Effects of diabetes mellitus on biomechanical properties of the rabbit cornea

Bao, Fangjun; Deng, ManLi; Zheng, Xiang; Li, LinNa; Zhao, Yiping; Cao, Si; Yu, A-Yong; Wang, Qinmei; Huang, Jinhai; Elsheikh, Ahmed

doi:10.1016/j.exer.2017.05.015

Cited by 31 publications

(19 citation statements)

References 46 publications

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“…8, rabbit corneal elastic modulus ranged from 0.16 to 0.60 MPa when IOP increased from 7 to 35 mmHg. Corneal elastic moduli were usually obtained from corneal uniaxial tensile test or corneal inflation tests, and the range of normal rabbit corneal elastic modulus ranged from 0.1 to 0.36 MPa in different studies [7, 24, 32–35]. Corneal elastic modulus extracted from this study has the same magnitude with the results reported by the literature.…”

Section: Discussionsupporting

confidence: 76%

Evaluation of corneal elastic modulus based on Corneal Visualization Scheimpflug Technology

et al. 2019

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Background Corneal biomechanical properties are important for the diagnosis of corneal diseases, individualized design and prognosis of corneal surgery. Clinical available devices such as Ocular Response Analyzer (ORA) and Corneal Visualization Scheimpflug Technology (Corvis ST) can provide corneal biomechanics related parameters, while corneal elastic modulus cannot be extracted directly from them at present. The aim of this study is to suggest a method to determine corneal elastic modulus based on the results of Corvis ST test according to Reissner’s theory on the relation between stress and small displacement in shallow spherical shell. Results Five rabbits (10 eyes) and 10 healthy humans (20 eyes) were measured with Corvis ST to obtain the normal range of corneal elastic modulus. Results showed Corneal elastic modulus of rabbit was 0.16 MPa to 0.35 MPa, human corneal elastic modulus was 0.16–0.30 MPa. Rabbit corneas were also measured at different intraocular pressures (IOP), and results showed corneal elastic modulus, first applanation time (A1T) and stiffness parameter (SP-A1) were positively correlated with IOP. Deformation amplitude (DA), the second applanations time (A2T), and peak distance (PD) were negatively correlated with IOP. Finite element method was used to simulate the Corvis measurements according to the calculated elastic modulus and the simulated corneal apical displacements were agreement with experimental results in general. Conclusions The method to determine corneal elastic modulus based on Corvis test according to the relationship between force and displacements of shallow spherical shell is convenient and effective.

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Section: Discussionsupporting

confidence: 76%

Evaluation of corneal elastic modulus based on Corneal Visualization Scheimpflug Technology

et al. 2019

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“…Hyperglycemia and associated accumulation of AGEs lead to crosslinking of the stroma which increases the corneal stiffness. 9 Patients with type 1 and type 2 diabetes have been shown to have increased corneal hysteresis, or viscosity, of the cornea as measured by resistance to deformation by air puff. 6 7 18 Corneal hysteresis is also associated with the duration of disease and A1c levels.…”

Section: Corneamentioning

confidence: 99%

Eye care providers’ emerging roles in early detection of diabetes and management of diabetic changes to the ocular surface: a review

Richdale

Chao

Hamilton

2020

BMJ Open Diab Res Care

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US adults visit eye care providers more often than primary healthcare providers, placing these doctors in a prime position to help identify and manage patients with prediabetes and diabetes. Currently, diabetes is identified in eye clinics in an advanced stage, only after visible signs of diabetic retinopathy. Recent ophthalmic research has identified multiple subclinical and clinical changes that occur in the anterior segment of the eye with metabolic disease. The corneal epithelium exhibits increased defects and poor healing, including an increased risk of neurotrophic keratitis. Increased thickness and stiffness of the cornea artificially alters intraocular pressure. There is damage to the endothelial cells and changes to the bacterial species on the ocular surface, both of which can increase risk of complications with surgery. Decreased corneal sensitivity due to a loss of nerve density predispose patients with metabolic disease to further neurotrophic complications. Patients with diabetes have increased Meibomian gland dysfunction, blepharitis and reduced tear production, resulting in increased rates of dry eye disease and discomfort. Early detection of metabolic disease may allow eye care providers to be more proactive in recommending referral and intervention in order to reduce the risk of blindness and other diabetes-related morbidity. Continued research is needed to better understand the time course of changes to the anterior segment and what can be done to better detect and diagnose patients with prediabetes or undiagnosed diabetes and provide improved care for these patients.

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“…Zou et al [32] compared eight monkeys with insulin-dependent diabetes (induced by streptozotocin injection) with four controls, and found a cross-linking with abnormal aggregates of collagen fibrils in the stromal matrix on transmission electron microscope examination in monkeys with diabetes. In another recent experimental study in rabbits, Bao et al [126] investigated the effects of diabetes on the behavior of the cornea, showing a significant increase in AGEs, CCT, and IOP in rabbits with diabetes. In addition, the tangent modulus of the cornea at four stress levels was significantly higher in rabbits with diabetes, indicated by greater mechanical rigidity of the cornea.…”

Section: Diabetes and Corneal Stromamentioning

confidence: 99%

“…In addition, there are further pathogenic factors that could modify the biomechanical properties of the cornea in diabetes patients; these should be considered to clarify some contradictory results in the published evidence. A dysfunction of the epithelial and endothelial cells of the cornea could alter control of hydration of the cornea, causing subclinical edema that could influence the results by causing a decrease in CH and CRF, as well as an increase in CCT [74, 105, 126]. This hypothesis could explain the decreased CH values reported in some studies [109, 113, 114] and the elevated CCT in most of the studies [77–80].…”

Section: Diabetes and Corneal Stromamentioning

confidence: 99%

An Update on Corneal Biomechanics and Architecture in Diabetes

Buey

Casas

Caramello

et al. 2019

Journal of Ophthalmology

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In the last decade, we have witnessed substantial progress in our understanding of corneal biomechanics and architecture. It is well known that diabetes is a systemic metabolic disease that causes chronic progressive damage in the main organs of the human body, including the eyeball. Although the main and most widely recognized ocular effect of diabetes is on the retina, the structure of the cornea (the outermost and transparent tissue of the eye) can also be affected by the poor glycemic control characterizing diabetes. The different corneal structures (epithelium, stroma, and endothelium) are affected by specific complications of diabetes. The development of new noninvasive diagnostic technologies has provided a better understanding of corneal tissue modifications. The objective of this review is to describe the advances in the knowledge of the corneal alterations that diabetes can induce.

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Effects of diabetes mellitus on biomechanical properties of the rabbit cornea

Cited by 31 publications

References 46 publications

Evaluation of corneal elastic modulus based on Corneal Visualization Scheimpflug Technology

Evaluation of corneal elastic modulus based on Corneal Visualization Scheimpflug Technology

Eye care providers’ emerging roles in early detection of diabetes and management of diabetic changes to the ocular surface: a review

An Update on Corneal Biomechanics and Architecture in Diabetes

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