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Xie M, Tang J, Zhang Y, Deng Y, Ma K, Xiang X, Tang L. Assessment of the Corneal Biomechanical Features of Sturge-Weber Syndrome Using Dynamic Ultrahigh-speed Scheimpflug Imaging. Cornea 2024:00003226-990000000-00650. [PMID: 39104013 DOI: 10.1097/ico.0000000000003617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 05/29/2024] [Indexed: 08/07/2024]
Abstract
PURPOSE To evaluate the corneal biomechanical characteristics of eyes with Sturge-Weber syndrome (SWS) secondary glaucoma (SSG) by analyzing corneal biomechanical parameters obtained using the Corneal Visualization Scheimpflug Technology instrument (Corvis ST). METHODS In patients with SWS, eyes affected by SSG were designated as the SSG group while the contralateral eyes were designated as the SWS contralateral group (SC group). Patients from the myopia clinic served as the control group. Dynamic corneal response parameters (DCRs) including the stress-strain index (SSI)-a critical material stiffness parameter that excludes interference from IOP and central corneal thickness (CCT)-were analyzed. RESULTS For CCT, no significant difference was observed between the SSG and SC groups. However, significant differences were found between the SSG and control groups and between the SC and control groups. Parameters such as HC Time, A1 Deformation Amp., A2 Deformation Amp., length of Whole Eye Movement (WEM), DA Ratio Max (2 mm), PachySlope, DA Ratio Max (1 mm), and ARTh showed significant differences between the SSG group and control group. In the SSG group, 4 of night eyes had an SSI of less than 0.85. CONCLUSIONS Some DCRs indicated a stiffer cornea in the SSG group, possibly due to a thicker cornea in this group. On analyzing SSI, it was found that corneal material properties change, becoming less stiff in some of the patients with SSG. In conclusion, our study provides a preliminary exploration of the biomechanical properties of SWS secondary glaucoma.
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Affiliation(s)
- Mengzhen Xie
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Jing Tang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Yao Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Yingping Deng
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Ke Ma
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Xingye Xiang
- School of Life Science and Engineering, Southwest Jiaotong University, Chengdu, Sichuan, China; and
- Georgia State University, Atlanta, GA
| | - Li Tang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
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Li DL, Qin Y, Zheng YJ, Yin ZJ, Li YZ, Ma R, Liang G, Pan CW. Refractive Associations With Whole Eye Movement Distance and Time Among Chinese University Students: A Corvis ST Study. Transl Vis Sci Technol 2023; 12:13. [PMID: 38085247 PMCID: PMC10720759 DOI: 10.1167/tvst.12.12.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/08/2023] [Indexed: 12/17/2023] Open
Abstract
Purpose Eye movement has been frequently studied in clinical conditions, but the association with myopia has been less explored, especially in population-based samples. The purpose of this study was to assess the associations of eye movement measured by the Corvis ST with refractive status in healthy university students. Methods A total of 1640 healthy students were included in the study (19.0 ± 0.9 years). Eye movement parameters (whole eye movement [WEM]; whole eye movement time [WEMT]) were measured by the Corvis ST. Spherical equivalent (SE) was measured using an autorefractor without cycloplegia. IOL Master was used to assess axial length (AL). Results AL was negatively correlated with WEM and WEMT (rWEM = -0.28, rWEMT = -0.08), and SE was positively correlated with WEM and WEMT (rWEM = 0.21, rWEMT = 0.14). For the risk of high myopia, breakpoint analysis and restricted cubic spline model showed that the knots of the significant steep downward trend of WEM and WEMT were 0.27 mm and 20.4 ms, respectively. The piecewise linear regression model revealed a significant correlation between AL, SE, and WEM when the value of WEM was below 0.27 mm. Additionally, when WEMT exceeded 20.4 ms, a significant decrease in AL and an increase in SE were observed with increasing WEMT. Conclusions A larger distance and longer duration of eye movement were correlated with a lower degree of myopia and shorter AL, and there was a threshold effect. Translational Relevance The findings might aid in understanding the pathogenesis of myopia and provide a theoretical foundation for clinical diagnosis and prediction.
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Affiliation(s)
- Dan-Lin Li
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Yu Qin
- Department of Ophthalmology, the Affiliated Hospital of Yunnan University, Kunming, China
| | - Ya-Jie Zheng
- Department of Ophthalmology, the Affiliated Hospital of Yunnan University, Kunming, China
| | - Zhi-Jian Yin
- Department of Ophthalmology, the First Affiliated Hospital of Dali University, Dali, China
| | - Yue-Zu Li
- Department of Ophthalmology, the Affiliated Hospital of Yunnan University, Kunming, China
| | - Rong Ma
- Department of Ophthalmology, the Affiliated Hospital of Yunnan University, Kunming, China
| | - Gang Liang
- Department of Ophthalmology, the Affiliated Hospital of Yunnan University, Kunming, China
| | - Chen-Wei Pan
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
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Aoki S, Asaoka R, Fujino Y, Nakakura S, Murata H, Kiuchi Y. Comparing corneal biomechanic changes among solo cataract surgery, microhook ab interno trabeculotomy and iStent implantation. Sci Rep 2023; 13:19148. [PMID: 37932377 PMCID: PMC10628136 DOI: 10.1038/s41598-023-46709-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 11/03/2023] [Indexed: 11/08/2023] Open
Abstract
Minimally invasive glaucoma surgery has expanded the surgical treatment options in glaucoma, particularly when combined with cataract surgery. It is clinically relevant to understand the associated postoperative changes in biomechanical properties because they are influential on the measurement of intraocular pressure (IOP) and play an important role in the pathogenesis of open-angle glaucoma (OAG). This retrospective case-control study included OAG patients who underwent cataract surgery combined with microhook ab interno trabeculotomy (µLOT group: 53 eyes of 36 patients) or iStent implantation (iStent group: 59 eyes of 37 patients) and 62 eyes of 42 solo cataract patients without glaucoma as a control group. Changes in ten biomechanical parameters measured with the Ocular Response Analyzer and Corneal Visualization Scheimpflug Technology (Corvis ST) at 3 and 6 months postoperatively relative to baseline were compared among the 3 groups. In all the groups, IOP significantly decreased postoperatively. In the µLOT and control groups, significant changes in Corvis ST-related parameters, including stiffness parameter A1 and stress‒strain index, indicated that the cornea became softer postoperatively. In contrast, these parameters were unchanged in the iStent group. Apart from IOP reduction, the results show variations in corneal biomechanical changes from minimally invasive glaucoma surgery combined with cataract surgery.
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Affiliation(s)
- Shuichiro Aoki
- Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Ryo Asaoka
- Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-Ku, Hamamatsu City, Shizuoka, Japan.
- Seirei Christopher University, Hamamatsu City, Shizuoka, Japan.
- The Graduate School for the Creation of New Photonics Industries, Hamamatsu City, Shizuoka, Japan.
| | - Yuri Fujino
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-Ku, Hamamatsu City, Shizuoka, Japan
- Department of Ophthalmology, Shimane University Faculty of Medicine, Shimane, Japan
| | - Shunsuke Nakakura
- Department of Ophthalmology, Tsukazaki Memorial Hospital, Hyogo, Japan
| | - Hiroshi Murata
- Department of Ophthalmology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoshiaki Kiuchi
- Department of Ophthalmology and Visual Science, Hiroshima University, Hiroshima, Japan
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Yuhas PT, McHugh-Morrison C, Canavan J, Jeyandran J, Mahmoud AM, Roberts CJ. Intereye Differences in the Clinical Assessment of Intraocular Pressure and Ocular Biomechanics. Optom Vis Sci 2023; 100:688-696. [PMID: 37639554 PMCID: PMC10662582 DOI: 10.1097/opx.0000000000002066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 07/23/2023] [Indexed: 08/31/2023] Open
Abstract
SIGNIFICANCE Clinicians and researchers will have evidence whether intereye differences confound clinical measurements of intraocular pressure or of ocular biomechanical parameters. PURPOSE The purpose of this study was to determine whether intraocular pressure and biomechanical parameters, as measured by the Ocular Response Analyzer (ORA) and by Cornea Visualization with Scheimpflug Technology (CorVis ST), are different between the first and second eye measured. METHODS Intraocular pressure and biomechanical parameters were collected from both eyes of healthy participants (N = 139). The ORA measured corneal-compensated intraocular pressure, Goldmann-correlated intraocular pressure, and corneal hysteresis. The CorVis ST measured biomechanically corrected intraocular pressure, stiffness parameter at first applanation, and stiffness parameter at highest concavity. For each measurement, a paired t test compared the value of the first eye measured against that of the second eye measured. RESULTS For the ORA, Goldmann-correlated intraocular pressure was significantly higher ( P = .001) in the first eye (14.8 [3.45] mmHg) than in the second eye (14.3 [3.63] mmHg). For the CorVis ST, biomechanically corrected intraocular pressure was significantly higher ( P < .001) in the second eye (14.7 [2.14] mmHg) than in the first eye (14.3 [2.11] mmHg). Stiffness parameter at first applanation (intereye difference, 6.85 [9.54] mmHg/mm) was significantly ( P < .001) higher in the first eye than in the second eye. Stiffness parameter at highest concavity was significantly higher ( P = .01) in the second eye (14.3 [3.18] mmHg/mm) than in the first eye (14.0 [3.13] mmHg/mm). CONCLUSIONS Although there were statistically significant intereye differences in intraocular pressure and in biomechanical parameters for both devices, the variations were small and thus unlikely to affect clinical outcomes.
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Affiliation(s)
| | | | - Joshua Canavan
- College of Optometry, The Ohio State University, Columbus, Ohio
| | | | - Ashraf M. Mahmoud
- Department of Ophthalmology and Visual Sciences, College of Medicine, The Ohio State University, Columbus, Ohio
| | - Cynthia J. Roberts
- Department of Ophthalmology and Visual Sciences, College of Medicine, The Ohio State University, Columbus, Ohio
- Department of Biomedical Engineering, College of Engineering, The Ohio State University, Columbus, Ohio
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Elhusseiny AM, Scarcelli G, Saeedi OJ. Corneal Biomechanical Measures for Glaucoma: A Clinical Approach. Bioengineering (Basel) 2023; 10:1108. [PMID: 37892838 PMCID: PMC10604716 DOI: 10.3390/bioengineering10101108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/11/2023] [Accepted: 09/14/2023] [Indexed: 10/29/2023] Open
Abstract
Over the last two decades, there has been growing interest in assessing corneal biomechanics in different diseases, such as keratoconus, glaucoma, and corneal disorders. Given the interaction and structural continuity between the cornea and sclera, evaluating corneal biomechanics may give us further insights into the pathogenesis, diagnosis, progression, and management of glaucoma. Therefore, some authorities have recommended baseline evaluations of corneal biomechanics in all glaucoma and glaucoma suspects patients. Currently, two devices (Ocular Response Analyzer and Corneal Visualization Schiempflug Technology) are commercially available for evaluating corneal biomechanics; however, each device reports different parameters, and there is a weak to moderate agreement between the reported parameters. Studies are further limited by the inclusion of glaucoma subjects taking topical prostaglandin analogues, which may alter corneal biomechanics and contribute to contradicting results, lack of proper stratification of patients, and misinterpretation of the results based on factors that are confounded by intraocular pressure changes. This review aims to summarize the recent evidence on corneal biomechanics in glaucoma patients and insights for future studies to address the current limitations of the literature studying corneal biomechanics.
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Affiliation(s)
- Abdelrahman M. Elhusseiny
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA;
- Department of Ophthalmology, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Giuliano Scarcelli
- Fischell Department of Bioengineering, University of Maryland, College Park, MD 20742, USA;
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Osamah J. Saeedi
- Fischell Department of Bioengineering, University of Maryland, College Park, MD 20742, USA;
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA
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Wei Y, Cai Y, Bao C, Zhu Y, Pan Y. The role of corneal biomechanics in visual field progression of primary open-angle glaucoma with ocular normotension or hypertension: a prospective longitude study. Front Bioeng Biotechnol 2023; 11:1174419. [PMID: 37234476 PMCID: PMC10206210 DOI: 10.3389/fbioe.2023.1174419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 04/20/2023] [Indexed: 05/28/2023] Open
Abstract
Introduction: To analyze effects of dynamic corneal response parameters (DCRs) on visual field (VF) progression in normal-tension glaucoma (NTG) and hypertension glaucoma (HTG). Methods: This was a prospective cohort study. This study included 57 subjects with NTG and 54 with HTG, followed up for 4 years. The subjects were divided into progressive and nonprogressive groups according to VF progression. DCRs were evaluated by corneal visualization Scheimpflug technology. General linear models (GLMs) were used to compare DCRs between two groups, adjusting for age, axial length (AL), mean deviation (MD), etc. VF progression risk factors were evaluated by logistic regression and receiver operating characteristic (ROC) curves. Results: For NTG, first applanation deflection area (A1Area) was increased in progressive group and constituted an independent risk factor for VF progression. ROC curve of A1Area combined with other relevant factors (age, AL, MD, etc.) for NTG progression had an area under curve (AUC) of 0.813, similar to the ROC curve with A1area alone (AUC = 0.751, p = 0.232). ROC curve with MD had an AUC of 0.638, lower than A1Area-combined ROC curve (p = 0.036). There was no significant difference in DCRs between the two groups in HTG. Conclusion: Corneas in progressive NTG group were more deformable than nonprogressive group. A1Area may be an independent risk factor for NTG progression. It suggested that the eyes with more deformable corneas may also be less tolerant to pressure and accelerate VF progression. VF progression in HTG group was not related to DCRs. Its specific mechanism needs further studies.
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Affiliation(s)
| | - Yu Cai
- *Correspondence: Yu Cai, ; Yingzi Pan,
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Liu MX, Zhou M, Li DL, Dong XX, Liang G, Pan CW. Corneal Biomechanics in Primary Open Angle Glaucoma and Ocular Hypertension: A Systematic Review and Meta-analysis. J Glaucoma 2023; 32:e24-e32. [PMID: 36583701 DOI: 10.1097/ijg.0000000000002170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 12/07/2022] [Indexed: 12/31/2022]
Abstract
PRCIS Normal tension glaucoma patients had softer corneas than normal controls, whereas high-tension glaucoma and ocular hypertension patients had stiffer corneas. PURPOSE To comprehensively identify the corneal biomechanical differences of patients with primary open angle glaucoma (POAG) and ocular hypertension (OHT) using the Ocular Response Analyzer or the Corvis ST. METHODS The electronic databases PubMed, Embase, and Web of Science were comprehensively searched for studies comparing corneal biomechanical differences between POAG and OHT patients with normal controls by Ocular Response Analyzer or Corvis ST. The weighted mean differences and 95% confidence intervals (CIs) were calculated. Subgroup analyses were performed according to the subtypes of POAG, including high-tension glaucoma (HTG) and normal tension glaucoma (NTG). RESULTS Thirty-one case-control studies were ultimately included, with 2462 POAG patients, 345 OHT patients, and 3281 normal controls. The corneal hysteresis (CH), corneal resistance factor (CRF), and highest concavity time (HC-t) were all lower in POAG patients than in normal controls. The CH, time at the second applanation (A2t), HC-t, highest concavity radius (HC-R), and deformation amplitude at the highest concavity (HC-DA) were lower in OHT patients, while the CRF, time at the first applanation (A1t), and stiffness parameter at the first applanation (SP-A1) were greater in OHT patients than in normal controls. The subgroup analyses showed that the CH, A2t, length at the second applanation (A2L), and HC-DA were lower in HTG, and the CH, CRF, A1t, and HC-t were lower in NTG patients than in normal controls. CONCLUSION The corneas of NTG patients are more deformable than normal controls, whereas the corneas of HTG and OHT patients are stiffer.
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Affiliation(s)
- Min-Xin Liu
- School of Public Health, Medical College of Soochow University, Suzhou
| | - Miao Zhou
- Department of Ophthalmology, Peking University People's Hospital, Beijing
| | - Dan-Lin Li
- School of Public Health, Medical College of Soochow University, Suzhou
| | - Xing-Xuan Dong
- School of Public Health, Medical College of Soochow University, Suzhou
| | - Gang Liang
- Department of Ophthalmology, The Affiliated Hospital of Yunnan University, Kunming
- Department of Ophthalmology, The Second People's Hospital of Yunnan Province, Kunming, China
| | - Chen-Wei Pan
- School of Public Health, Medical College of Soochow University, Suzhou
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Ramm L, Herber R, Lorenz G, Jasper CS, Pillunat LE, Pillunat KR. Evaluation of corneal biomechanical properties using the ocular response analyzer and the dynamic Scheimpflug-Analyzer Corvis ST in high pressure and normal pressure open-angle glaucoma patients. PLoS One 2023; 18:e0281017. [PMID: 36701409 PMCID: PMC9879466 DOI: 10.1371/journal.pone.0281017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 01/12/2023] [Indexed: 01/27/2023] Open
Abstract
PURPOSE To characterize differences in corneal biomechanics in high (HPG) and normal pressure (NPG) primary open-angle glaucoma, and its association to disease severity. METHODS Corneal biomechanical properties were measured using the Ocular Response Analyzer (ORA) and the dynamic Scheimpflug-Analyzer Corvis ST (CST). Disease severity was functionally assessed by automated perimetry (Humphrey field analyzer) and structurally with the Heidelberg Retina Tomograph. To avoid a possible falsification by intraocular pressure, central corneal thickness and age, which strongly influence ORA and CST measurements, group matching was performed. Linear mixed models and generalized estimating equations were used to consider inter-eye correlation. RESULTS Following group matching, 60 eyes of 38 HPG and 103 eyes of 60 NPG patients were included. ORA measurement revealed a higher CRF in HPG than in NPG (P < 0.001). Additionally, the CST parameter integrated radius (P < 0.001) was significantly different between HPG and NPG. The parameter SSI (P < 0.001) representing corneal stiffness was higher in HPG than in NPG. Furthermore, regression analysis revealed associations between biomechanical parameters and indicators of disease severity. In HPG, SSI correlated to RNFL thickness. In NPG, dependencies between biomechanical readings and rim area, MD, and PSD were shown. CONCLUSION Significant differences in corneal biomechanical properties were detectable between HPG and NPG patients which might indicate different pathophysiological mechanisms underlying in both entities. Moreover, biomechanical parameters correlated to functional and structural indices of diseases severity. A reduced corneal deformation measured by dynamic methods was associated to advanced glaucomatous damage.
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Affiliation(s)
- Lisa Ramm
- Department of Ophthalmology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Robert Herber
- Faculty of Medicine Carl Gustav Carus, Department of Ophthalmology, TU Dresden, Dresden, Germany
- * E-mail:
| | - Georg Lorenz
- Department of Ophthalmology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Carolin S. Jasper
- Department of Ophthalmology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Lutz E. Pillunat
- Department of Ophthalmology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Karin R. Pillunat
- Department of Ophthalmology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
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