Biomechanics in Keratoconus Diagnosis

Esporcatte, Louise Pellegrino Gomes; Salomão, Marcella Q.; Lopes, Bernardo; Sena, Nelson; Ferreira, Érica; Filho, Joao Batista R F; Machado, Aydano Pamponet; Ambrósio, Renato

doi:10.1080/02713683.2022.2041042

Cited by 16 publications

(15 citation statements)

References 65 publications

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“…(1) How to perform a fast, non-invasive, reliable, and high-resolution corneal biomechanical examination? There is a growing appreciation for the need to identify regional/ spatial variations in corneal mechanical characteristics for early-stage keratoconus diagnosis [117] , [118] , [119] when focal degenerations appear prior to clinical symptom caused by gross corneal deformations [166] . Because both ORA and Corvis ST measure tissue responses to global deformation forces, it is not possible to assess regional differences in tissue properties with these devices [163] , [164] , [165] .…”

Section: Discussionmentioning

confidence: 99%

“…Early stages of subclinical asymptomatic keratoconus and form-fruste (non-progressing) keratoconus [118] , which may not be easily detectable by common clinical examination methods is regarded as a significant risk factor for the development of ectasia following laser refractive surgery [117] . Comprehensive evaluations that integrate corneal morphological and biomechanical measurements are required to detect keratoconus, particularly in its early or subclinical stages, and are advantageous for providing timely intervention [119] .…”

Section: Corneal Biomechanics Associated With Disease and Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

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

Lan¹,

Twa²,

Song³

et al. 2023

Computational and Structural Biotechnology Journal

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Section: Discussionmentioning

confidence: 99%

Section: Corneal Biomechanics Associated With Disease and Treatmentmentioning

confidence: 99%

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

Lan¹,

Twa²,

Song³

et al. 2023

Computational and Structural Biotechnology Journal

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“…Ocular Response Analyzer (ORA) and Corvis ST (CVS) are the only two clinical devices that facilitate in vivo biomechanical evaluations of the cornea and numerous studies have demonstrated enhanced diagnostic efficacy with biomechanical indices provided by these devices. The ORA applies an air puff to the anterior cornea, then records and measures the pressures at the two corneal applanation times [ 8 ]. CH (corneal hysteresis) and CRF (corneal resistance factor) are two important parameters measured by ORA.…”

Section: Introductionmentioning

confidence: 99%

Mendelian Randomisation Analysis of Causal Association between Lifestyle, Health Factors, and Keratoconus

Cheng,

Yang,

et al. 2024

Bioengineering

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Keratoconus (KC), a leading cause of vision impairment, has an unclear aetiology. This study used Mendelian randomization (MR) to explore the causal links between various factors (smoking, asthma, Down syndrome, inflammatory bowel disease, atopic dermatitis, and serum 25-hydroxyvitamin D levels) and KC. A two-sample MR design, grounded in genome-wide association study (GWAS) summary statistics, was adopted using data from FinnGen, UK Biobank, and other GWAS-related articles. The inverse-variance weighted (IVW) method was employed, complemented by the Wald ratio method for factors with only one single-nucleotide polymorphism (SNP). Sensitivity and stability were assessed through Cochrane’s Q test, the MR-Egger intercept test, MR-PRESSO outlier test, and the leave-one-out analysis. The IVW results for the ORA (Ocular Response Analyzer) biomechanical parameters indicated significant associations between tobacco smoking (CH: p < 0.001; CRF: p = 0.009) and inflammatory bowel disease (CH: p = 0.032; CRF: p = 0.001) and corneal biomechanics. The Wald ratio method showed tobacco smoking was associated with a lower risk of KC (p = 0.024). Conversely, asthma (p = 0.009), atopic dermatitis (p = 0.012), inflammatory bowel disease (p = 0.017), and serum 25-hydroxyvitamin D levels (p = 0.039) were associated with a higher risk of KC by IVW, and the same applied to Down syndrome (p = 0.004) using the Wald ratio. These results underscore the role of corneal biomechanics as potential mediators in KC risk, warranting further investigation using Corvis ST and Brillouin microscopy. The findings emphasise the importance of timely screening for specific populations in KC prevention and management.

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“…Performing refractive surgeries on keratoconus suspect eyes could lead to postoperative iatrogenic progressive ectatic disorder of the cornea (5). Due to the alteration of corneal biomechanical and viscoelastic properties in keratoconus pathophysiology (6), it has been proposed that corneal biomechanical parameters could detect subclinical keratoconus patients before the appearance of signi cant changes in the corneal topography and tomography (2,7).…”

Section: Introductionmentioning

confidence: 99%

Corneal Biomechanics in Normal and Subclinical Keratoconus Eyes

Peyman

Sepahvand

Pourazizi

et al. 2023

Preprint

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Background The diagnosis of keratoconus, as the most prevalent corneal ectatic disorder, at the subclinical stage gained great attention due to the increased acceptance of refractive surgeries. This study aimed to assess the pattern of the corneal biomechanical properties derived from Corneal Visualization Scheimpflug Technology (Corvis ST) and evaluate the diagnostic value of these parameters in distinguishing subclinical keratoconus (SKC) from normal eyes. Methods This prospective study was conducted on 73 SKC and 69 normal eyes. Subclinical keratoconus eyes were defined as corneas with no clinical evidence of keratoconus and suspicious tomographic and tomographic features. Following a complete ophthalmic examination, topographic and tomographic corneal assessment via Pentacam HR, and corneal biomechanical evaluation utilizing Corvis ST were done. Results Subclinical keratoconus eyes presented significantly higher Deformation Amplitude (DA) ratio, Tomographic Biomechanical Index (TBI), and Corvis Biomechanical Index (CBI) rates than the control group. Conversely, Ambrósio Relational Thickness to the Horizontal profile (ARTh), and Stiffness Parameter at the first Applanation (SPA1) showed significantly lower rates in SKC eyes. In diagnosing SKC from normal eyes, TBI (AUC: 0.858, Cut-off value: > 0.33, Youden index: 0.55), ARTh (AUC: 0.813, Cut-off value: ≤ 488.1, Youden index: 0.58), and CBI (AUC: 0.804, Cut-off value: > 0.47, Youden index: 0.49) appeared as good indicators. Conclusions Integrated Corvis ST parameters could be valuable in distinguishing SKC eyes from normal ones.

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Biomechanics in Keratoconus Diagnosis

Cited by 16 publications

References 65 publications

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

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

Mendelian Randomisation Analysis of Causal Association between Lifestyle, Health Factors, and Keratoconus

Corneal Biomechanics in Normal and Subclinical Keratoconus Eyes

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