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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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Macedo M, Hatanaka M, Barboza WL, Mingione GM, Ambrósio R, Susanna R. The influence of topical anesthetic and fluorescein on non-contact tonometry measurements using ultra-high-speed dynamic Scheimpflug. Sci Rep 2023; 13:17864. [PMID: 37857798 PMCID: PMC10587345 DOI: 10.1038/s41598-023-45165-5] [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: 07/12/2023] [Accepted: 10/17/2023] [Indexed: 10/21/2023] Open
Abstract
This study aimed to investigate the effects of topical anesthetic and fluorescein drops on intraocular pressure (IOP), central corneal thickness (CCT) and biomechanical properties as measured by Corvis ST (CST-Oculus; Wezlar, Germany) in healthy eyes. A cross-sectional observational study was conducted on 46 healthy patients. The CST measurements were obtained before and immediately after the instillation of topical anesthetic and fluorescein drops. Pre-post instillation data were statistically analyzed. IOP measurements were compared to Goldmann's Applanation Tonometry (GAT), which was also performed after drops instillation. Biomechanical parameters analyzed included applanation 1 velocity, applanation 2 velocity, applanation 1 time, applanation 2 time, whole eye movement, deflection amplitude, and stiffness parameter at first applanation. A statistically significant difference in IOP, both for non-corrected IOP (IOPnct) and biomechanically corrected IOP (bIOP), was observed before and after the instillation of eyedrops. Despite this statistical significance, the observed difference lacked clinical relevance. The IOPnct demonstrated a significant difference pre and post-anesthetic and fluorescein instillation compared to GAT (14.99 ± 2.27 mmHg pre-instillation and 14.62 ± 2.50 mmHg post-instillation, versus 13.98 ± 2.04 mmHg, with p-values of 0.0014 and 0.0490, respectively). Comparable findings were noted when justaposing bIOP to GAT (14.53 ± 2.10 mmHg pre-instillation and 13.15 ± 2.25 mmHg post-instillation, against 13.98 ± 2.04 mmHg, with p-values of 0.0391 and 0.0022, respectively). Additionally, CCT measurements revealed a statistically significant elevation following the administration of topical anesthetic and fluorescein drops (from 544.64 ± 39.85 µm to 586.74 ± 41.71 µm, p < 0.01. None of the analyzed biomechanical parameters showed statistically significant differences after drops instillation. While the administration of topical anesthetic and fluorescein drops induced a statistically significant alteration in both IOPnct and bIOP readings, these changes were not clinically consequential. Furthermore, a notable statistical rise was observed in CCT measurements post-drops instillation, as determined by CST. Yet, corneal biomechanical parameters remained unaffected.
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Affiliation(s)
- Marcelo Macedo
- Department of Ophthalmology, University of São Paulo, São Paulo, Brazil.
| | - Marcelo Hatanaka
- Department of Ophthalmology, University of São Paulo, São Paulo, Brazil
| | | | | | - Renato Ambrósio
- Department of Ophthalmology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Remo Susanna
- Department of Ophthalmology, University of São Paulo, São Paulo, Brazil
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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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Aoki S, Asaoka R, Fujino Y, Nakakura S, Murata H, Kiuchi Y. Comparison of two analyzer measurements focusing on material stiffness among normal, treatment-naïve, and treated glaucoma eyes. Sci Rep 2023; 13:96. [PMID: 36596840 PMCID: PMC9810725 DOI: 10.1038/s41598-022-27346-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 12/30/2022] [Indexed: 01/04/2023] Open
Abstract
To investigate differences in biomechanical properties focusing on stiffness parameters between normal, treatment-naïve primary open-angle glaucoma (POAG), and treated POAG eyes. Retrospective case-control study, This study included 46 treatment-naïve POAG eyes, 46 POAG eyes treated with prostaglandin analogues, and 49 normal eyes used as controls; matched in terms of age and axial length. Corneal hysteresis (CH) and corneal resistance factor (CRF) were measured using an ocular response analyzer (ORA). Fifteen biomechanical parameters were measured with the Corneal Visualization Scheimpflug Technology (Corvis ST), including biomechanical glaucoma factor (BGF) and two stiffness parameters of 'SP A1' and 'stress-strain index (SSI)', which were compared among the three groups. Additionally, the area under the curve (AUC) values of the receiver-operating curve to discriminate control and treatment-naïve POAG eyes were calculated for BGF and CH. Treatment-naïve POAG eyes had higher 'SSI' than normal eyes even after controlling for IOP (p < 0.05, Tukey-Cramer test). Treated POAG eyes had significantly lower CRF, and higher BGF than treatment-naïve POAG eyes. There were also significant differences in CH or SP A1 among the three groups. BGF and CH had similar AUC values (0.61 and 0.59). Treatment-naïve POAG eyes had stiffer corneas compared to normal eyes, which seemed to result from the material/structure of the cornea rather than higher intraocular pressure. Antiglaucoma topical medication alters biomechanical properties measured with Corvis ST. These results are important for understanding the pathogenesis and improving the management of POAG.
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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, 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, Hamamatsu City, Shizuoka, Japan
- Department of Ophthalmology, Faculty of Medicine, Shimane University, Matsue, Japan
| | - Shunsuke Nakakura
- Department of Ophthalmology, Saneikai Tsukazaki 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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Abstract
PURPOSE OF THE REVIEW This review summarizes recent findings on corneal hysteresis, a biomechanical property of the cornea. Corneal hysteresis measurements can be easily acquired clinically and may serve as surrogate markers for biomechanical properties of tissues in the back of the eye, like the lamina cribrosa and peripapillary sclera, which may be related to the susceptibility to glaucomatous damage. RECENT FINDINGS Several studies have provided evidence of the associations between corneal hysteresis and clinically relevant outcomes in glaucoma. Corneal hysteresis has been shown to be predictive of glaucoma development in eyes suspected of having the disease. For eyes already diagnosed with glaucoma, lower corneal hysteresis has been associated with higher risk of progression and faster rates of visual field loss over time. Such associations appear to be stronger than those for corneal thickness, suggesting that corneal hysteresis may be a more important predictive factor. Recent evidence has also shown that cornealcorrected intraocular pressure measurements may present advantages compared to conventional Goldmann tonometry in predicting clinically relevant outcomes in glaucoma. SUMMARY Given the evidence supporting corneal hysteresis as an important risk factor for glaucoma development and its progression, practitioners should consider measuring corneal hysteresis in all patients at risk for glaucoma, as well as in those already diagnosed with the disease.
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Affiliation(s)
| | - Felipe A Medeiros
- Duke Eye Center and Department of Ophthalmology
- Department of Electrical and Computer Engineering, Pratt School of Engineering, Duke University, Durham, North Carolina, USA
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Iglesias M, Kudsieh B, Laiseca A, Santos C, Nadal J, Barraquer R, Casaroli-Marano RP. Intraocular pressure after myopic laser refractive surgery measured with a new Goldmann convex prism: correlations with GAT and ORA. BMC Ophthalmol 2022; 22:79. [PMID: 35168601 PMCID: PMC8849021 DOI: 10.1186/s12886-022-02309-x] [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: 11/22/2021] [Accepted: 02/09/2022] [Indexed: 12/04/2022] Open
Abstract
Background The purpose of this study is to describe measurements using a newly developed modified Goldmann convex tonometer (CT) 1 year after myopic laser refractive surgery. Intraocular pressure (IOP) measurements were compared with IOP values obtained by Goldmann applanation tonometer (GAT), and Ocular Response Analyzer (ORA). Methods Prospective double-masked study performed on thirty eyes of thirty patients that underwent laser in situ keratomileusis (LASIK; n = 19) or photorefractive keratectomy (PRK; n = 11). IOP was measured before and 3 and 12 months after surgery. Intraclass correlation coefficient (ICC) and Bland-Altman plot were calculated to assess the agreement between GAT, CT, IOPg (Goldmann-correlated IOP) and IOPcc (corneal-compensated IOP) from ORA. Results Twelve months after LASIK, IOP measured with CT showed the best correlation with IOP measured with GAT before surgery (GATpre) (ICC = 0.886, 95% CI: 0.703–0.956) (15.60 ± 3.27 vs 15.80 ± 3.22; p < 0.000). However, a moderate correlation was found for IOP measured with IOPcc and CT 12 months after LASIK (ICC = 0.568, 95% CI: − 0.185 – 0.843) (15.80 ± 3.22 vs 12.87 ± 2.77; p < 0.004). Twelve months after PRK, CT showed a weak correlation (ICC = − 0.266, 95% CI: − 3.896 – 0.663), compared to GATpre (17.30 ± 3.47 vs 16.01 ± 1.45; p < 0.642), as well as poor correlation (ICC = 0.256, 95% CI: − 0.332 – 0.719) with IOPcc (17.30 ± 3.47 vs 13.38 ± 1.65; p < 0.182). Conclusions Twelve months after LASIK, IOP measured with CT strongly correlated with GAT before surgery and could therefore provide an alternative method for measuring IOP after this surgery. More studies regarding this new convex prism are needed to assess its accuracy.
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Affiliation(s)
- María Iglesias
- Instituto Universitario Barraquer, Barraquer Ophthalmology Centre, Laforja 88, 08012, Barcelona, Spain.
| | - Bachar Kudsieh
- Department of Ophthalmology, Hospital Universitario Puerta De Hierro, 28222, Madrid, Spain
| | - Andrea Laiseca
- Instituto Universitario Barraquer, Barraquer Ophthalmology Centre, Laforja 88, 08012, Barcelona, Spain
| | - Cristina Santos
- Unitat Antropologia Biològica, Department Biologia Animal, Biologia Vegetal i Ecologia, Universitat Autònoma de Barcelona (UAB), 08193, Barcelona, Spain
| | - Jeroni Nadal
- Instituto Universitario Barraquer, Barraquer Ophthalmology Centre, Laforja 88, 08012, Barcelona, Spain
| | - Rafael Barraquer
- Instituto Universitario Barraquer, Barraquer Ophthalmology Centre, Laforja 88, 08012, Barcelona, Spain.,International University of Catalunya (UIC), 08017, Barcelona, Spain
| | - Ricardo P Casaroli-Marano
- Department of Surgery, School of Medicine and Hospital Clinic de Barcelona, University of Barcelona (UB), 08036, Barcelona, Spain
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Zvietcovich F, Larin KV. Wave-based optical coherence elastography: The 10-year perspective. PROGRESS IN BIOMEDICAL ENGINEERING (BRISTOL, ENGLAND) 2022; 4:012007. [PMID: 35187403 PMCID: PMC8856668 DOI: 10.1088/2516-1091/ac4512] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
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.
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Affiliation(s)
- Fernando Zvietcovich
- University of Houston, Biomedical Engineering, Houston, TX, United States, 77204
| | - Kirill V. Larin
- University of Houston, Biomedical Engineering, Houston, TX, United States, 77204,
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Aoki S, Miki A, Omoto T, Fujino Y, Matsuura M, Murata H, Asaoka R. Biomechanical Glaucoma Factor and Corneal Hysteresis in Treated Primary Open-Angle Glaucoma and Their Associations With Visual Field Progression. Invest Ophthalmol Vis Sci 2021; 62:4. [PMID: 34086046 PMCID: PMC8185393 DOI: 10.1167/iovs.62.7.4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate the relationship between biomechanical glaucoma factor (BGF) measured with Corvis ST and glaucomatous visual field (VF) progression, compared to corneal hysteresis (CH) measured with ocular response analyzer using a longitudinal dataset of primary open-angle glaucoma (POAG). The discriminative powers of BGF and CH were also compared using a cross-sectional dataset. Methods The longitudinal dataset included 166 POAG eyes. The rate of VF change during the follow-up period was evaluated using the mean of 52 pointwise total deviations in the Humphrey 24-2 field test. Variables associated with the VF progression rate were identified from BGF, CH, age, baseline VF severity, and intraocular pressure during the VF follow-up period by identifying the optimal model. The cross-sectional dataset included 68 POAG eyes and 68 healthy eyes. Using this dataset, the area under the curve (AUC) values of the receiver-operating curve were compared between CH and BGF. Results The optimal multivariate linear mixed model to describe the VF rate included age and CH, but not BGF. Between POAG and healthy eyes, CH was statistically different (P < 0.001), although this was not the case with BGF. The AUC values were 0.61 and 0.71 for BGF and CH, respectively (P = 0.027). Conclusions CH, but not BGF, was associated with VF progression in POAG patients under treatment. BGF was not useful to discriminate POAG between treated and normal eyes.
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Affiliation(s)
- Shuichiro Aoki
- Department of Ophthalmology, Sapporo City General Hospital, Sapporo, Japan.,Department of Ophthalmology, the University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Atsuya Miki
- Department of Ophthalmology and Visual Science, Osaka University, Osaka, Japan.,Department of Innovative Visual Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takashi Omoto
- Department of Ophthalmology, the University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Yuri Fujino
- Department of Ophthalmology, the University of Tokyo Graduate School of Medicine, Tokyo, Japan.,Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | - Masato Matsuura
- Department of Ophthalmology, the University of Tokyo Graduate School of Medicine, Tokyo, Japan.,Orthopic and Visual Science, Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan.,Department of Ophthalmology, Saneikai Tsukazaki Hospital, Hyogo, Japan
| | - Hiroshi Murata
- 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, Hamamatsu, Japan.,Nanovision Research Division, Research Institute of Electronics, Shizuoka University, Shizuoka, Japan.,The Graduate School for the Creation of New Photonics Industries, Shizuoka, Japan
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The Relationship Between Corvis ST Tonometry Parameters and Ocular Response Analyzer Corneal Hysteresis. J Glaucoma 2020; 29:479-484. [PMID: 32134829 DOI: 10.1097/ijg.0000000000001486] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PRECIS Corvis ST Tonometry and Ocular Response Analyzer (ORA) measurements were conducted in primary open-angle glaucoma and normative subjects. Many parameters were significantly correlated, however, the strengths were weak to moderate. PURPOSE Reichert ORA parameters are derived from pressure information following the application of air-jet, whereas detailed structural observation can be made using the Corneal Visualization Scheimpflug Technology instrument (CST). The purpose of the study was to investigate the association between CST measurements and ORA measured corneal hysteresis (CH). METHODS Measurements of CST, ORA, axial length, average corneal curvature, central corneal thickness (CCT) and intraocular pressure with Goldmann applanation tonometry were carried out in 104 eyes of 104 patients with primary open-angle glaucoma and 35 eyes from normative subjects. The association between CST and ORA parameters was assessed using linear regression analysis, with model selection based on the second order bias corrected Akaike Information Criterion index. RESULTS Deformation amplitude ratio (corneal softness, R=-0.51), SP A1 (corneal stiffness, R=0.41), and Inverse Radius (integrated area under the curve of the inverse concave radius, R=-0.44) were significantly correlated with CH (P <0.05). The optimal model to explain CH using CST measurements was given by: CH=-76.3+4.6×A1 time (applanation time in the corneal inward movement)+1.9×A2 time (second applanation time in the corneal outward movement) + 3.1 × highest concavity deformation amplitude (magnitude of movement of the corneal apex from before deformation to its highest concavity) + 0.016×CCT (R=0.67; P<0.001). CONCLUSIONS CST parameters are significant, but weakly or moderately, related to ORA measured CH.
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A comparison of the corneal biomechanics in pseudoexfoliation glaucoma, primary open-angle glaucoma and healthy controls using Corvis ST. PLoS One 2020; 15:e0241296. [PMID: 33104764 PMCID: PMC7588080 DOI: 10.1371/journal.pone.0241296] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 10/12/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose To compare the corneal biomechanical parameters between pseudoexfoliation glaucoma (PXG), primary open-angle glaucoma (POAG) and healthy controls using Corvis ST. Methods A prospective, cross-sectional study was conducted which included 132 treatment-naïve eyes which underwent Corvis ST. The study cohort comprised of 44 eyes with PXG, 42 eyes with POAG and 46 healthy controls. Corneal biomechanical parameters, which included corneal velocities, length of corneal applanated surface, deformation amplitude (DA), peak distance and radius of curvature, were compared between the groups using analysis of variance models. Results The 3 groups were demographically similar. The mean IOP was 15.7 ±3 mmHg in the control group, 21.3 ±5 mmHg in the POAG group and 25.8 ±7 mmHg in the PXG group (p<0.0001). Corneal pachymetry was similar across the 3 groups. Mean DA was significantly lower (p<0.0001) in the PXG group (0.86 ±0.18 mm) compared to the POAG group (0.97 ±0.14mm) and the control group (1.10 ±0.15mm). Corneal velocities were also found to be statistically significantly different between the groups. However, after adjusting for IOP, there was no difference in any of the biomechanical parameters between the 3 groups. Conclusion Corneal biomechanical parameters measured on Corvis ST are not different between eyes with PXG, POAG and healthy controls after adjusting for IOP.
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Priyadarsini S, Whelchel A, Nicholas S, Sharif R, Riaz K, Karamichos D. Diabetic keratopathy: Insights and challenges. Surv Ophthalmol 2020; 65:513-529. [PMID: 32092364 PMCID: PMC8116932 DOI: 10.1016/j.survophthal.2020.02.005] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 02/10/2020] [Accepted: 02/11/2020] [Indexed: 12/11/2022]
Abstract
Ocular complications from diabetes mellitus are common. Diabetic keratopathy, the most frequent clinical condition affecting the human cornea, is a potentially sight-threatening condition caused mostly by epithelial disturbances that are of clinical and research attention because of their severity. Diabetic keratopathy exhibits several clinical manifestations, including persistent corneal epithelial erosion, superficial punctate keratopathy, delayed epithelial regeneration, and decreased corneal sensitivity, that may lead to compromised visual acuity or permanent vision loss. The limited amount of clinical studies makes it difficult to fully understand the pathobiology of diabetic keratopathy. Effective therapeutic approaches are elusive. We summarize the clinical manifestations of diabetic keratopathy and discuss available treatments and up-to-date research studies in an attempt to provide a thorough overview of the disorder.
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Affiliation(s)
- S Priyadarsini
- Department of Ophthalmology, Dean McGee Eye Institute, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - A Whelchel
- Department of Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - S Nicholas
- Department of Ophthalmology, Dean McGee Eye Institute, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - R Sharif
- Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - K Riaz
- Department of Ophthalmology, Dean McGee Eye Institute, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - D Karamichos
- Department of Ophthalmology, Dean McGee Eye Institute, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA; Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
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Bao F, Huang W, Zhu R, Lu N, Wang Y, Li H, Wu S, Lin H, Wang J, Zheng X, Huang J, Li Y, Wang Q, Elsheikh A. Effectiveness of the Goldmann Applanation Tonometer, the Dynamic Contour Tonometer, the Ocular Response Analyzer and the Corvis ST in Measuring Intraocular Pressure following FS-LASIK. Curr Eye Res 2019; 45:144-152. [PMID: 31869261 DOI: 10.1080/02713683.2019.1660794] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Purpose: To test the performance of the four tonometers in providing IOP measurements that were free of the effects of corneal biomechanics changes caused by refractive surgery.Methods: Four tonometers were employed to provide IOP measurements for 65 participants who accepted Femtosecond laser-assisted LASIK (FS-LASIK). The measurements included GAT-IOP by the Goldmann Applanation Tonometer, DCT-IOP by the Dynamic Contour Tonometer, Goldmann-correlated IOP (ORA-IOPg) and corneal-compensated IOP (ORA-IOPcc) by the Ocular Response Analyzer, and uncorrected IOP (CVS-IOP) and biomechanically corrected IOP (CVS-bIOP) by the Corvis ST. Statistical analyses were performed to assess the association of the differences in IOP caused by FS-LASIK with central corneal thickness (CCT), mean corneal curvature (Km), age, refractive error correction (REC), optical zone diameter (OZD), ablation zone diameter (AZD), residual stromal bed thickness (RSB) and RSB ratio (RSB/CCT). Multiple linear regression models were constructed to explore factors influencing IOP changes.Results: All four tonometers exhibited significant differences between IOP measurements taken pre and post-surgery except for CVS-bIOP in the low to moderate myopia group (t = 1.602, p = .12). CVS-bIOP, followed by DCT-IOP, provided the best agreement between pre and post-FS-LASIK measurements with the lowest differences in IOP and the narrowest limits of agreement. The pre-post IOP differences were also significantly associated with the reduction in CCT in only GAT-IOP, ORA-IOPg, and CVS-IOP. CVS-bIOP and ORA-IOPcc were the only measurements that were not correlated with CCT, Km or age both before and after FS-LASIK.Conclusions: The biomechanically corrected bIOP from the Corvis ST provided post-FS-LASIK measurements that were in closest agreement with those obtained before surgery. In comparison, GAT-IOP, ORA-IOPg, ORA-IOPcc, and CVS-IOP appeared to be more influenced by the changes in corneal biomechanics caused by FS-LASIK.
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Affiliation(s)
- Fangjun Bao
- Eye Hospital, WenZhou Medical University, Wenzhou, China.,The Institution of Ocular Biomechanics, Wenzhou Medical University, Wenzhou, China
| | - Wei Huang
- Eye Hospital, WenZhou Medical University, Wenzhou, China
| | - Rong Zhu
- Eye Hospital, WenZhou Medical University, Wenzhou, China
| | - Nanji Lu
- Eye Hospital, WenZhou Medical University, Wenzhou, China
| | - Yuan Wang
- Eye Hospital, WenZhou Medical University, Wenzhou, China
| | - Hechen Li
- Eye Hospital, WenZhou Medical University, Wenzhou, China
| | - Songan Wu
- Eye Hospital, WenZhou Medical University, Wenzhou, China
| | - Huini Lin
- Eye Hospital, WenZhou Medical University, Wenzhou, China
| | - Junjie Wang
- Eye Hospital, WenZhou Medical University, Wenzhou, China.,The Institution of Ocular Biomechanics, Wenzhou Medical University, Wenzhou, China
| | - Xiaobo Zheng
- Eye Hospital, WenZhou Medical University, Wenzhou, China.,The Institution of Ocular Biomechanics, Wenzhou Medical University, Wenzhou, China
| | - JinHai Huang
- Eye Hospital, WenZhou Medical University, Wenzhou, China
| | - Yiyu Li
- Eye Hospital, WenZhou Medical University, Wenzhou, China
| | - Qinmei Wang
- Eye Hospital, WenZhou Medical University, Wenzhou, China.,The Institution of Ocular Biomechanics, Wenzhou Medical University, Wenzhou, China
| | - Ahmed Elsheikh
- School of Engineering, University of Liverpool, Liverpool, UK.,National Institute for Health Research (NIHR) Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.,School of Biological Science and Biomedical Engineering, Beihang University, Beijing, China
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Association between optic nerve head morphology in open-angle glaucoma and corneal biomechanical parameters measured with Corvis ST. Graefes Arch Clin Exp Ophthalmol 2019; 258:629-637. [PMID: 31865467 DOI: 10.1007/s00417-019-04572-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 12/11/2019] [Accepted: 12/13/2019] [Indexed: 12/12/2022] Open
Abstract
PURPOSES To investigate associations between Corvis ST-measured corneal biomechanical parameters and glaucomatous optic nerve head (ONH) morphology. METHODS In total, 118 eyes of 70 patients with open-angle glaucoma were examined in this retrospective cross-sectional study. We measured Heidelberg retina tomograph and Corvis ST values in all eyes. We used the linear mixed model in four sectors (temporal superior, TS; temporal inferior, TI; nasal superior, NS; and nasal inferior, NI) to detect associations between six ONH-related parameters and 14 Corvis ST-related parameters, controlling for age, intraocular pressure, axial length, and central corneal thickness. We calculated the ONH temporal and nasal sector vertical asymmetries (TS-TI and NS-NI asymmetries) and identified the optimal linear mixed models to describe them using model selection with the second-order bias corrected Akaike Information Criterion. RESULTS The Corvis ST A2 velocity was negatively associated with the rim volume in the NS sector (p < 0.05). The optimal model for TS-TI asymmetry was TS-TI asymmetry = - 3.22 + 0.15 × HC time + 0.88 × HC deflection amplitude, whereas that for NS-NI asymmetry was 0.49-0.048 × axial length - 2.45 × A2 velocity. CONCLUSION Glaucomatous ONH superior-inferior asymmetries were associated with biomechanical properties measured with Corvis ST. Eyes with superior-dominant rim volume reduction of ONH were associated with small deformations and slow recovery of the cornea.
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Intraocular Pressure Measurement Using Ocular Response Analyzer, Dynamic Contour Tonometer, and Scheimpflug Analyzer Corvis ST. J Ophthalmol 2019; 2019:3879651. [PMID: 31737355 PMCID: PMC6815996 DOI: 10.1155/2019/3879651] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 09/17/2019] [Indexed: 11/29/2022] Open
Abstract
Purpose To compare intraocular pressure (IOP) measurements with Goldmann applanation tonometry (GAT), ocular response analyzer (ORA), dynamic contour tonometer (DCT), and Corvis ST (CST) in healthy subjects. Methods In a prospective, observational study, IOP measurements with GAT (GAT-IOPc), ORA (IOPcc), DCT (DCT-IOP), and CST (bIOP) were performed and analyzed in 94 healthy subjects. Results Mean age of the participants was 45.6 ± 17.2 years (range 18 to 81 years). Mean GAT-IOPc was 12.9 ± 2.4 mmHg, mean DCT-IOP was 16.1 ± 2.6 mmHg, and mean IOPcc was 15.6 ± 3.3 mmHg. DCT-IOP and IOPcc were significantly higher than GAT-IOPc (P < 0.001). Mean bIOP was 13.5 ± 2.4 mmHg that was slightly higher but not significantly different from GAT-IOPc (P=0.146). Correlation analysis of IOP values and central corneal thickness (CCT) revealed a negative correlation between GAT-IOPc and CCT (r = −0.347; P=0.001). However, IOPcc, DCT-IOP, and bIOP showed no significant correlation to CCT. Only bIOP revealed a weak but significant age dependency (r = 0.321, P=0.002). Conclusion All tonometry devices showed a good agreement of biomechanical corrected IOP values with GAT-IOPc. As no influence of CCT on IOPcc, DCT-IOP, and bIOP was detectable, the used correction algorithms appear to be appropriate in these tonometers in the clinical setting. The highest agreement was found between GAT-IOPc and bIOP. However, bIOP weakly correlated with participants' age. Further studies are needed to elucidate the role of bIOP for IOP measurement.
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Effect of congenital blepharoptosis on corneal biomechanical properties and changes after ptosis surgery. Eye (Lond) 2019; 34:1055-1062. [PMID: 31558826 DOI: 10.1038/s41433-019-0586-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 07/11/2019] [Accepted: 08/27/2019] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES We studied the difference in the corneal biomechanical parameters of ptotic and fellow eyes in patients with congenital blepharoptosis. The correlations between corneal biomechanical parameters and demographic or ocular parameters, and the changes after surgery were also researched. METHODS The corneal biomechanical parameters were measured by Corvis ST tonometry. The central corneal thickness (CCT), axial length (AL) and keratometry measurements were performed with LenStar LS900, and intraocular pressure (IOP) by non-contact applanation tonometry. The parameters were evaluated for the effect of ptosis and the relationship of corneal biomechanical parameters. These examinations were repeated 6 months after blepharoptosis surgery. RESULTS Twenty-nine patients were enroled. The Corvis ST parameters (Deformation amplitude [DA], A1 times, and A1 velocity), CCT, IOP with NCT, IOP with corrected, differed significantly between ptotic and fellow eyes. CCT was significantly positively correlated with Length A1 and IOP with Corvis, and negatively correlated with IOP corrected by Corvis of the ptotic eyes. The same tendency was found in the fellow eyes. Six months after the ptosis surgery, the differences in corneal biomechanics parameters between ptotic eyes and fellow eyes were not significantly changed. CONCLUSIONS Congenital blepharoptosis causes significant corneal biomechanical changes measured by Corvis ST. The ptotic eyes had thicker and less deformable corneas. The differences in corneal biomechanics between ptotic eyes and fellow eyes were mostly related to CCT changes. Six months after surgery, these differences in corneal biomechanics did not change significantly.
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Jung Y, Park HYL, Park CK. Relationship between corneal deformation amplitude and optic nerve head structure in primary open-angle glaucoma. Medicine (Baltimore) 2019; 98:e17223. [PMID: 31567980 PMCID: PMC6756713 DOI: 10.1097/md.0000000000017223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The purpose of the study was to investigate the relationship between corneal deformation amplitude (DA), which is the amount of corneal displacement at highest degree of concavity measured by Corvis Scheimpflug Technology (ST), and various optic nerve head parameters in patients with primary open-angle glaucoma (POAG).Fifty-eight POAG patients were included in this observational study. For each patient, DA with Corvis ST, color optic disc photography, and optic nerve head imaging by enhanced depth imaging with a Heidelberg spectralis optical coherence tomography (OCT), Cirrus OCT, and Heidelberg retina tomograph (HRT) were obtained. Pearson correlation was used to analyze the relationship between DA and optic nerve head parameters before and after adjusting for age, intraocular pressure, central corneal thickness, and axial length.Corneal DA was negatively associated with lamina cribrosa (LC) depth (r = -0.390, P = .003) after adjusting for confounders. It showed positive relationship with parapapillary atrophy (PPA) area (r = 0.321, P = .046). In addition, the corneal DA was negatively correlated with cup volume (r = -0.351, P = .017) and mean cup depth (r = -0.409, P = .005) measured by HRT.Corneal DA is related with optic nerve head parameters in patients with POAG. Patients with lower corneal DA showed greater LC depth, greater cup area, deeper cup, and smaller PPA than those with higher corneal DA.
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Affiliation(s)
- Younhea Jung
- Department of Ophthalmology, Yeouido St. Mary's Hospital, College of Medicine
| | - Hae-Young Lopilly Park
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chan Kee Park
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Asano S, Asaoka R, Yamashita T, Aoki S, Matsuura M, Fujino Y, Murata H, Nakakura S, Nakao Y, Kiuchi Y. Correlation Between the Myopic Retinal Deformation and Corneal Biomechanical Characteristics Measured With the Corvis ST Tonometry. Transl Vis Sci Technol 2019; 8:26. [PMID: 31440423 PMCID: PMC6701875 DOI: 10.1167/tvst.8.4.26] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 06/03/2019] [Indexed: 11/24/2022] Open
Abstract
Purpose We previously reported that the retinal deformation due to myopia was represented by the peripapillary retinal arteries angle (PRAA). In this study, we investigated the relationship between the PRAA and biomechanical properties measured with Corvis ST (CST) tonometry. Methods Thirty-four normative eyes of 34 subjects who underwent CST measurement were enrolled. The PRAA was calculated from a fundus photograph. Variables related to the PRAA were identified from age, axial length, spherical equivalent refractive error, and 10 CST parameters using model selection with the second-order bias-corrected Akaike information criterion index. Results The PRAA was best described with axial length (coefficient = −5.66, P < 0.0001), maximum deflection amplitude (mm; coefficient = 130.5, P = 0.0004), and deflection amplitude ratio (DA ratio) 2 mm (coefficient = −25.8, P = 0.0032), where mm was the amount of the maximum corneal apex movement and DA ratio 2 mm was the ratio between the deformation amplitudes at the apex and 2 mm away from the apex. The optimal model was significantly better than the model only with axial length (P = 0.0014, analysis of variance). Conclusions The PRAA was significantly better described with the CST parameters compared to the axial length model only; eyes with small PRAA (larger myopic retinal deformation) showed narrow and shallow maximum corneal deflection. Translational Relevance The Corvis ST parameters, which represents corneal biomechanical characteristics, were associated with myopic retinal deformation.
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Affiliation(s)
- Shotaro Asano
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryo Asaoka
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takehiro Yamashita
- Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Shuichiro Aoki
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Ophthalmology, Sapporo City General Hospital, Hokkaido, Japan
| | - Masato Matsuura
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Ophthalmology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan
| | - Yuri Fujino
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Ophthalmology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan
| | - Hiroshi Murata
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shunsuke Nakakura
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Hyogo, Japan
| | - Yoshitaka Nakao
- Department of Ophthalmology and Visual Science, Hiroshima University, Hiroshima, Japan
| | - Yoshiaki Kiuchi
- Department of Ophthalmology and Visual Science, Hiroshima University, Hiroshima, Japan
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Influence of Anterior Biometry on Corneal Biomechanical Stiffness of Glaucomatous Eyes Treated With Chronic Medication or Filtration Surgery. J Glaucoma 2019; 28:626-632. [DOI: 10.1097/ijg.0000000000001247] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Matsuura M, Murata H, Fujino Y, Yanagisawa M, Nakao Y, Nakakura S, Kiuchi Y, Asaoka R. Repeatability of the Novel Intraocular Pressure Measurement From Corvis ST. Transl Vis Sci Technol 2019; 8:48. [PMID: 31275733 PMCID: PMC6594315 DOI: 10.1167/tvst.8.3.48] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 04/07/2019] [Indexed: 12/03/2022] Open
Abstract
Purpose To assess the repeatability of intraocular pressure (IOP) measured with the Corvis ST (CST) and the Ocular Response Analyzer (ORA). Methods A total of 141 eyes from 141 subjects were studied, including 35 healthy eyes and 106 glaucomatous eyes. All subjects underwent IOP evaluations with Goldmann applanation tonometer, CST, and ORA. With CST, biomechanical corrected IOP (bIOP) was calculated; bIOP is purported to be less dependent on biomechanical properties. For ORA, corneal-compensated intraocular pressure (IOPcc) and Goldmann-correlated IOP (IOPg) were derived. The repeatability of the various IOP values was assessed using the coefficient of variance (CV) and the intraclass correlation coefficient (ICC). Results The CV with bIOP (5.5 ± 3.1: mean ± standard deviation) was significantly smaller than the CVs measured with IOPg (7.3 ± 4.3) and IOPcc (7.2 ± 4.4). ICC values were 0.90, 0.80, and 0.86 with IOPg, IOPcc, and bIOP, respectively. Conclusions The bIOP showed a better prevision and repeatability for IOP measurement. Translational Relevance The bIOP measurement from CST had a better reproducible than IOPcc measurement from ORA.
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Affiliation(s)
- Masato Matsuura
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan.,Department of Ophthalmology, Graduate School of Medical Science, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Hiroshi Murata
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
| | - Yuri Fujino
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
| | - Mieko Yanagisawa
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
| | - Yoshitaka Nakao
- Department of Ophthalmology and Visual Sciences, Hiroshima University, Hiroshima, Japan
| | - Shunsuke Nakakura
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan
| | - Yoshiaki Kiuchi
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
| | - Ryo Asaoka
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
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Asano S, Asaoka R, Yamashita T, Aoki S, Matsuura M, Fujino Y, Murata H, Nakakura S, Nakao Y, Kiuchi Y. Relationship Between the Shift of the Retinal Artery Associated With Myopia and Ocular Response Analyzer Waveform Parameters. Transl Vis Sci Technol 2019; 8:15. [PMID: 31016069 PMCID: PMC6467091 DOI: 10.1167/tvst.8.2.15] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 01/21/2019] [Indexed: 11/24/2022] Open
Abstract
PURPOSE We have recently reported that the retinal stretch due to myopia is closely related to the peripapillary retinal arteries angle (PRAA) (Yamashita et al., Invest Ophthalmol Vis Sci 2013;54:5481-5488). The purpose of the current study was to investigate the relationship between retinal artery position and Ocular Response Analyzer (ORA) waveform parameters. METHODS In 43 eyes of 41 healthy subjects, ORA measurements were carried out and the PRAA was calculated from fundus photographs. Then, the variables related to PRAA were identified from 40 variables of age, axial length (AL), keratometry, ORA corneal hysteresis (CH), ORA corneal resistant factor (CRF), and 35 ORA waveform parameters, using the Lasso regression and model selection with the second-order bias-corrected Akaike information criterion index. RESULTS The optimal model for PRAA included AL, CRF, and three ORA waveform parameters (aindex, w2, and slew1). This optimal model was significantly better than the model with AL-only, the model only with AL and CH, and the model only with AL and CRF (P < 0.0001, P < 0.0001, P < 0.0001, respectively; analysis of variance). CONCLUSIONS The PRAA was significantly better represented by using AL and ORA parameters including waveform parameters, compared with AL alone, with AL and CH alone, and with AL and CRF alone. TRANSLATIONAL RELEVANCE ORA waveform, which represents corneal biomechanical properties, was associated with myopic retinal stretch.
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Affiliation(s)
- Shotaro Asano
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryo Asaoka
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takehiro Yamashita
- Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Shuichiro Aoki
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masato Matsuura
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Ophthalmology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan
| | - Yuri Fujino
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Ophthalmology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan
| | - Hiroshi Murata
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shunsuke Nakakura
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Hyogo, Japan
| | - Yoshitaka Nakao
- Department of Ophthalmology and Visual Science, Hiroshima University, Hiroshima, Japan
| | - Yoshiaki Kiuchi
- Department of Ophthalmology and Visual Science, Hiroshima University, Hiroshima, Japan
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Comparison of the Intraocular Pressure Measured Using the New Rebound Tonometer Icare ic100 and Icare TA01i or Goldmann Applanation Tonometer. J Glaucoma 2019; 28:172-177. [DOI: 10.1097/ijg.0000000000001138] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Development of a Novel Corneal Concavity Shape Parameter and Its Association with Glaucomatous Visual Field Progression. Ophthalmol Glaucoma 2019; 2:47-54. [PMID: 32672557 DOI: 10.1016/j.ogla.2018.10.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 10/14/2018] [Accepted: 10/30/2018] [Indexed: 12/22/2022]
Abstract
PURPOSE To develop a novel Corvis ST (Oculus Co. Ltd, Wetzlar, Germany) corneal concavity shape parameter (concavity shape index [CSI]) and investigate its association with glaucomatous visual field (VF) progression. DESIGN Retrospective longitudinal study. PARTICIPANTS A total of 103 eyes with primary open-angle glaucoma in 68 patients with 8 reliable VFs using the Humphrey Field Analyzer (HFA) (Carl Zeiss Meditec Inc, Dublin, CA). METHODS The mean total deviation (mTD) of the 52 test points in the 24-2 HFA test pattern was calculated for each VF, and the mTD progression rate was determined. A Corvis ST measurement was performed, and CSI was calculated as the ratio of (peak distance × curvature radius at the time of highest concavity [HC] state) to (the deflection amplitude at the time of HC × curvature radius at the undeformed state). The association between mTD progression rate and CSI, as well as other variables (including age, intraocular pressure, corneal hysteresis [CH], and 35 standard Corvis ST parameters), was investigated using the linear mixed model. The optimal linear mixed model to describe mTD progression rate was selected using the Random Forest method followed by variable selection using the second order bias corrected Akaike Information Criterion (AICc) index. MAIN OUTCOME MEASURES Optimal linear mixed models for the mTD progression rate, as determined by AICc index. RESULTS Univariate analysis revealed mTD progression rate was significantly associated with CSI (P = 0.0042), CH, HC radius, A1 deflection length, max inverse radius, and integrated radius. The optimal model to describe mTD progression rate included CSI, max inverse radius, Ambrósio rational thickness horizontal, and age (AICc = 41.59). CONCLUSIONS A novel corneal concavity shape parameter, CSI, was closely related to glaucomatous VF progression.
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Naderi M, Farsiani AR, Salouti R, Panahi Y, Zamani M, Azimi A, Sahebkar A. Evaluation of corneal biomechanical properties in mustard gas keratopathy. Saudi J Ophthalmol 2018; 33:24-27. [PMID: 30930659 PMCID: PMC6424689 DOI: 10.1016/j.sjopt.2018.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 10/16/2018] [Accepted: 11/05/2018] [Indexed: 11/25/2022] Open
Abstract
Background Degenerative biomechanical factors and immunologic processes with effect on collagen and corneal reparative process are known as the main cause of ocular surface dysfunction in mustard gas keratopathy (MGK) and may cause changes in the corneal biomechanical values. Therefore, we evaluate corneal biomechanical properties of these patients. Methods and materials This case-control study includes 61 chemical warfare victims with MGK. After omission according to our exclusion criteria, 88 eyes of patients with MGK were enrolled as the case group and also a group of 88 normal eyes, which were matched regarding their age and sex in the control group, were enrolled. Measurements of corneal biomechanical properties which reported by ORA and Corvis ST (CST) devices were compared. The SPSS software version 23.0 was used in the statistical analysis. For comparisons between groups, if the data had a normal distribution, were analyzed by Student’s t-test and ANOVA, and if the data didn’t have a normal distribution, Mann–Whitney U test, and Kruskal-Wallis were used. Furthermore, to identify a relationship between two groups of data Spearman's rank Correlation test was used. P value < 0.05 were considered statistically significant. Results In the MGK group, A1 length (A1L), A1 velocity (A1V), A2 velocity (A2V), deformation amplitude (DA) and peak distance (PD) were higher than the control group (P < 0.001). However, the corneal hysteresis (CH) (P = 0.003), corneal resistant factor (CRF), non-corrected IOP (IOPnct), corrected IOP based on corneal thickness (IOPpachy), and central corneal thickness (CCT) were lower than the control group (P < 0.001). The visual acuity according to the LogMAR scale and severity of MGK was positively associated with IOPpachy and negatively associated with CH, CRF, CCT and highest concavity radius (Radius). Conclusion Measurement of corneal biomechanical properties may be, have a useful role in the classification, monitoring or diagnosis of MGK.
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Affiliation(s)
- Mostafa Naderi
- Chemical Injuries Research Center, System Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Amir Reza Farsiani
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ramin Salouti
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.,Salouti Eye Research Center, Salouti Eye Clinic, Shiraz, Iran
| | - Yunes Panahi
- Chemical Injuries Research Center, System Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohammad Zamani
- Salouti Eye Research Center, Salouti Eye Clinic, Shiraz, Iran
| | - Ali Azimi
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.,Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
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Salouti R, Alishiri AA, Gharebaghi R, Naderi M, Jadidi K, Shojaei-Baghini A, Talebnejad M, Nasiri Z, Hosseini S, Heidary F. Comparison among Ocular Response Analyzer, Corvis ST and Goldmann applanation tonometry in healthy children. Int J Ophthalmol 2018; 11:1330-1336. [PMID: 30140637 DOI: 10.18240/ijo.2018.08.13] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 04/23/2018] [Indexed: 11/23/2022] Open
Abstract
AIM To explore the relationship between different parameters of Ocular Response Analyzer (ORA) and Corvis ST (CST) in a sample of healthy Iranian school-aged children and the relationship between parameters of these 2 instruments against intraocular pressure (IOP), measured by the Goldmann applanation tonometer (GAT-IOP), age and gender, and find possible correlation between ORA and CST with GAT. METHODS This cross-sectional study included 90 healthy children. A general interview and complete eye examination were performed. Following successful GAT-IOP measurement, ORA and CST were conducted. The CST parameters were A 1/2 length (A1L, A2L), A 1/2 velocity (A1V, A2V), highest concavity deformation amplitude (HCDA), radius of curvature (RoC), peak distance (PD), central corneal thickness (CCT) and IOP. The ORA parameters were corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated IOP (IOP-G) and corneal compensated IOP (IOP-CC). Extracted data was analyzed using the Statistical Package for Social Science software. RESULTS Totally 39 males with age of 9.08±1.60 (6-12)y and 51 females with age of 8.96±1.55 (6-13)y were included. Many CST parameters were significantly correlated with CH, CRF, IOP-G and IOP-CC. Some CST parameters had a significant correlation with GAT-IOP, including IOP-CST in both eyes and HCDA, A2L, PD, and RoC in the left eye, but none with age, except A2L in the right eye. The CRF measurement showed a significant correlation with GAT-IOP in both eyes and CH in the right eye, yet, none with age. Among all CST and ORA parameters, CCT-CST in both eyes and A1L in right eye had a significant correlation with gender, although this was a negligible negative correlation. Comparison of mean IOP values by different devices showed a significantly highest IOP overestimation by CST and lowest by IOP-CC compared with GAT. Also, IOP-G versus IOP-CST significantly had the lowest IOP overestimation among others. Overall, either low positive correlation or negligible correlation was found between IOP measurements by 3 instruments. CONCLUSION The study finds the highest IOP overestimation by CST and lowest by IOP-CC compared with GAT. Overall, either low positive correlation or negligible correlation is found between IOP measurements by the 3 instruments.
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Affiliation(s)
- Ramin Salouti
- Department of Ophthalmology, Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz 7134814336, Iran
| | - Ali Agha Alishiri
- Department of Ophthalmology, Baqiyatallah University of Medical Sciences, Tehran 141551856, Iran
| | - Reza Gharebaghi
- Department of Ophthalmology, Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz 7134814336, Iran
| | - Mostafa Naderi
- Department of Ophthalmology, Baqiyatallah University of Medical Sciences, Tehran 141551856, Iran
| | - Khosrow Jadidi
- Department of Ophthalmology, Baqiyatallah University of Medical Sciences, Tehran 141551856, Iran
| | - Ahmad Shojaei-Baghini
- Department of Ophthalmology, Baqiyatallah University of Medical Sciences, Tehran 141551856, Iran
| | - Mohammadreza Talebnejad
- Department of Ophthalmology, Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz 7134814336, Iran
| | - Zahra Nasiri
- Faculty of Mathematical Sciences, Tarbiat Modares University, Tehran 141551856, Iran
| | - Seyedmorteza Hosseini
- Department of Ophthalmology, Baqiyatallah University of Medical Sciences, Tehran 141551856, Iran
| | - Fatemeh Heidary
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences; Immunoregulation Research Center, Shahed University, Tehran 141551856, Iran
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Asano S, Nakajima K, Kure K, Azuma K, Shimizu K, Murata H, Inoue T, Obata R, Asaoka R. Corneal biomechanical properties are associated with the activity and prognosis of Angioid Streaks. Sci Rep 2018; 8:8130. [PMID: 29802262 PMCID: PMC5970224 DOI: 10.1038/s41598-018-26430-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 05/08/2018] [Indexed: 11/26/2022] Open
Abstract
The aim of the current study is to investigate corneal biomechanical properties in detail using Ocular Response Analyzer (ORA) and Corvis ST (CST) tonometry and to analyze the association between corneal biomechanical properties and the frequency of intravitreal anti-vascular endothelial growth factor (VEGF) injections (FIV) in AS eyes with choroidal neovascularization (CNV). Twenty-eight eyes of 15 patients with AS were enrolled. Mean age of AS patients was 67.9 ± 9.8 years. ORA and CST measurements were carried out, in addition to comprehensive ophthalmic examinations. LogMAR visual acuity (VA) and ΔVA (the change of VA from baseline to the final visit) were calculated in each eye. Also, the relationships between FIV, and the variables of initial age at the observation period, axial length, and corneal biomechanical properties were investigated in eyes with AS using linear mixed model with model selection using AICc. In 28 AS eyes, 16 eyes underwent intravitreal anti-VEGF injections during follow-up period. Lower corneal hysteresis (CH), higher corneal resistant factor (CRF) and higher CST measured the DA ratio were associated with the increase of FIV in AS eyes (p = 0.01, p = 0.002, p = 0.027, respectively), suggesting the usefulness for monitoring of corneal biomechanical properties.
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Affiliation(s)
- Shotaro Asano
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Kosuke Nakajima
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Kana Kure
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Keiko Azuma
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Kimiko Shimizu
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Hiroshi Murata
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Tatsuya Inoue
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Ryo Obata
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Ryo Asaoka
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan.
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The Relationship between the Waveform Parameters from the Ocular Response Analyzer and the Progression of Glaucoma. Ophthalmol Glaucoma 2018; 1:123-131. [PMID: 32672562 DOI: 10.1016/j.ogla.2018.08.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 08/14/2018] [Accepted: 08/17/2018] [Indexed: 11/23/2022]
Abstract
PURPOSE To investigate the usefulness of waveform parameters measured with the Ocular Response Analyzer (Reichert Ophthalmic Instruments, Depew, NY) in assessing the progression of glaucomatous visual field (VF). DESIGN Observational cross-sectional study. PARTICIPANTS One hundred and one eyes with primary open-angle glaucoma in 68 patients with 8 reliable VFs using the Humphrey Field Analyzer (Carl Zeiss Meditec, Inc., Dublin, CA). METHODS The mean of total deviation (mTD) value of the 52 test points in the 24-2 Humphrey Field Analyzer VF test pattern was calculated, and the progression rate of mTD was determined using 8 VFs. Ocular Response Analyzer measurement was performed 3 times in the same day, and the average values of the 3 measurements were used in the analysis. Then, the optimal linear mixed model was selected using 7 parameters: age, mean and standard deviation of intraocular pressure with the Goldmann applanation tonometry during the observation period, central corneal thickness, axial length, mTD in the initial VF, and corneal hysteresis (CH) other than waveform parameters, henceforth known as the basic model. In addition, using the 37 waveform parameters, the optimal model for the mTD progression rate was identified, according to the second-order bias-corrected Akaike information criterion (AICc) index, using 15 preselected waveform parameters with the least absolute shrinkage and selection operator regression (henceforth known as the waveform model). MAIN OUTCOME MEASURES Optimal linear mixed models for the mTD progression rate, as determined by AICc index. RESULTS The mean ± standard deviation mTD progression rate was -0.25±0.31 dB/year. The basic model was mTD progression rate = -0.94 + 0.075 × CH (AICc = 46.71). The waveform model was mTD progression rate = 1.25 - 0.066 × path2 - 0.000099 × p2area + 0.0021 × mslew2 (AICc = 44.95). The relative likelihood of the latter model being the optimal model was 6.23 times greater than that of the former model. CONCLUSIONS Ocular Response Analyzer waveform parameters were correlated significantly with glaucomatous VF progression and showed a stronger than correlation with VF progression than CH.
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Corneal Biomechanical Properties After Penetrating Keratoplasty or Deep Anterior Lamellar Keratoplasty Using the Ocular Response Analyzer: A Meta-Analysis. Cornea 2017; 36:310-316. [PMID: 28002108 DOI: 10.1097/ico.0000000000001113] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE To evaluate the corneal biomechanical properties of patients who have undergone penetrating keratoplasty (PK) or deep anterior lamellar keratoplasty (DALK) using the ocular response analyzer. METHODS Stata 13.0 SE was used for this meta-analysis. Studies in the literature that focused on corneal hysteresis (CH) or corneal resistance factor (CRF) after PK or DALK were retrieved by searching PubMed, Embase, Ovid, and Cochrane databases. We present the results as weighted mean difference (WMD) with a corresponding 95% confidence interval (CI). RESULTS Eight studies with a total of 750 eyes were included in the post-PK versus control group, and 4 studies with a total of 218 eyes were included in the post-DALK versus control group. The pooled results showed that CH and CRF were significantly reduced (P < 0.00001) for patients who have undergone PK (WMD = -1.16, 95% CI: -1.73 to -0.60 and WMD = -1.00, 95% CI: -1.61 to -0.40). No significant differences were found in both CH and CRF for patients who have undergone DALK (WMD = -0.27, 95% CI: -0.64 to -0.09 and WMD = -0.15, 95% CI: -0.53 to 0.23). CONCLUSIONS This meta-analysis suggested that both CH and CRF had better recovery after corneal transplantation with DALK than PK.
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Corneal biomechanical metrics of healthy Chinese adults using Corvis ST. Cont Lens Anterior Eye 2017; 40:97-103. [DOI: 10.1016/j.clae.2016.12.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 11/30/2016] [Accepted: 12/06/2016] [Indexed: 11/19/2022]
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The relationship between retinal nerve fibre layer thickness profiles and CorvisST tonometry measured biomechanical properties in young healthy subjects. Sci Rep 2017; 7:414. [PMID: 28341831 PMCID: PMC5428286 DOI: 10.1038/s41598-017-00345-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 02/22/2017] [Indexed: 11/18/2022] Open
Abstract
We previously reported that a shallow circumpapillary retinal nerve fiber layer (cpRNFL) peak angle as measured by optical coherence tomography (OCT) suggests the temporal retina is stretched around the optic disc from the papillo-macular bundle (Yamashita T et al. Investigative Ophthalmol Vis Sci 2013). The purpose of the current study was to investigate the relationship between CorvisST tonometry (CST) corneal measurements, axial length (AL) and the change in OCT-measured cpRNFL peak angle, in young healthy subjects. OCT and CST measurements were carried out in 97 eyes of 97 young healthy volunteers. The relationship between cpRNFL peak angle and 12 CST parameters, adjusted for AL, was investigated using linear modelling. The mean ± standard deviation cpRNFL peak angle of the 97 healthy volunteers was 130.6 ± 25.4 (range: 77.8 to 207.0) degrees. The optimal linear model to explain cpRNFL peak angle (chosen from 216 different models) included three CST variables related to the speed and size of energy absorption (namely, A1 time, A1 length and A2 time), in addition to AL. In eyes with longer AL and shorter energy absorption in CST measurement, temporal retina is stretched around the optic disc from the papillo-macular bundle, as suggested by a shallow cpRNFL peak angle.
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