep 2019; 9:19963. [PMID: 31882786 PMCID: PMC6934547 DOI: 10.1038/s41598-019-56529-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 12/05/2019] [Indexed: 02/04/2023] Open
Abstract
Keratoconus (KC) is a progressive corneal disorder in which vision gradually deteriorates as a result of continuous conical protrusion and the consequent altered corneal curvature. While the majority of the literature focus on assessing the center of this diseased cornea, there is growing evidence of peripheral involvement in the disease process. Thus, we investigated the organization of collagen fibrils (CFs) and proteoglycans (PGs) in the periphery and center of KC corneal stroma. Three-dimensional transmission electron tomography on four KC corneas showed the degeneration of microfibrils within the CFs and disturbance in the attachment of the PGs. Within the KC corneas, the mean CF diameter of the central-anterior stroma was significantly (p ˂ 0.001) larger than the peripheral-anterior stroma. The interfibrillar distance of CF was significantly (p ˂ 0.001) smaller in the central stroma than in the peripheral stroma. PGs area and the density in the central KC stroma were larger than those in the peripheral stroma. Results of the current study revealed that in the pre- Descemet's membrane stroma of the periphery, the degenerated CFs and PGs constitute biomechanically weak lamellae which are prone to disorganization and this suggests that the peripheral stroma plays an important role in the pathogenicity of the KC cornea.
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Affiliation(s)
- Aljoharah Alkanaan
- Cornea Research Chair, Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Robert Barsotti
- Department of Biomedical Sciences, Philadelphia college of Osteopathic Medicine, Philadelphia, PA, USA
| | - Omar Kirat
- Department of Ophthalmology, King Khalid Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Adnan Khan
- Cornea Research Chair, Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Turki Almubrad
- Cornea Research Chair, Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Saeed Akhtar
- Cornea Research Chair, Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
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Hashmani N, Hashmani S, Murad A, Asghar N, Islam M. Effect of Demographic Variables on the Regional Corneal Pachymetry. Asia Pac J Ophthalmol (Phila) 2019; 8:324-329. [PMID: 31356367 PMCID: PMC6727915 DOI: 10.1097/apo.0000000000000252] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 04/20/2019] [Indexed: 11/25/2022] Open
Abstract
PURPOSE The measurement of corneal thickness by corneal pachymetry provides valuable information in the setting of corneal disease; however, spectral-domain optical coherence tomography (SD-OCT)-based assessment of different corneal sectors has been scarce in Pakistan. DESIGN We aimed to obtain a whole-corneal thickness map using SD-OCT and to evaluate its correlation with age, sex, and axial length. METHODS Our study included 214 subjects with healthy corneas; each eye was scanned with an SD-OCT covering a 9-mm diameter, and reproducibility was evaluated in a subset of 50 participants by means of an identical scan protocol repeated by 2 different OCT operators. RESULTS Our analysis revealed corneal thickness to be thinnest inferotemporally whereas thickest in the superior and superonasal quadrants. No statistically significant differences could be detected between male and female participants with respect to corneal thickness, age, intraocular pressure, axial length, and refractive errors. However, we identified a significant negative correlation between age and corneal thickness in all corneal sections, excluding the inner and middle superior, inner superonasal, and inner and middle superotemporal quadrants. Conversely, the correlation between axial length and corneal thickness was found to be positive in the central region (P = 0.03, R = 0.149), the outer inferotemporal quadrant (P = 0.012, R = 0.171), throughout the temporal quadrant (P = 0.024, R = 0.154 for inner; P = 0.025, R = 0.153 for middle; P = 0.006, R = 0.186 for outer), and in the inner superotemporal quadrant (P = 0.018, R = 0.162). CONCLUSIONS Different corneal sectors may interact heterogeneously with patient-related characteristics. This may provide incentive to evaluate whole-corneal thickness as a distinct parameter for clinical identification of disease processes.
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Affiliation(s)
- Nauman Hashmani
- Department of Ophthalmology and Visual Sciences, Hashmanis Hospital, Karachi, Pakistan
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