Quantitative assessment of corneal biomechanical changes in vivo after photorefractive intrastromal corneal cross-linking using optical coherence elastography.

IF 2.9 2区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Quantitative Imaging in Medicine and Surgery Pub Date : 2024-10-01 Epub Date: 2024-09-26 DOI:10.21037/qims-24-590
Hongwei Yang, Yaoying Shen, Yong Chen, Yange Yan, Yingjie Li, Yongan Lu, Jingchao Liu, Xiaolong Yin, Guofu Huang, Yanzhi Zhao
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Abstract

Background: Photorefractive intrastromal corneal cross-linking (PiXL) treatment corrects myopia by enhancing localized central corneal biomechanics. However, the dose-effect relationship between the changes in corneal biomechanics and alterations in corneal curvature resulting from this treatment remain unclear. We therefore developed an acoustic radiation force optical coherence elastography (ARF-OCE) technique to investigate the dose-effect relationship in PiXL.

Methods: ARF-OCE measurements and corneal topography were performed 3 days before and 1 week after PiXL treatment. Depth-resolved Young's modulus images of the in vivo corneas were obtained based on the phase velocity of the Lamb wave. PiXL treatments with five ultraviolet-A (UVA) energy doses (5.4, 15, 25, 35, and 45 J/cm2) were administered to rabbit corneas in vivo (n=15).

Results: The percentage change in Young's modulus (ΔE%) of the cornea increased from 0.26 to 1.71 as the UVA energy dose increased from group I (5.4 J/cm2) to group V (45 J/cm2). Meanwhile, the change in the mean keratometry (ΔKm ) of the cornea increased from 0.40 to 2.10 diopters (D) as the UVA energy dose increased from group I to group IV (35 J/cm2). Furthermore, a statistically significant positive correlation was observed between ΔE% and ΔKm in groups I to IV.

Conclusions: With increasing UVA energy dose, the corneal Young's modulus significantly increased. Given the observed correlation, ΔE% holds promise as a new quantitative biomechanical parameter for determining the dose-effect relationship in PiXL treatment. It should be emphasized that there may be an inflection point of ΔE%, at which corneal keratometry ceases to flatten and begins to increase. The ARF-OCE system has demonstrated its efficacy in quantitatively assessing changes in corneal biomechanics in vivo following PiXL treatment. This technique has great potential in facilitating the quantitative determination of the dose-effect relationship in PiXL treatment.

利用光学相干弹性成像技术定量评估光屈光性基质内角膜交联术后体内角膜生物力学变化。
背景:光屈光基质内角膜交联(PiXL)疗法通过增强局部中央角膜生物力学来矫正近视。然而,这种治疗方法导致的角膜生物力学变化与角膜曲率改变之间的剂量效应关系仍不清楚。因此,我们开发了一种声辐射力光学相干弹性成像(ARF-OCE)技术来研究 PiXL 的剂量效应关系:方法:在 PiXL 治疗前 3 天和治疗后 1 周进行 ARF-OCE 测量和角膜地形图检查。根据 Lamb 波的相位速度,获得了活体角膜的深度分辨杨氏模量图像。用五种紫外线-A(UVA)能量剂量(5.4、15、25、35 和 45 J/cm2)对兔子角膜进行活体 PiXL 治疗(n=15):从第一组(5.4 J/cm2)到第五组(45 J/cm2),随着 UVA 能量剂量的增加,角膜杨氏模量的百分比变化(ΔE%)从 0.26 增加到 1.71。同时,随着 UVA 能量剂量从第一组增加到第四组(35 J/cm2),角膜平均角膜度数(ΔKm)从 0.40 度增加到 2.10 度(D)。此外,在第一组至第四组中,ΔE% 与 ΔKm 在统计学上呈显著正相关:结论:随着 UVA 能量剂量的增加,角膜杨氏模量明显增加。鉴于观察到的相关性,ΔE%有望成为确定 PiXL 治疗剂量效应关系的新的定量生物力学参数。需要强调的是,ΔE% 可能存在一个拐点,在这个拐点上,角膜角膜度数不再变平,而是开始增加。ARF-OCE 系统已证明其在定量评估 PiXL 治疗后角膜生物力学的活体变化方面的功效。这项技术在促进定量确定 PiXL 治疗的剂量效应关系方面具有巨大潜力。
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来源期刊
Quantitative Imaging in Medicine and Surgery
Quantitative Imaging in Medicine and Surgery Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
4.20
自引率
17.90%
发文量
252
期刊介绍: Information not localized
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