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Hannay V, Czerpak C, Quigley HA, Nguyen TD. A Noninvasive Clinical Method to Measure in Vivo Mechanical Strains of the Lamina Cribrosa by OCT. OPHTHALMOLOGY SCIENCE 2024; 4:100473. [PMID: 38560276 PMCID: PMC10973664 DOI: 10.1016/j.xops.2024.100473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/04/2024] [Accepted: 01/12/2024] [Indexed: 04/04/2024]
Abstract
Objective To measure mechanical strain of the lamina cribrosa (LC) after intraocular pressure (IOP) change produced 1 week after a change in glaucoma medication. Design Cohort study. Participants Adult glaucoma patients (23 eyes, 15 patients) prescribed a change in IOP-lowering medication. Intervention Noninvasive OCT imaging of the eye. Main Outcome Measures Deformation calculated by digital volume correlation of OCT scans of the LC before and after IOP lowering by medication. Results Among 23 eyes, 17 eyes of 12 persons had IOP lowering ≥ 3 mmHg (reduced IOP group) with tensile anterior-posterior Ezz strain = 1.0% ± 1.1% (P = 0.003) and compressive radial strain (Err) = -0.3% ± 0.5% (P = 0.012; random effects models accounting inclusion of both eyes in some persons). Maximum in-plane principal (tensile) strain and maximum shear strain in the reduced-IOP group were as follows: Emax = 1.7% ± 1.0% and Γmax = 1.4% ± 0.7%, respectively (both P < 0.0001 vs. zero). Reduced-IOP group strains Emax and Γmax were significantly larger with greater % IOP decrease (P < 0.0001 and P < 0.0001, respectively). The compliances of the Ezz, Emax, and Γmax strain responses, defined as strain normalized by the IOP decrease, were larger with more abnormal perimetric mean deviation or visual field index values (all P ≤ 0.02). Strains were unrelated to age (all P ≥ 0.088). In reduced-IOP eyes, mean LC anterior border posterior movement was only 2.05 μm posteriorly (P = 0.052) and not related to % IOP change (P = 0.94, random effects models). Only Err was significantly related to anterior lamina depth change, becoming more negative with greater posterior LC border change (P = 0.015). Conclusions Lamina cribrosa mechanical strains can be effectively measured by changes in eye drop medication using OCT and are related to degree of visual function loss in glaucoma. Financial Disclosures Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Vanessa Hannay
- Department of Mechanical Engineering, The Johns Hopkins University, Baltimore, Maryland
| | - Cameron Czerpak
- Department of Mechanical Engineering, The Johns Hopkins University, Baltimore, Maryland
| | - Harry A. Quigley
- Department of Ophthalmology, Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Thao D. Nguyen
- Department of Mechanical Engineering, The Johns Hopkins University, Baltimore, Maryland
- Department of Ophthalmology, Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Czerpak CA, Quigley HA, Nguyen TD. Long-term Remodeling Response in the Lamina Cribrosa Years after Intraocular Pressure Lowering by Suturelysis after Trabeculectomy. Ophthalmol Glaucoma 2024; 7:298-307. [PMID: 38272391 PMCID: PMC11127792 DOI: 10.1016/j.ogla.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/15/2023] [Accepted: 01/17/2024] [Indexed: 01/27/2024]
Abstract
OBJECTIVE To measure the remodeling of the lamina cribrosa (LC) years after intraocular pressure (IOP) lowering by suturelysis. DESIGN Cohort study. PARTICIPANTS Glaucoma patients were imaged 20 minutes after laser suturelysis after trabeculectomy surgery and at their follow-up appointment 1 to 4 years later (16 image pairs; 15 persons). INTERVENTION Noninvasive OCT imaging of the eye. MAIN OUTCOME MEASURES Deformation calculated by correlating OCT scans of the LC immediately after IOP lowering by suturelysis and those acquired years later (defined as remodeling strain). RESULTS The LC anterior border moved 60.9 ± 54.6 μm into the eye (P = 0.0007), and the LC exhibited regions of large local stretch in the anterior-posterior direction on long-term, maintained IOP lowering, resulting in a mean anterior-posterior remodeling strain of 14.0% ± 21.3% (P = 0.02). This strain and the LC border movement was 14 times and 124 times larger, respectively, than the direct response to IOP lowering by suturelysis. A larger anterior LC border movement was associated with greater mean anterior-posterior remodeling strain (P = 0.004). A thinner retinal nerve fiber layer at suturelysis was also associated with greater mean anterior-posterior remodeling strain at follow-up (P = 0.05). Worsening visual field indexes during follow-up were associated with a greater mean circumferential remodeling strain (P = 0.02), due to regions of large local circumferential stretch of the LC. Eyes with a more compliant LC torsional shear strain response at lysis were associated with worse mean deviation at follow-up (P = 0.03). CONCLUSIONS Strains and LC border position changes measured years after IOP lowering are far larger than the immediate response to IOP lowering and indicate dramatic remodeling of the LC anatomical structure caused by IOP lowering and glaucoma progression. The remodeling strains indicate substantial local stretch in the anterior-posterior direction and are associated with movement of the LC anterior border into the eye. Eyes with greater direct strain response to IOP lowering, greater glaucoma damage at suturelysis, and greater worsening of visual field at follow-up experienced greater remodeling. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03267849. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Cameron A Czerpak
- Department of Mechanical Engineering, The Johns Hopkins University, Baltimore, Maryland.
| | - Harry A Quigley
- Wilmer Ophthalmological Institute, School of Medicine, The Johns Hopkins University, Baltimore, Maryland
| | - Thao D Nguyen
- Department of Mechanical Engineering, The Johns Hopkins University, Baltimore, Maryland; Wilmer Ophthalmological Institute, School of Medicine, The Johns Hopkins University, Baltimore, Maryland
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Xu FY, Lam AK. Intraocular pressure variation from ocular compression in low and high myopia. Clin Exp Optom 2024; 107:213-218. [PMID: 36975202 DOI: 10.1080/08164622.2023.2191784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 03/10/2023] [Indexed: 03/29/2023] Open
Abstract
CLINICAL RELEVANCE Change in intraocular pressure during acute ocular compression is related to aqueous humour dynamics. Monitoring intraocular pressure (IOP) change throughout ocular compression has potential to evaluate aqueous outflow facilities. BACKGROUND Recent studies have monitored lamina cribrosa deformation using optical coherence tomography during ocular compression. IOP was measured only once immediately after ocular compression. This study aimed to evaluate IOP changes during and after ocular compression and compare the differences between low and high myopia. METHODS Two groups of young, healthy adults were age-matched and underwent ocular compression. IOP was measured at baseline and monitored during a 2-min ocular compression followed by a 10-min recovery phase. Rebound tonometry was used and applied at 30-s intervals. RESULTS Thirty low and 30 high myopes (60 right eyes) were included in the study. They had similar baseline IOP at 14.9 mmHg. IOP was elevated to 21.7 ± 3.8 mmHg and 22.3 ± 4.2 mmHg for the low and high myopic group, respectively (p = 0.877). Low myopes had faster IOP decay during ocular compression at -3.24 mmHg/min than high myopes at -2.58 mmHg/min (p = 0.0528). The IOP dropped below the baseline level after the release of the compressive force. Low myopes had IOP that returned to baseline levels faster (at 360 s) than high myopes (at 510 s). CONCLUSION Measuring IOP once immediately after ocular compression could under-estimate the effect of IOP elevation during ocular compression. Further studies are required regarding IOP changes from ocular compression in aqueous humour dynamics.
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Affiliation(s)
- Fang-Yu Xu
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Andrew Kc Lam
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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Otani T, Miyata K, Miki A, Wada S. Computational study on the effects of central retinal blood vessels with asymmetric geometries on optic nerve head biomechanics. Med Eng Phys 2024; 123:104086. [PMID: 38365339 DOI: 10.1016/j.medengphy.2023.104086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/28/2023] [Accepted: 12/10/2023] [Indexed: 02/18/2024]
Abstract
Optic nerve head (ONH) biomechanics are associated with glaucoma progression and have received considerable attention. Central retinal vessels (CRVs) oriented asymmetrically in the ONH are the single blood supply source to the retina and are believed to act as mechanically stable elements in the ONH in response to intraocular pressure (IOP). However, these mechanical effects are considered negligible in ONH biomechanical studies and received less attention. This study investigated the effects of CRVs on ONH biomechanics taking into consideration three-dimensional asymmetric CRV geometries. A CRV geometry was constructed based on CRV centerlines extracted from optical coherence tomography ONH images in eight healthy subjects and superimposed in the idealized ONH geometry established in previous studies. Mechanical analyses of the ONH in response to the IOP were conducted in the cases with and without CRVs for comparison. Obtained results demonstrated that the CRVs induced anisotropic ONH deformation, particularly in the lamina cribrosa and the associated upper neural tissues (prelamina) with wide ranges of spatial strain distributions. These results indicated that the CRVs result in anisotropic deformation with local strain concentration, rather than function to mechanically support in response to the IOP as in the conventional thinking in ophthalmology.
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Affiliation(s)
- Tomohiro Otani
- Department of Mechanical Science and Bioengineering, Graduate School of Engineering Science, Osaka University, 1-3 Machikaneyamacho, Toyonaka, Osaka 560-8531, Japan.
| | - Kota Miyata
- Department of Mechanical Science and Bioengineering, Graduate School of Engineering Science, Osaka University, 1-3 Machikaneyamacho, Toyonaka, Osaka 560-8531, Japan
| | - Atsuya Miki
- Department of Myopia Control Research, Aichi Medical University, Japan
| | - Shigeo Wada
- Department of Mechanical Science and Bioengineering, Graduate School of Engineering Science, Osaka University, 1-3 Machikaneyamacho, Toyonaka, Osaka 560-8531, Japan
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Hannay V, Czerpak CA, Quigley HA, Nguyen TD. A noninvasive clinical method to measure in vivo mechanical strains of the lamina cribrosa by optical coherence tomography. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.08.14.23294082. [PMID: 37645852 PMCID: PMC10462204 DOI: 10.1101/2023.08.14.23294082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Objective To measure mechanical strain of the lamina cribrosa (LC) after intraocular pressure (IOP) change produced one week after a change in glaucoma medication. Design Cohort study. Participants Adult glaucoma patients (23 eyes, 15 patients) prescribed a change in IOP-lowering medication. Intervention Non-invasive optical coherence tomography (OCT) imaging of the eye. Main Outcomes Deformation calculated by digital volume correlation of OCT scans of the LC before and after IOP lowering by medication. Results Among 23 eyes, 17 eyes of 12 persons had IOP lowering ≥ 3 mmHg (reduced IOP group) with tensile anterior-posterior E zz strain = 1.0% ± 1.1% (p = 0.003) and compressive radial strain ( E rr ) = -0.3% ± 0.5% (p=0.012; random effects models accounting inclusion of both eyes in some persons). Maximum in-plane principal (tensile) strain and maximum shear strain in the reduced IOP group were: E max = 1.7% ± 1.0% and Γ max = 1.4% ± 0.7%, respectively (both p<0.0001 versus zero). Reduced IOP group strains E max and Γ max were significantly larger with greater %IOP decrease (<0.0001, <0.0001). The compliance of the E zz , E max , and Γ max strain response, defined as strain normalized by the IOP decrease, were larger with more abnormal perimetric mean deviation or visual field index values (all p≥0.02). Strains were unrelated to age (all p≥0.088). In reduced IOP eyes, mean LC anterior border posterior movement was only 2.05 μm posteriorly (p=0.052) and not related to % IOP change (p=0.94, random effects models). Only E rr was significantly related to ALD change, becoming more negative with greater posterior LC border change (p=0.015). Conclusion LC mechanical strains can be effectively measured by changes in eye drop medication using OCT and are related to degree of visual function loss in glaucoma. Trial Registration ClinicalTrials.gov Identifier: NCT03267849.
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Muñoz Sarmiento DM, Rodríguez Montaño ÓL, Alarcón Castiblancoa JD, Cortés Rodríguez CJ. The impact of horizontal eye movements versus intraocular pressure on optic nerve head biomechanics: A tridimensional finite element analysis study. Heliyon 2023; 9:e13634. [PMID: 36865452 PMCID: PMC9970910 DOI: 10.1016/j.heliyon.2023.e13634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 01/31/2023] [Accepted: 02/06/2023] [Indexed: 02/13/2023] Open
Abstract
It has been proposed that eye movements could be related to glaucoma development. This research aimed to compare the impact of intraocular pressure (IOP) versus horizontal duction on optic nerve head (ONH) strains. Thus, a tridimensional finite element model of the eye including the three tunics of the eye, all of the meninges, and the subarachnoid space (SAS) was developed using a series of medical tests and anatomical data. The ONH was divided into 22 subregions, and the model was subjected to 21 different eye pressures, as well as 24 different degrees of adduction and abduction ranging from 0.5° to 12°. Mean deformations were documented along anatomical axes and in principal directions. Additionally, the impact of tissue stiffness was assessed. The results show no statistically significant differences between the lamina cribrosa (LC) strains due to eye rotation and IOP variation. However, when assessing LC regions some experienced a reduction in principal strains following a 12° duction, while after the IOP reached 12 mmHg, all LC subzones showed an increase in strains. From an anatomical perspective, the effect on the ONH following 12° duction was opposite to that observed after a rise in IOP. Moreover, high strain dispersion inside the ONH subregions was obtained with lateral eye movements, which was not observed with increased IOP and variation. Finally, SAS and orbital fat stiffness strongly influenced ONH strains during eye movements, while SAS stiffness was also influential under ocular hypertension. Even if horizontal eye movements cause large ONH deformations, their biomechanical effect would be markedly distinct from that induced by IOP. It could be predicted that, at least in physiological conditions, their potential to cause axonal injury would not be so relevant. Thus, a causative role in glaucoma does not appear likely. By contrast, an important role of SAS would be expectable.
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Affiliation(s)
- Diana Marcela Muñoz Sarmiento
- Grupo de Investigación en Biomecánica, Universidad Nacional de Colombia, Colombia,Sociedad de Oftalmología Eduardo Arenas Archila, Colombia,Laboratorio de Anatomía y Fisiología, Grupo de Ciencias Básicas y Laboratorios, Universidad Manuela Beltrán, Colombia,Corresponding author. Grupo de Investigación en Biomecánica, Universidad Nacional de Colombia, Colombia.
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Ma D, Pasquale LR, Girard MJA, Leung CKS, Jia Y, Sarunic MV, Sappington RM, Chan KC. Reverse translation of artificial intelligence in glaucoma: Connecting basic science with clinical applications. FRONTIERS IN OPHTHALMOLOGY 2023; 2:1057896. [PMID: 36866233 PMCID: PMC9976697 DOI: 10.3389/fopht.2022.1057896] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
Artificial intelligence (AI) has been approved for biomedical research in diverse areas from bedside clinical studies to benchtop basic scientific research. For ophthalmic research, in particular glaucoma, AI applications are rapidly growing for potential clinical translation given the vast data available and the introduction of federated learning. Conversely, AI for basic science remains limited despite its useful power in providing mechanistic insight. In this perspective, we discuss recent progress, opportunities, and challenges in the application of AI in glaucoma for scientific discoveries. Specifically, we focus on the research paradigm of reverse translation, in which clinical data are first used for patient-centered hypothesis generation followed by transitioning into basic science studies for hypothesis validation. We elaborate on several distinctive areas of research opportunities for reverse translation of AI in glaucoma including disease risk and progression prediction, pathology characterization, and sub-phenotype identification. We conclude with current challenges and future opportunities for AI research in basic science for glaucoma such as inter-species diversity, AI model generalizability and explainability, as well as AI applications using advanced ocular imaging and genomic data.
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Affiliation(s)
- Da Ma
- School of Medicine, Wake Forest University, Winston-Salem, NC, United States
- Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, NC, United States
- School of Engineering Science, Simon Fraser University, Burnaby, BC, Canada
| | - Louis R. Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Michaël J. A. Girard
- Ophthalmic Engineering & Innovation Laboratory (OEIL), Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
- Institute for Molecular and Clinical Ophthalmology, Basel, Switzerland
| | | | - Yali Jia
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, United States
| | - Marinko V. Sarunic
- School of Engineering Science, Simon Fraser University, Burnaby, BC, Canada
- Institute of Ophthalmology, University College London, London, United Kingdom
| | - Rebecca M. Sappington
- School of Medicine, Wake Forest University, Winston-Salem, NC, United States
- Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, NC, United States
| | - Kevin C. Chan
- Departments of Ophthalmology and Radiology, Neuroscience Institute, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY, United States
- Department of Biomedical Engineering, Tandon School of Engineering, New York University, New York, NY, United States
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Czerpak CA, Kashaf MS, Zimmerman BK, Quigley HA, Nguyen TD. The Strain Response to Intraocular Pressure Decrease in the Lamina Cribrosa of Patients with Glaucoma. Ophthalmol Glaucoma 2023; 6:11-22. [PMID: 35863747 PMCID: PMC9849479 DOI: 10.1016/j.ogla.2022.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To measure biomechanical strains in the lamina cribrosa (LC) of living human eyes with intraocular pressure (IOP) lowering. DESIGN Cohort study. PARTICIPANTS Patients with glaucoma underwent imaging before and after laser suturelysis after trabeculectomy surgery (29 image pairs; 26 persons). INTERVENTION Noninvasive imaging of the eye. MAIN OUTCOME MEASURES Strains in optic nerve head tissue and changes in depths of the anterior border of the LC. RESULTS Intraocular pressure decreases caused the LC to expand in thickness in the anterior-posterior strain (Ezz = 0.94 ± 1.2%; P = 0.00020) and contract in radius in the radial strain (Err = - 0.19 ± 0.33%; P = 0.0043). The mean LC depth did not significantly change with IOP lowering (1.33 ± 6.26 μm; P = 0.26). A larger IOP decrease produced a larger, more tensile Ezz (P < 0.0001), greater maximum principal strain (Emax; P < 0.0001), and greater maximum shear strain (Γmax; P < 0.0001). The average LC depth change was associated with the Γmax and radial-circumferential shear strain (Erθ; P < 0.02) but was not significantly related to tensile or compressive strains. An analysis by clock hour showed that in temporal clock hours 3 to 6, a more anterior LC movement was associated with a more positive Emax, and in clock hours 3, 5, and 6, it was associated with a more positive Γmax. At 10 o'clock, a more posterior LC movement was related to a more positive Emax (P < 0.004). Greater compliance (strain/ΔIOP) of Emax (P = 0.044), Γmax (P = 0.052), and Erθ (P = 0.018) was associated with a thinner retinal nerve fiber layer. Greater compliance of Emax (P = 0.041), Γmax (P = 0.021), Erθ (P = 0.024), and in-plane shear strain (Erz; P = 0.0069) was associated with more negative mean deviations. Greater compliance of Γmax (P = 0.055), Erθ (P = 0.040), and Erz (P = 0.015) was associated with lower visual field indices. CONCLUSIONS With IOP lowering, the LC moves either into or out of the eye but, on average, expands in thickness and contracts in radius. Shear strains are nearly as substantial as in-plane strains. Biomechanical strains are more compliant in eyes with greater glaucoma damage. This work was registered at ClinicalTrials.gov as NCT03267849.
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Affiliation(s)
- Cameron A Czerpak
- Department of Mechanical Engineering, The Johns Hopkins University, Baltimore, Maryland.
| | - Michael Saheb Kashaf
- Wilmer Ophthalmological Institute, School of Medicine, The Johns Hopkins University, Baltimore, Maryland
| | - Brandon K Zimmerman
- Department of Mechanical Engineering, The Johns Hopkins University, Baltimore, Maryland
| | - Harry A Quigley
- Wilmer Ophthalmological Institute, School of Medicine, The Johns Hopkins University, Baltimore, Maryland
| | - Thao D Nguyen
- Department of Mechanical Engineering, The Johns Hopkins University, Baltimore, Maryland; Wilmer Ophthalmological Institute, School of Medicine, The Johns Hopkins University, Baltimore, Maryland
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Zhao D, Wang H, Deng J, Slavashevich I, Guo X, Mei Y, Sun C. Optical Coherence Elastography of 3D bilayer soft solids using full-field and partial displacement measurements. MEDICINE IN NOVEL TECHNOLOGY AND DEVICES 2022. [DOI: 10.1016/j.medntd.2022.100134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Abstract
PURPOSE OF REVIEW Biomechanics is an important aspect of the complex family of diseases known as the glaucomas. Here, we review recent studies of biomechanics in glaucoma. RECENT FINDINGS Several tissues have direct and/or indirect biomechanical roles in various forms of glaucoma, including the trabecular meshwork, cornea, peripapillary sclera, optic nerve head/sheath, and iris. Multiple mechanosensory mechanisms and signaling pathways continue to be identified in both the trabecular meshwork and optic nerve head. Further, the recent literature describes a variety of approaches for investigating the role of tissue biomechanics as a risk factor for glaucoma, including pathological stiffening of the trabecular meshwork, peripapillary scleral structural changes, and remodeling of the optic nerve head. Finally, there have been advances in incorporating biomechanical information in glaucoma prognoses, including corneal biomechanical parameters and iridial mechanical properties in angle-closure glaucoma. SUMMARY Biomechanics remains an active aspect of glaucoma research, with activity in both basic science and clinical translation. However, the role of biomechanics in glaucoma remains incompletely understood. Therefore, further studies are indicated to identify novel therapeutic approaches that leverage biomechanics. Importantly, clinical translation of appropriate assays of tissue biomechanical properties in glaucoma is also needed.
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Affiliation(s)
- Babak N. Safa
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta GA, USA
| | - Cydney A. Wong
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta GA, USA
| | - Jungmin Ha
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta GA, USA
| | - C. Ross Ethier
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta GA, USA
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