In-vivo 3D corneal elasticity using air-coupled ultrasound optical coherence elastography

Dynamic optical coherence elastography for skin burn assessment: A preliminary study on mice model

Skin burns that include tissue coagulation necrosis imply variations in stiffness. Dynamic phase-sensitive optical coherence elastography (OCE) is used to evaluate the stiffness of burned skin nondestructively in this paper. The homemade dynamic OCE was initially verified through tissue-mimicking phantom experiments regarding Rayleigh wave speed. After being burned with a series of temperatures and durations, the corresponding structure and stiffness variations of mice skin were demonstrated by histological images, optical coherence tomography B-scans, and OCE elastic wave speed maps. The results clearly displayed the variation in elastic properties and stiffness of the scab edge extending in the lateral direction. Statistical analysis revealed that murine skin burned at temperatures exceeding 100°C typically exhibited greater stiffness than skin burned at temperatures below 100°C. The dynamic OCE technique shows potential application for incorporating elasticity properties as a biomechanical extension module to diagnose skin burn injuries.

Spatial mapping of corneal biomechanical properties using wave-based optical coherence elastography

Quantifying the mechanical properties of the cornea can provide valuable insights into the occurrence and progression of keratoconus, as well as the effectiveness of corneal crosslinking surgery. This study presents a non-contact and non-invasive wave-based optical coherence elastography system that utilizes air-pulse stimulation to create a two-dimensional map of corneal elasticity. Homogeneous and dual concentration phantoms were measured with the sampling of 25 × 25 points over a 6.6 × 6.6 mm2 area, to verify the measurement capability for elastic mapping and the spatial resolution (0.91 mm). The velocity of elastic waves distribution of porcine corneas before and after corneal crosslinking surgery were further mapped, showing a significant change in biomechanics in crosslinked region. This system features non-invasiveness and high resolution, holding great potential for application in ophthalmic clinics.

Quantitative Optical Coherence Elastography of the Optic Nerve Head In Vivo

OBJECTIVE

Optical coherence elastography (OCE) was used to demonstrate the relationship between the elasticity of the optic nerve head (ONH) and different intraocular pressure (IOP) levels in an in-vivo rabbit model for the first time.

METHOD

Both ex-vivo and in-vivo rabbit ONH were imaged using OCE system. A mechanical shaker initiated the propagation of elastic waves, and the elasticity of the ONH was determined by tracking the wave propagation speed. The elasticity of the ONH under varying IOP levels was reconstructed based on the wave speed. Notably, the ONH exhibited increased stiffness with elevated IOP.

RESULTS

In the in-vivo rabbit models, the Young's modulus of ONH increased from 14 kPa to 81 kPa with the IOP increased from 15 mmHg to 35 mmHg. This revealed a positive correlation between the Young's modulus of the ONH and intraocular pressure.

CONCLUSION

The OCE system proved effective in measuring the mechanical properties of ONH at different IOP levels, with validation in an in-vivo rabbit model.

SIGNIFICANCE

Considering ONH plays a critical role in vision and eye diseases, the capability to image and quantify in vivo ONH biomechanical properties has great potential to advance vision science research and improve the clinical management of glaucoma patients.

Simultaneous tensile and shear measurement of the human cornea in vivo using S0- and A0-wave optical coherence elastography

Understanding corneal stiffness is valuable for improving refractive surgery, detecting corneal abnormalities, and assessing intraocular pressure. However, accurately measuring the elastic properties, specifically the tensile and shear moduli that govern mechanical deformation, has been challenging. To tackle this issue, we have developed guided-wave optical coherence elastography that can simultaneously excite and analyze symmetric (S0) and anti-symmetric (A0) elastic waves in the cornea at around 10 kHz frequencies, enabling us to extract tensile and shear properties from measured wave dispersion curves. We verified the technique using elastomer phantoms and ex vivo porcine corneas and investigated the dependence on intraocular pressure using acoustoelastic theory that incorporates corneal tension and a nonlinear constitutive tissue model. In a pilot study involving six healthy human subjects aged 31 to 62, we measured shear moduli (Gzx) of 94±20 kPa (mean±standard deviation) and tensile moduli (Exx) of 4.0±1.1 MPa at central corneas. Our preliminary analysis of age-dependence revealed contrasting trends: -8.3±4.5 kPa/decade for shear and 0.30±0.21 MPa/decade for tensile modulus. This OCE technique has the potential to become a highly useful clinical tool for the quantitative biomechanical assessment of the cornea. STATEMENT OF SIGNIFICANCE: This article reports an innovative elastography technique using two guided elastic waves, demonstrating the measurement of both tensile and shear moduli in human cornea in vivo with unprecedented precision. This technique paves the way for comprehensive investigations into corneal mechanics and holds clinical significance in various aspects of corneal health and disease management.

Noncontact longitudinal shear wave imaging for the evaluation of heterogeneous porcine brain biomechanical properties using optical coherence elastography

High-resolution quantification of heterogeneous brain biomechanical properties has long been an important topic. Longitudinal shear waves (LSWs) can be used to assess the longitudinal Young's modulus, but contact excitation methods have been used in most previous studies. We propose an air-coupled ultrasound transducer-based optical coherence elastography (AcUT-OCE) technique for noncontact excitation and detection of LSWs in samples and assessment of the nonuniformity of the brain's biomechanical properties. The air-coupled ultrasonic transducer (AcUT) for noncontact excitation of LSWs in the sample has a center frequency of 250 kHz. Phase-resolved Doppler optical coherence tomography (OCT) was used to image and reconstruct the propagation behavior of LSWs and surface ultrasound waves at high resolution. An agar phantom model was used to verify the feasibility of the experimental protocol, and experiments with ex vivo porcine brain samples were used to assess the nonuniformity of the brain biomechanical properties. LSWs with velocities of 0.83 ± 0.11 m/s were successfully excited in the agar phantom model. The perivascular elastography results in the prefrontal cortex (PFC) of the ex vivo porcine brains showed that the Young's modulus was significantly higher in the longitudinal and transverse directions on the left side of the cerebral vessels than on the right side and that the Young's modulus of the PFC decreased with increasing depth. The AcUT-OCE technique, as a new scheme for LSW applications in in vivo elastography, can be used for noncontact excitation of LSWs in brain tissue and high-resolution detection of heterogeneous brain biomechanical properties.

Simultaneous tensile and shear measurement of the human cornea in vivo using S0- and A0-wave optical coherence elastography

Understanding corneal stiffness is valuable for improving refractive surgery, detecting corneal abnormalities, and assessing intraocular pressure. However, accurately measuring the elastic properties, particularly the tensile and shear moduli that govern mechanical deformation, has been challenging. To tackle this issue, we have developed guided-wave optical coherence elastography that can simultaneously excite and analyze symmetric (S0) and anti-symmetric (A0) elastic waves in the cornea at frequencies around 10 kHz and allows us to extract tensile and shear properties from measured wave dispersion curves. By applying acoustoelastic theory that incorporates corneal tension and a nonlinear constitutive tissue model, we verified the technique using elastomer phantoms and ex vivo porcine corneas and investigated the dependence on intraocular pressure. For two healthy human subjects, we measured a mean tensile modulus of 3.6 MPa and a mean shear modulus of 76 kPa in vivo with estimated errors of < 4%. This technique shows promise for the quantitative biomechanical assessment of the cornea in a clinical setting.

Acoustic radiation force optical coherence elastography: A preliminary study on biomechanical properties of trabecular meshwork

Evaluating biomechanical properties of trabecular meshwork (TM) is of great significance for understanding the mechanism of aqueous humor circulation and its relationship to some eye diseases such as glaucoma; however, there is almost no relevant study due to the lack of clinical measurement tool. In this paper, an acoustic radiation force optical coherence elastography (ARF-OCE) system is developed with the advantages of noninvasive detection, high resolution, high sensitivity, and high-speed imaging, by which elastic modulus of the porcine and human TMs is accurately quantified. As the first OCE imaging of TM, our study demonstrates that ARF-OCE may be an effective approach to advance the research of diseases related to aqueous humor circulation.

Novel acoustic radiation force optical coherence elastography based on ultrasmall ultrasound transducer for biomechanics evaluation of in vivo cornea

We developed a novel acoustic radiation force optical coherence elastography (ARF-OCE) based on an ultrasmall ultrasound transducer for quantitative biomechanics evaluations of in vivo cornea. A custom single-sided meta-ultrasonic transducer with an outer diameter of 1.8 mm, focal spot diameter of 1.6 mm, central frequency of 930 kHz, and focal length of 0.8 mm was applied to excite the sample. The sample arm of the ARF-OCE system employed a three-dimensional printed holder that allowed for ultrasound excitation and ARF-OCE detection. The phase-resolved algorithm was combined with a Lamb wave model to depth-resolved evaluate corneal biomechanics after keratoconus and cross-linking treatments (CXL). The results showed that, compare to the healthy cornea, the Lamb wave velocity was significantly reduced in the keratoconus, increased in the cornea after CXL, and increased with cross-linked irradiation energy in the cornea. These results indicated the good clinical translation potential of the proposed novel ARF-OCE.

In vivo corneal elastography: A topical review of challenges and opportunities

Clinical measurement of corneal biomechanics can aid in the early diagnosis, progression tracking, and treatment evaluation of ocular diseases. Over the past two decades, interdisciplinary collaborations between investigators in optical engineering, analytical biomechanical modeling, and clinical research has expanded our knowledge of corneal biomechanics. These advances have led to innovations in testing methods (ex vivo, and recently, in vivo) across multiple spatial and strain scales. However, in vivo measurement of corneal biomechanics remains a long-standing challenge and is currently an active area of research. Here, we review the existing and emerging approaches for in vivo corneal biomechanics evaluation, which include corneal applanation methods, such as ocular response analyzer (ORA) and corneal visualization Scheimpflug technology (Corvis ST), Brillouin microscopy, and elastography methods, and the emerging field of optical coherence elastography (OCE). We describe the fundamental concepts, analytical methods, and current clinical status for each of these methods. Finally, we discuss open questions for the current state of in vivo biomechanics assessment techniques and requirements for wider use that will further broaden our understanding of corneal biomechanics for the detection and management of ocular diseases, and improve the safety and efficacy of future clinical practice.

Simultaneous Assessment of the Whole Eye Biomechanics Using Ultrasonic Elastography

OBJECTIVE

Current elastography techniques in the field of ophthalmology usually target one specific tissue, such as the cornea or the sclera. However, the eye is an inter-related organ, and some ocular diseases can alter the biomechanical properties of multiple anatomical structures. Hence, there is a need to develop an imaging tool that can non-invasively, quantitatively, and accurately characterize dynamic changes among these biomechanical properties.

METHODS

A high resolution ultrasound elastography system was developed to achieve this goal. The efficacy and accuracy of the system was first validated on tissue-mimicking phantoms while mechanical testing measurements served as the gold standard. Next, an in vivo elevated intraocular pressure (IOP) model was established in rabbits to further test our system. In particular, elastography measurements were obtained at 5 IOP levels, ranging from 10 mmHg to 30 mmHg in 5 mmHg increments. Spatial-temporal maps of the multiple ocular tissues (cornea, lens, iris, optic nerve head, and peripapillary sclera) were obtained.

RESULTS

The spatial-temporal maps were acquired simultaneously for the ocular tissues at the 5 different IOP levels. The statistical analysis of the elastic wave speed was presented for ocular tissues. Finally, the mapping for the elastic wave speed of each ocular component was acquired at each IOP level.

CONCLUSION

Our elastography system can concurrently assess the biomechanical properties of multiple ocular structures and detect changes in biomechanical properties associated with changes in IOP.

SIGNIFICANCE

This system provides a novel tool to measure and quantify the biomechanical properties of the whole eye.

Noncontact Acoustic Micro-Tapping Optical Coherence Elastography for Quantification of Corneal Anisotropic Elasticity: In Vivo Rabbit Study

Purpose

The purpose of this study was to demonstrate accurate measurement of corneal elastic moduli in vivo with noncontact and noninvasive optical coherence elastography.

Methods

Elastic properties (in-plane Young's modulus, E, and both in-plane, μ, and out-of-plane, G, shear moduli) of rabbit cornea were quantified in vivo using noncontact dynamic acoustic micro-tapping optical coherence elastography (AµT-OCE). The intraocular pressure (IOP)-dependence of measured mechanical properties was explored in extracted whole globes following in vivo measurement. A nearly incompressible transverse isotropic (NITI) model was used to reconstruct moduli from AµT-OCE data. Independently, cornea elastic moduli were also measured ex vivo with traditional, destructive mechanical tests (tensile extensometry and shear rheometry).

Results

Our study demonstrates strong anisotropy of corneal elasticity in rabbits. The in-plane Young's modulus, computed as E = 3μ, was in the range of 20 MPa to 44 MPa, whereas the out-of-plane shear modulus was in the range of 34 kPa to 261 kPa. Both pressure-dependent ex vivo OCE and destructive mechanical tests performed on the same samples within an hour of euthanasia strongly support the results of AµT-OCE measurements.

Conclusions

Noncontact AµT-OCE can noninvasively quantify cornea anisotropic elastic properties in vivo.

Translational Relevance

As optical coherence tomography (OCT) is broadly accepted in ophthalmology, these results suggest the potential for rapid translation of AµT-OCE into clinical practice. In addition, AµT-OCE can likely improve diagnostic criteria of ectatic corneal diseases, leading to early diagnosis, reduced complications, customized surgical treatment, and personalized biomechanical models of the eye.

Recent advances in optical elastography and emerging opportunities in the basic sciences and translational medicine [Invited]

Optical elastography offers a rich body of imaging capabilities that can serve as a bridge between organ-level medical elastography and single-molecule biophysics. We review the methodologies and recent developments in optical coherence elastography, Brillouin microscopy, optical microrheology, and photoacoustic elastography. With an outlook toward maximizing the basic science and translational clinical impact of optical elastography technologies, we discuss potential ways that these techniques can integrate not only with each other, but also with supporting technologies and capabilities in other biomedical fields. By embracing cross-modality and cross-disciplinary interactions with these parallel fields, optical elastography can greatly increase its potential to drive new discoveries in the biomedical sciences as well as the development of novel biomechanics-based clinical diagnostics and therapeutics.

High-Frequency Ultrasound Elastography to Assess the Nonlinear Elastic Properties of the Cornea and Ciliary Body

Mechanical properties of the anterior anatomical structures of the eye, such as the cornea and ciliary body, play a key role in the ocular function and homeostasis. However, measuring the biomechanical properties of the anterior ocular structures, especially deeper structures, such as the ciliary body, remains a challenge due to the lack of high-resolution imaging tools. Herein, we implement a mechanical shaker-based high-frequency ultrasound elastography technique that can track the induced elastic wave propagation to assess the linear and nonlinear elastic properties of anterior ocular structures. The findings of this study advance our understanding of the role of anterior ocular structures in the pathogenesis of different ocular disorders, such as glaucoma.

In vivo assessment of corneal biomechanics under a localized cross-linking treatment using confocal air-coupled optical coherence elastography

The localized application of the riboflavin/UV-A collagen cross-linking (UV-CXL) corneal treatment has been proposed to concentrate the stiffening process only in the compromised regions of the cornea by limiting the epithelium removal and irradiation area. However, current clinical screening devices dedicated to measuring corneal biomechanics cannot provide maps nor spatial-dependent changes of elasticity in corneas when treated locally with UV-CXL. In this study, we leverage our previously reported confocal air-coupled ultrasonic optical coherence elastography (ACUS-OCE) probe to study local changes of corneal elasticity in three cases: untreated, half-CXL-treated, and full-CXL-treated in vivo rabbit corneas (n = 8). We found a significant increase of the shear modulus in the half-treated (>450%) and full-treated (>650%) corneal regions when compared to the non-treated cases. Therefore, the ACUS-OCE technology possesses a great potential in detecting spatially-dependent mechanical properties of the cornea at multiple meridians and generating elastography maps that are clinically relevant for patient-specific treatment planning and monitoring of UV-CXL procedures.

Wave-based optical coherence elastography: The 10-year perspective

After 10 years of progress and innovation, optical coherence elastography (OCE) based on the propagation of mechanical waves has become one of the major and the most studied OCE branches, producing a fundamental impact in the quantitative and nondestructive biomechanical characterization of tissues. Preceding previous progress made in ultrasound and magnetic resonance elastography; wave-based OCE has pushed to the limit the advance of three major pillars: (1) implementation of novel wave excitation methods in tissues, (2) understanding new types of mechanical waves in complex boundary conditions by proposing advance analytical and numerical models, and (3) the development of novel estimators capable of retrieving quantitative 2D/3D biomechanical information of tissues. This remarkable progress promoted a major advance in answering basic science questions and the improvement of medical disease diagnosis and treatment monitoring in several types of tissues leading, ultimately, to the first attempts of clinical trials and translational research aiming to have wave-based OCE working in clinical environments. This paper summarizes the fundamental up-to-date principles and categories of wave-based OCE, revises the timeline and the state-of-the-art techniques and applications lying in those categories, and concludes with a discussion on the current challenges and future directions, including clinical translation research.

Viscoelastic properties' characterization of corneal stromal models using non-contact surface acoustic wave optical coherence elastography (SAW-OCE)

Viscoelastic characterization of the tissue-engineered corneal stromal model is important for our understanding of the cell behaviors in the pathophysiologic altered corneal extracellular matrix (ECM). The effects of the interactions between stromal cells and different ECM characteristics on the viscoelastic properties during an 11-day culture period were explored. Collagen-based hydrogels seeded with keratocytes were used to replicate human corneal stroma. Keratocytes were seeded at 8 × 10³ cells per hydrogel and with collagen concentrations of 3, 5 and 7 mg/ml. Air-pulse-based surface acoustic wave optical coherence elastography (SAW-OCE) was employed to monitor the changes in the hydrogels' dimensions and viscoelasticity over the culture period. The results showed the elastic modulus increased by 111%, 56% and 6%, and viscosity increased by 357%, 210% and 25% in the 3, 5 and 7 mg/ml hydrogels, respectively. To explain the SAW-OCE results, scanning electron microscope was also performed. The results confirmed the increase in elastic modulus and viscosity of the hydrogels, respectively, arose from increased fiber density and force-dependent unbinding of bonds between collagen fibers. This study reveals the influence of cell-matrix interactions on the viscoelastic properties of corneal stromal models and can provide quantitative guidance for mechanobiological investigations which require collagen ECM with tuneable viscoelastic properties.

Quantification of biomechanical properties of human corneal scar using acoustic radiation force optical coherence elastography

Biomechanical properties of corneal scar are strongly correlated with many corneal diseases and some types of corneal surgery, however, there is no elasticity information available about corneal scar to date. Here, we proposed an acoustic radiation force optical coherence elastography system to evaluate corneal scar elasticity. Elasticity quantification was first conducted on ex vivo rabbit corneas, and the results validate the efficacy of our system. Then, experiments were performed on an ex vivo human scarred cornea, where the structural features, the elastic wave propagations, and the corresponding Young's modulus of both the scarred region and the normal region were achieved and based on this, 2D spatial distribution of Young's modulus of the scarred cornea was depicted. Up to our knowledge, we realized the first elasticity quantification of corneal scar, which may provide a potent tool to promote clinical research on the disorders and surgery of the cornea.

A review of corneal biomechanics: Mechanisms for measurement and the implications for refractive surgery

Detailed clinical assessment of corneal biomechanics has the potential to revolutionize the ophthalmic industry through enabling quicker and more proficient diagnosis of corneal disease, safer and more effective surgical treatments, and the provision of customized and optimized care. Despite these wide-ranging benefits, and an outstanding clinical need, the provision of technology capable of the assessment of corneal biomechanics in the clinic is still in its infancy. While laboratory-based technologies have progressed significantly over the past decade, there remain significant gaps in our knowledge regarding corneal biomechanics and how they relate to shape and function, and how they change in disease and after surgical intervention. Here, we discuss the importance, relevance, and challenges associated with the assessment of corneal biomechanics and review the techniques currently available and underdevelopment in both the laboratory and the clinic.

Advances in multimodal imaging in ophthalmology

Multimodality ophthalmic imaging systems aim to enhance the contrast, resolution, and functionality of existing technologies to improve disease diagnostics and therapeutic guidance. These systems include advanced acquisition and post-processing methods using optical coherence tomography (OCT), combined scanning laser ophthalmoscopy and OCT systems, adaptive optics, surgical guidance, and photoacoustic technologies. Here, we provide an overview of these ophthalmic imaging systems and their clinical and basic science applications.

Two-dimensional (2D) dynamic vibration optical coherence elastography (DV-OCE) for evaluating mechanical properties: a potential application in tissue engineering

Mechanical properties in tissues are an important indicator because they are associated with disease states. One of the well-known excitation sources in optical coherence elastography (OCE) to determine mechanical properties is acoustic radiation force (ARF); however, a complicated focusing alignment cannot be avoided. Another excitation source is a piezoelectric (PZT) stack to obtain strain images via compression, which can affect the intrinsic mechanical properties of tissues in tissue engineering. In this study, we report a new technique called two-dimensional (2D) dynamic vibration OCE (DV-OCE) to evaluate 2D wave velocities without tedious focusing alignment procedures and is a non-contact method with respect to the samples. The three-dimensional (3D) Fourier transform was utilized to transfer the traveling waves (x, y, t) into 3D k-space (k_x, k_y, f). A spatial 2D wavenumber filter and multi-angle directional filter were employed to decompose the waves with omni-directional components into four individual traveling directions. The 2D local wave velocity algorithm was used to calculate a 2D wave velocity map. Six materials, two homogeneous phantoms with 10 mm thickness, two homogeneous phantoms with 2 mm thickness, one heterogeneous phantom with 2 mm diameter inclusion and an ex vivo porcine kidney, were examined in this study. In addition, the ARF-OCE was used to evaluate wave velocities for comparison. Numerical simulations were performed to validate the proposed 2D dynamic vibration OCE technique. We demonstrate that the experimental results were in a good agreement with the results from ARF-OCE (transient OCE) and numerical simulations. Our proposed 2D dynamic vibration OCE could potentially pave the way for mechanical evaluation in tissue engineering and for laboratory translation with easy-to-setup and contactless advantages.

Heartbeat optical coherence elastography: corneal biomechanics in vivo

SIGNIFICANCE

Mechanical assessment of the cornea can provide important structural and functional information regarding its health. Current clinically available tools are limited in their efficacy at measuring corneal mechanical properties. Elastography allows for the direct estimation of mechanical properties of tissues in vivo but is generally performed using external excitation force.

AIM

To show that heartbeat optical coherence elastography (Hb-OCE) can be used to assess the mechanical properties of the cornea in vivo.

APPROACH

Hb-OCE was utilized to detect Hb-induced deformations in the rabbit cornea in vivo without the need for external excitation. Furthermore, we demonstrate how this technique can distinguish corneal stiffness between untreated (UT) and crosslinked (CXL) tissue.

RESULTS

Our results demonstrate that stiffness changes in the cornea can be detected using only the Hb-induced deformations in the cornea. Additionally, we demonstrate a statistically significant difference in strain between the UT and CXL corneas.

CONCLUSIONS

Hb-OCE may be an effective tool for assessing the mechanical properties of the cornea in vivo without the need for external excitation. This tool may be effective for clinical assessment of corneal mechanical properties because it only requires optical coherence tomography imaging and data processing.

High Frequency Ultrasound Elastography for Estimating the Viscoelastic Properties of the Cornea Using Lamb Wave Model

OBJECTIVE

Estimating the elasticity distribution in the cornea is important because corneal elasticity is usually influenced by corneal pathologies and surgical treatments, especially for early corneal sclerosis. Because the thickness of the cornea is typically less than 1 mm, high-resolution ultrasound elastography as well as the Lamb wave model is required for viscoelastic property estimation. In the present study, an array high-frequency ultrasound (HFUS) elastography method based on ultrafast ultrasound imaging was proposed for estimating the viscoelastic properties of porcine cornea.

METHODS

The elastic wave was generated by an external vibrator, after which the wave propagation image was obtained using a 40-MHz array transducer. Viscoelasticity estimation was performed by fitting the phase velocity curve using the Lamb wave model. The performance of the proposed HFUS elastography system was verified using 2-mm-thick thin-layer gelatin phantoms with gelatin concentrations of 7% and 12%. Ex vivo experiments were carried out using fresh porcine cornea with artificial sclerosing.

RESULTS

Experimental results showed that the estimated elasticity was close to the standard value obtained in the phantom study when the Lamb wave model was used for elasticity measurement. However, the error between the standard elasticity values and the elasticity values estimated using group shear wave velocity was large. In the ex vivo eyeball experiments, the estimated elasticities and viscosities were respectively 9.1 ± 1.3 kPa and 0.5 ± 0.10 Pa·s for a healthy cornea and respectively 15.9 ± 2.1 kPa and 1.1 ± 0.12 Pa·s for a cornea with artificial sclerosis. A 3D HFUS elastography was also obtained for distinguishing the region of sclerosis in the cornea.

CONCLUSION

The experimental results demonstrated that the proposed HFUS elastography method has high potential for the clinical diagnosis of corneal diseases compared with other HFUS single-element transducer elastography systems.

Confocal air-coupled ultrasonic optical coherence elastography probe for quantitative biomechanics

We present an air-coupled ultrasonic radiation force probe co-focused with a phase-sensitive optical coherence tomography (OCT) system for quantitative wave-based elastography. A custom-made 1 MHz spherically focused piezoelectric transducer with a concentric 10 mm wide circular opening allowed for confocal micro-excitation of waves and phase-sensitive OCT imaging. Phantom studies demonstrated the capabilities of this probe to produce quasi-harmonic excitation up to 4 kHz for generation of elastic waves. Experimental results in ocular tissues showed highly detailed 2D and 3D elasticity mapping using this approach with great potential for clinical translation.

In vivo noninvasive measurement of spatially resolved corneal elasticity in human eyes using Lamb wave optical coherence elastography

Current elastography techniques are limited in application to accurately assess spatially resolved corneal elasticity in vivo for human eyes. The air-puff optical coherence elastography (OCE) with an eye motion artifacts correction algorithm is developed to distinguish the in vivo cornea vibration from the eye motion and visualize the Lamb wave propagation clearly in healthy subjects. Based on the Lamb wave model, the phase velocity dispersion curve in the high-frequency is calculated to obtain spatially resolved corneal elasticity accurately with high repeatability. It is found that the corneal elasticity has regional variations and is correlated with intraocular pressure, which suggests that the method has the potential to provide noninvasive measurement of spatially resolved corneal elasticity in clinical practice.

Heartbeat OCE: corneal biomechanical response to simulated heartbeat pulsation measured by optical coherence elastography

SIGNIFICANCE

It is generally agreed that the corneal mechanical properties are strongly linked to many eye diseases and could be used to assess disease progression and response to therapies. Elastography is the most notable method of assessing corneal mechanical properties, but it generally requires some type of external excitation to induce a measurable displacement in the tissue.

AIM

We present Heartbeat Optical Coherence Elastography (Hb-OCE), a truly passive method that can measure the elasticity of the cornea based on intrinsic corneal displacements induced by the heartbeat.

APPROACH

Hb-OCE measurements were performed in untreated and UV-A/riboflavin cross-linked porcine corneas ex vivo, and a distinct difference in strain was detected. Furthermore, a partially cross-linked cornea was also assessed, and the treated and untreated areas were similarly distinguished.

RESULTS

Our results suggest that Hb-OCE can spatially map displacements in the cornea induced by small fluctuations in intraocular pressure, similar to what is induced by the heartbeat.

CONCLUSIONS

The described technique opens the possibility for completely passive and noncontact in vivo assessment of corneal stiffness.

High resolution optical coherence elastography of retina under prosthetic electrode

Background

Quantitatively investigating the biomechanics of retina with a retinal prosthetic electrode, we explored the effects of the prosthetic electrode on the retina, and further supplemented data for a potential clinical trial.

Methods

Biomechanical properties were assessed with a high resolution optical coherence tomography (OCT) based elastography (OCE) system. A shaker was used to initiate elastic waves and an OCT system was used to track axial displacement along with wave propagation. Rabbits received surgery to implant the retinal prosthetic electrode, and elastic wave speed was measured before and after implantation; anatomical B-mode images were also acquired.

Results

Spatial-temporal maps of each layer in retina with and without prosthetic electrodes were acquired. Elastic wave speed of nerve fiber to inner plexiform layer, inner nuclear to outer nuclear layer, retinal pigmented epithelium layer and choroid to sclera layer without prosthetic electrode were found to be 3.66±0.36, 5.33±0.07, 6.85±0.37, and 9.69±0.24 m/s, respectively. With prosthetic electrode, the elastic wave speed was found to be 4.09±0.26, 5.14±0.11, 6.88±0.70, and 9.99±0.73 m/s, respectively in each layer.

Conclusions

Our results show that the elastic wave speed in each layer of retina is slightly faster with the retinal electrode, and further demonstrate that the retinal prosthetic electrode does not affect biomechanical properties significantly. In the future, we expect OCE technology to be used by clinicians where it could become part of routine testing and evaluation of the biomechanical properties of the retina in response to long term use of prosthetic electrodes in patients.