1
|
Jeon S, Toh G, Park J, Lee WJ. Exploring the Feasibility of Estimating Intraocular Pressure Using Vibrational Response of the Eye: A Methodological Approach. SENSORS (BASEL, SWITZERLAND) 2024; 24:3997. [PMID: 38931781 PMCID: PMC11207738 DOI: 10.3390/s24123997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 06/12/2024] [Accepted: 06/17/2024] [Indexed: 06/28/2024]
Abstract
This study addresses the limitations of current tonometry techniques by exploring vibroacoustic properties for estimating intraocular pressure (IOP), a key diagnostic parameter for monitoring glaucoma-a significant risk factor for vision loss. Utilizing vivo porcine eyeballs, we investigated the relationship between IOP and the nonlinear vibration transfer function ratio (NVTFR). Through applying varying vibration levels and analyzing responses with transfer function analysis and univariate regression, we identified a strong negative correlation between NVTFR and IOP, evidenced by a Pearson correlation coefficient of -0.8111 and significant results from generalized linear model (GLM) regression (p-value < 0.001). These findings indicate the potential of NVTFR as a vital indicator of IOP changes. Our study highlights the feasibility of using vibroacoustic properties, specifically NVTFR, to measure IOP. While further refinement is necessary for in vivo application, this approach opens new possibilities for non-invasive and patient-friendly IOP monitoring, potentially enhancing ophthalmology diagnostic techniques and providing a foundation for future research and development in this critical area.
Collapse
Affiliation(s)
- Seongwook Jeon
- Department of Mechanical Engineering, Hanyang University, Seoul 04763, Republic of Korea; (S.J.); (G.T.)
| | - Gyungmin Toh
- Department of Mechanical Engineering, Hanyang University, Seoul 04763, Republic of Korea; (S.J.); (G.T.)
| | - Junhong Park
- Department of Mechanical Engineering, Hanyang University, Seoul 04763, Republic of Korea; (S.J.); (G.T.)
| | - Won June Lee
- Department of Ophthalmology, Hanyang University College of Medicine, Seoul 04763, Republic of Korea
- Department of Ophthalmology, Hanyang University Seoul Hospital, Seoul 04763, Republic of Korea
| |
Collapse
|
2
|
Luo J, Zhang Y, Ai S, Shi G, Han X, Wang Y, Zhao Y, Yang H, Li Y, He X. Two-dimensional elastic distribution imaging of the sclera using acoustic radiation force optical coherence elastography. JOURNAL OF BIOPHOTONICS 2024; 17:e202300368. [PMID: 38010344 DOI: 10.1002/jbio.202300368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/23/2023] [Accepted: 11/15/2023] [Indexed: 11/29/2023]
Abstract
The scleral elasticity is closely related with many ocular diseases, but the relevant research is still insufficient. Here, we utilized optical coherence elastography to carefully study biomechanical properties of the sclera at different positions and under different intraocular pressures. Meanwhile, elastic wave velocity and Young's modulus of each position were obtained using a phase velocity algorithm. Accordingly, the two-dimensional elasticity distribution image was achieved by mapping the Young's modulus values to the corresponding structure based on the relationship between the position and its Young's modulus. Therefore, elastic information in regions-of-interest can be read and compared directly from the scleral structure, indicating that our method may be a very useful tool to evaluate the elasticity of sclera and provide intuitive and reliable proof for diagnosis and research.
Collapse
Affiliation(s)
- Jiahui Luo
- Key Laboratory of Opto-Electronic Information Science and Technology of Jiangxi Province and Jiangxi Engineering Laboratory for Optoelectronics Testing Technology, Nanchang Hangkong University, Nanchang, PR China
| | - Yubao Zhang
- Key Laboratory of Opto-Electronic Information Science and Technology of Jiangxi Province and Jiangxi Engineering Laboratory for Optoelectronics Testing Technology, Nanchang Hangkong University, Nanchang, PR China
| | - Sizhu Ai
- Key Laboratory of Opto-Electronic Information Science and Technology of Jiangxi Province and Jiangxi Engineering Laboratory for Optoelectronics Testing Technology, Nanchang Hangkong University, Nanchang, PR China
| | - Gang Shi
- Key Laboratory of Opto-Electronic Information Science and Technology of Jiangxi Province and Jiangxi Engineering Laboratory for Optoelectronics Testing Technology, Nanchang Hangkong University, Nanchang, PR China
| | - Xiao Han
- Key Laboratory of Opto-Electronic Information Science and Technology of Jiangxi Province and Jiangxi Engineering Laboratory for Optoelectronics Testing Technology, Nanchang Hangkong University, Nanchang, PR China
| | - Yidi Wang
- Key Laboratory of Opto-Electronic Information Science and Technology of Jiangxi Province and Jiangxi Engineering Laboratory for Optoelectronics Testing Technology, Nanchang Hangkong University, Nanchang, PR China
| | - Yanzhi Zhao
- Eye Center, Second Affiliated Hospital of Nanchang University, Nanchang, PR China
| | - Hongwei Yang
- Eye Center, Second Affiliated Hospital of Nanchang University, Nanchang, PR China
| | - Yingjie Li
- Department of Ophthalmology, Nanchang First Hospital, Nanchang, PR China
| | - Xingdao He
- Key Laboratory of Opto-Electronic Information Science and Technology of Jiangxi Province and Jiangxi Engineering Laboratory for Optoelectronics Testing Technology, Nanchang Hangkong University, Nanchang, PR China
| |
Collapse
|
3
|
Trabecular Meshwork Motion Profile from Pulsatile Pressure Transients: A New Platform to Simulate Transitory Responses in Humans and Nonhuman Primates. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app12010011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Trabecular meshwork (TM) motion abnormality is the leading cause of glaucoma. With technique limitations, how TM moves is still an enigma. This study describes a new laboratory platform to investigate TM motion responses to ocular transients in ex vivo eyes. The anterior segments of human cadaver and primate eyes were mounted in a perfusion system fitting. Perfusion needles were placed to establish mean baseline pressure. A perfusion pump was connected to the posterior chamber and generated an immediate transient pressure elevation. A phase-sensitive optical coherent tomography system imaged and quantified the TM motion. The peak-to-peak TM displacements (ppTMD) were determined, a tissue relaxation curve derived, and a time constant obtained. This study showed that the ppTMD increased with a rise in the pulse amplitude. The ppTMD was highest for the lowest mean pressure of 16 mmHg and decreased with mean pressure increase. The pulse frequency did not significantly change ppTMD. With a fixed pulse amplitude, an increase in mean pressure significantly reduced the time constant of recoil from maximum distension. Our research platform permitted quantitation of TM motion responses to designed pulse transients. Our findings may improve the interpretation of new TM motion measurements in clinic, aiding in understanding mechanisms and management.
Collapse
|
4
|
Ni L, Riesterer J, Wang H, Berry L, Blackburn K, Chuang J, Kim W, Xu G, Moroi SE, Argento A. Method for the biomechanical analysis of aqueous veins and perilimbal sclera by three-dimensional photoacoustic imaging and strain field calculation. Sci Rep 2021; 11:22108. [PMID: 34764362 PMCID: PMC8585983 DOI: 10.1038/s41598-021-01458-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/12/2021] [Indexed: 11/09/2022] Open
Abstract
A method motivated by the eye's aqueous veins is described for the imaging and strain calculation within soft biological tissues. A challenge to the investigation of the biomechanics of the aqueous vein-perilimbal sclera tissue complex is resolution of tissue deformations as a function of intraocular pressure and the subsequent calculation of strain (a normalized measure of deformation). The method involves perfusion of the eye with a contrast agent during conduction of non-invasive, optical resolution photoacoustic microscopy. This imaging technique permits three-dimensional displacement measurements of tracked points on the inner walls of the veins which are used in a finite element model to determine the corresponding strains. The methods are validated against two standard strain measurement methods. Representative porcine globe perfusion experiments are presented that demonstrate the power of the method to determine complex strain fields in the veins dependent on intraocular pressure as well as vein anatomy. In these cases, veins are observed to move radially outward during increases in intraocular pressure and to possess significant spatial strain variation, possibly influenced by their branching patterns. To the authors' knowledge, these are the only such quantitative, data driven, calculations of the aqueous vein strains available in the open literature.
Collapse
Affiliation(s)
- Linyu Ni
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
| | - John Riesterer
- Department of Mechanical Engineering, University of Michigan-Dearborn, 4901 Evergreen Road, Dearborn, MI, 48128, USA
| | - Huaizhou Wang
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, 48105, USA.,Currently at Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Layla Berry
- Department of Mechanical Engineering, University of Michigan-Dearborn, 4901 Evergreen Road, Dearborn, MI, 48128, USA
| | - Kara Blackburn
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, 48105, USA
| | - Jonathan Chuang
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, 48105, USA
| | - Wonsuk Kim
- Department of Mechanical Engineering, University of Michigan-Dearborn, 4901 Evergreen Road, Dearborn, MI, 48128, USA
| | - Guan Xu
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA.,Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, 48105, USA
| | - Sayoko E Moroi
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, 48105, USA.,Department of Ophthalmology and Visual Sciences, Havener Eye Institute, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA
| | - Alan Argento
- Department of Mechanical Engineering, University of Michigan-Dearborn, 4901 Evergreen Road, Dearborn, MI, 48128, USA.
| |
Collapse
|
5
|
Fernández-Vigo JI, Shi H, Burgos-Blasco B, Fernández-Aragón S, De-Pablo-Gómez-de-Liaño L, Kudsieh B, Macarro-Merino A, Fernández-Vigo JÁ. Anterior scleral thickness dimensions by swept-source optical coherence tomography. Clin Exp Optom 2021; 105:13-19. [PMID: 34134598 DOI: 10.1080/08164622.2021.1924629] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Clinical relevance: Given the association of scleral characteristics with many ophthalmological diseases, there is an important need to measure the anterior scleral thickness (AST).Background: This study examined the AST by swept-source optical coherence tomography (SS-OCT) in a large healthy population, assessing also the reproducibility of AST measurements and the correlation with different parameters.Methods: Cross-sectional study in 605 eyes of 605 subjects. AST measurements were made in the temporal and nasal quadrants at 1 (AST1) and 3 mm (AST3) from the scleral spur using SS-OCT. These dimensions were then assessed for associations in a multivariate model with the factors age, sex, refractive error, conjunctival-Tenon capsule thickness (CTT), anterior chamber angle (ACA), intraocular pressure (IOP), iris thickness (IT), limbus-sulcus distance (LSD), and ciliary muscle thickness (CMT). The reproducibility of the AST measurements was determined in 30 of the participants.Results: The mean age was 42.6 ± 17.3 years (range 5 to 86 years). The following means were recorded: AST1 was 522.3 ± 65.7 µm (355 to 761) and 558.4 ± 71.5 µm (357 to 889); AST2 was 513.3 ± 67.3 µm (343 to 732) and 574.4 ± 71.6 µm (389 to 789), and AST3 548.8 ± 71.9 µm (356 to 762) and 590.1 ± 76.6 µm (414 to 873) in the temporal and nasal quadrants respectively, being thicker the nasal quadrant (all p < 0.001). A positive correlation was detected between AST and age, sex, temporal ACA and LSD (all p ≤ 0.043), being negative the correlation with CMT (p ≤ 0.044). No correlation was observed between AST measurements and refractive error, CTT and IT (p ≥ 0.064). The reproducibility of AST measurements was excellent (intraclass correlation coefficient ≥0.951).Conclusions: SS-OCT allows for in vivo AST measurements. Our data contained a wide range of measurements, showing an association between AST and age, sex, ACA, LSD and CMT.
Collapse
Affiliation(s)
- José Ignacio Fernández-Vigo
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - Hang Shi
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - Bárbara Burgos-Blasco
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | | | | | - Bachar Kudsieh
- Department of Ophthalmology, Hospital Puerta de Hierro Majadahonda, Madrid, Spain
| | - Ana Macarro-Merino
- Department of Ophthalmology, Centro Internacional de Oftalmología Avanzada, Madrid, Spain
| | | |
Collapse
|
6
|
Konopińska J, Lewczuk K, Jabłońska J, Mariak Z, Rękas M. Microinvasive Glaucoma Surgery: A Review of Schlemm's Canal-Based Procedures. Clin Ophthalmol 2021; 15:1109-1118. [PMID: 33737802 PMCID: PMC7961128 DOI: 10.2147/opth.s293702] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 02/18/2021] [Indexed: 12/12/2022] Open
Abstract
Microinvasive glaucoma surgery has gained popularity over the past decade. It can be performed using three different mechanisms. In the present review, we focused on Schlemm’s canal (SC)-based surgery, which increases aqueous humor (AH) outflow into the aqueous veins by either removal of the trabecular meshwork (TM) or an increase in the tension in the TM. In primary open-angle glaucoma (POAG), the TM is the most likely region for increased AH outflow resistance. Theoretically, removal of the TM can improve the AH outflow; hence, glaucoma specialists focus on microsurgical dissection of the TM. In this review, we analyzed the available literature to examine SC-related microsurgical modalities based on the histopathological proofs of the localization of resistance of the AH outflow. First, we considered the role, anatomy, and physiology of the TM and SC. We referred to studies that describe the mechanisms and potential pathways, related to increased intraocular pressure in the POAG, that are targeted using the SC-related microsurgical interventions. Next, we took a closer look at the gonioscopic tools necessary for an ab-interno approach and explored incision canal surgery: ab-interno trabeculectomy using different instrumentation (Trabectome®, Kahook Dual Blade) and variations of the technique. Thereafter, we discussed ab-interno canaloplasty, explaining the technique and reviewing its effectiveness. Finally, we presented the scope for future research in the field. Although the iStent also targets SC by bypassing it, this device has been reviewed extensively elsewhere.
Collapse
Affiliation(s)
- Joanna Konopińska
- Department of Ophthalmology, Medical University of Bialystok, Białystok, Poland
| | - Katarzyna Lewczuk
- Department of Ophthalmology, Military Institute of Medicine, Warsaw, Poland
| | - Joanna Jabłońska
- Department of Ophthalmology, Military Institute of Medicine, Warsaw, Poland
| | - Zofia Mariak
- Department of Ophthalmology, Medical University of Bialystok, Białystok, Poland
| | - Marek Rękas
- Department of Ophthalmology, Military Institute of Medicine, Warsaw, Poland
| |
Collapse
|
7
|
Kim D, Chung Y, Yeon Y, Cho H, Lim HW, Park J, Lee WJ. A pilot study for intraocular pressure measurements based on vibroacoustic parameters. Sci Rep 2021; 11:1264. [PMID: 33441815 PMCID: PMC7806898 DOI: 10.1038/s41598-020-80321-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 12/15/2020] [Indexed: 02/01/2023] Open
Abstract
The present study aimed to identify vibroacoustic properties associated with intraocular pressure (IOP) changes and to suggest a new way to measure the IOP based on these properties. Ten ex vivo porcine eyeballs were used in this study. Each eyeball was fixated in a central hole of a Styrofoam block, and vibration applied to the Styrofoam block was transmitted to the eyeball. An accelerometer directly attached to the eyeball measured the vibration response. Excitations and measurements were performed for 1 s, and the excitation magnitude was varied for the same signal in repeat measurements. A 30-gauge needle was inserted into the anterior chamber of the eyeball to inject a balanced salt solution, and the height of the bottle was adjusted to adjust the IOP. A tonometer was used under identical conditions to measure the IOP five times, and the mean value was determined for further analyses. The measurements showed that the parameters resonance frequency and change in the magnitude of the vibration response (CMVR) increased with rising IOP values. The CMVR was highly correlated with the IOP (p-value < 0.0001). A linear mixed effects model (LMM) was used as a statistical analysis method. We confirmed that vibroacoustic properties of the eyeball are correlated with IOP changes. It is expected that the CMVR will serve as a new parameter for IOP measurements. Thus, in the future, continuous IOP measurements would be easily performed using the CMVR.
Collapse
Affiliation(s)
- Deukha Kim
- Department of Mechanical Engineering, Hanyang University College of Engineering, Seoul, Korea
| | - Youngbeen Chung
- Department of Mechanical Engineering, Hanyang University College of Engineering, Seoul, Korea
| | - Yeji Yeon
- Department of Ophthalmology, Hanyang University College of Medicine, Wangsimni-ro 222, Seongdong-gu, Seoul, 04763, Korea
| | - Hyunsoo Cho
- Department of Ophthalmology, Hanyang University College of Medicine, Wangsimni-ro 222, Seongdong-gu, Seoul, 04763, Korea
| | - Han Woong Lim
- Department of Ophthalmology, Hanyang University College of Medicine, Wangsimni-ro 222, Seongdong-gu, Seoul, 04763, Korea.,Department of Ophthalmology, Hanyang University Seoul Hospital, Wangsimni-ro 222, Seongdong-gu, Seoul, 04763, Korea
| | - Junhong Park
- Department of Mechanical Engineering, Hanyang University College of Engineering, Seoul, Korea
| | - Won June Lee
- Department of Ophthalmology, Hanyang University College of Medicine, Wangsimni-ro 222, Seongdong-gu, Seoul, 04763, Korea. .,Department of Ophthalmology, Hanyang University Seoul Hospital, Wangsimni-ro 222, Seongdong-gu, Seoul, 04763, Korea.
| |
Collapse
|
8
|
Xin C, Wang H, Wang N. Minimally Invasive Glaucoma Surgery: What Do We Know? Where Should We Go? Transl Vis Sci Technol 2020; 9:15. [PMID: 32821487 PMCID: PMC7401977 DOI: 10.1167/tvst.9.5.15] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 12/02/2019] [Indexed: 12/17/2022] Open
Abstract
With the arrival of a plethora of new and revolving minimally invasive glaucoma surgery techniques, glaucoma specialists currently are fortunate to have various surgical options that aim to recovery of the function of the aqueous outflow system in different ways. Meanwhile, the aqueous outflow system has become the hot point of researching. In ARVO 2019, a special interest group session was held on new perspectives on minimally invasive glaucoma surgery. Ten surgeons, clinical professors, and experimental scientists were invited to report their latest studies and discussed on five hot topics in this special interest group. This review summarizes the special interest group session and posts the issues of greatest concern, providing insight to the aqueous outflow system and areas that require further study.
Collapse
Affiliation(s)
- Chen Xin
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Huangzhou Wang
- Ophthalmology Department, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ningli Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
9
|
Abstract
PURPOSE OF REVIEW Approximately 10% of patients become blind despite using evidence-based guidelines developed from clinical trials and epidemiology studies. Our purpose is to review opportunities to decrease glaucoma-related blindness using the emerging principles of precision medicine. RECENT FINDINGS The current review focuses on three topics: first, candidate biomarkers for angle-based surgeries, second, head-mounted display (HMD) technology for vision and testing, and third, glaucoma risk alleles discovered by genome-wide association studies. First, in angle-based surgeries, tracers injected into the anterior chamber or Schlemm's canal have allowed visualization of aqueous veins. We describe an innovative use of optical coherence tomography angiography to visualize aqueous veins in a case with 6-year successful outcome following catheter-based trabeculotomy. Second, HMD technology can augment perceived vision and can be used for perimetry testing. Third, developing genetic risk scores that characterize patients who are at highest risk for blindness is a priority. Such biomarker risk scores will integrate genome-wide association study-based risk alleles for glaucoma along with well known demographic and clinical risk factors. SUMMARY As we gain more knowledge, precision medicine will enable clinicians to decrease glaucoma-related blindness by providing more timely interventions to those patients who are at highest risk for progression to blindness. VIDEO ABSTRACT: http://links.lww.com/COOP/A29.
Collapse
|