The changes of corneal biomechanical properties with long-term treatment of prostaglandin analogue measured by Corvis ST

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Abstract

Background

To investigate the corneal biomechanical changes in primary open angle glaucoma (POAG) patients treated with long-term prostaglandin analogue (PGA).

Methods

One hundred eleven newly diagnosed POAG patients, including 43 high tension glaucoma (HTG) and 68 normal tension glaucoma (NTG), were measured by Corvis ST to obtain intraocular pressure (IOP), central corneal thickness (CCT) and corneal biomechanical parameters at baseline and at each follow-up visit after initiation of PGA treatment. The follow-up measurements were analyzed by the generalized estimate equation model with an exchangeable correlation structure. Restricted cubic spline was employed to estimate the dose–response relation between follow-up time and corneal biomechanics.

Results

The mean follow-up time was 10.3 ± 7.02 months. Deformation amplitude (β = -0.0015, P = 0.016), the first applanation velocity (AV1, β = -0.0004, P = 0.00058) decreased and the first applanation time (AT1, β = 0.0089, P < 0.000001) increased statistically significantly with PGA therapy over time after adjusting for age, gender, axial length, corneal curvature, IOP and CCT. In addition, AT1 was lower (7.2950 ± 0.2707 in NTG and 7.5889 ± 0.2873 in HTG, P = 0.00011) and AV1 was greater (0.1478 ± 0.0187 in NTG and 0.1314 ± 0.0191 in HTG, P = 0.00002) in NTG than in HTG after adjusting for confounding factors.

Conclusions

Chronic use of PGA probably influences the corneal biomechanical properties directly, which is to make cornea less deformable. Besides, corneas in NTG tended to be more deformable compared to those in HTG with long-term treatment of PGA.

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Most cited references 28

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Central corneal thickness and corneal hysteresis associated with glaucoma damage.

Aimee Broman, Karen Bandeen-Roche, N Congdon … (2006)

We sought to measure the impact of central corneal thickness (CCT), a possible risk factor for glaucoma damage, and corneal hysteresis, a proposed measure of corneal resistance to deformation, on various indicators of glaucoma damage. Observational study. Adult patients of the Wilmer Glaucoma Service underwent measurement of hysteresis on the Reichert Ocular Response Analyzer and measurement of CCT by ultrasonic pachymetry. Two glaucoma specialists (H.A.Q., N.G.C.) reviewed the chart to determine highest known intraocular pressure (IOP), target IOP, diagnosis, years with glaucoma, cup-to-disk ratio (CDR), mean defect (MD), pattern standard deviation (PSD), glaucoma hemifield test (GHT), and presence or absence of visual field progression. Among 230 subjects, the mean age was 65 +/- 14 years, 127 (55%) were female, 161 (70%) were white, and 194 (85%) had a diagnosis of primary open-angle glaucoma (POAG) or suspected POAG. In multivariate generalized estimating equation models, lower corneal hysteresis value (P = .03), but not CCT, was associated with visual field progression. When axial length was included in the model, hysteresis was not a significant risk factor (P = .09). A thinner CCT (P = .02), but not hysteresis, was associated with a higher CDR at the most recent examination. Neither CCT nor hysteresis was associated with MD, PSD, or GHT "outside normal limits." Thinner CCT was associated with the state of glaucoma damage as indicated by CDR. Axial length and corneal hysteresis were associated with progressive field worsening.

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Factors influencing optic nerve head biomechanics.

Ian Sigal, John Flanagan, C. Ross Ethier (2005)

The biomechanical environment within the optic nerve head (ONH) may play a role in retinal ganglion cell loss in glaucomatous optic neuropathy. This was a systematic analysis in which finite element methods were used to determine which anatomic and biomechanical factors most influenced the biomechanical response of the ONH to acute changes in IOP. Based on a previously described computational model of the eye, each of 21 input factors, representing the biomechanical properties of relevant ocular tissues, the IOP, and 14 geometric factors were independently varied. The biomechanical response of the ONH tissues was quantified through a set of 29 outcome measures, including peak and mean stress and strain within each tissue, and measures of geometric changes in ONH tissues. Input factors were ranked according to their aggregated influence on groups of outcome measures. The five input factors that had the largest influence across all outcome measures were, in ranked order: stiffness of the sclera, radius of the eye, stiffness of the lamina cribrosa, IOP, and thickness of the scleral shell. The five least influential factors were, in reverse ranked order: retinal thickness, peripapillary rim height, cup depth, cup-to-disc ratio, and pial thickness. Factor ranks were similar for various outcome measure groups and factor ranges. The model predicts that ONH biomechanics are strongly dependent on scleral biomechanical properties. Acute deformations of ONH tissues, and the consequent high levels of neural tissue strain, were less strongly dependent on the action of IOP directly on the internal surface of the ONH than on the indirect effects of IOP on the sclera. This suggests that interindividual variations in scleral properties could be a risk factor for the development of glaucoma. Eye size and lamina cribrosa biomechanical properties also have a strong influence on ONH biomechanics.

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Corneal deformation measurement using Scheimpflug noncontact tonometry.

Y Hon, Andrew K C Lam (2012)

To determine the intraexaminer repeatability and intersession reproducibility of corneal deformation measurement using Scheimpflug noncontact tonometry (Corvis ST) on normal subjects. Thirty-seven adults aged 20 to 48 years were invited to have their corneal deformation and curvature measurements taken using Corvis ST and Pentacam, respectively. Three consecutive measurements were taken for each instrument between 9:00 and 11:00 AM for intraexaminer repeatability analysis. Participants returned between 3:00 and 5:00 PM the same day for intersession reproducibility analysis. The most repeatable corneal parameter measured by Corvis ST was central corneal thickness ([CCT] ICC, 0.96; precision, 10.85 μm; repeatability, 15.34 μm; CV, 1.01%), followed by deformation amplitude ([DA] ICC, 0.80; precision, 0.08 mm; repeatability, 0.13 mm; CV, 4.33%), first applanation time ([1st A-time] ICC, 0.77; precision, 0.22 milliseconds; repeatability, 0.31 milliseconds; CV, 1.42), and intraocular pressure ([IOP] ICC, 0.75; precision, 1.39 mm Hg; repeatability, 1.97 mm Hg; CV, 4.98). Other parameters showed poor repeatability. The DA and 1st A-time showed good intersession reproducibility. The 95% limits of agreement were +0.13 to -0.13 mm for DA and +0.27 to -0.33 milliseconds for 1st A-time. The DA was negatively correlated with central corneal thickness (r = -0.53, p < 0.001) but not with corneal curvatures (flattest curvature, r = 0.13, p = 0.46; steepest curvature, r = 0.05, p = 0.75). Corneal deformation parameters DA and 1st A-time were repeatable and reproducible. A thinner cornea was associated with a higher corneal deformation. Measurement of DA serves as an indicator of corneal biomechanical properties.

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Author and article information

Contributors

Yuhong Chen: doctorrainbow@gmail.com

Journal

Journal ID (nlm-ta): BMC Ophthalmol

Journal ID (iso-abbrev): BMC Ophthalmol

Title: BMC Ophthalmology

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2415

Publication date (Electronic): 20 October 2020

Publication date PMC-release: 20 October 2020

Publication date Collection: 2020

Volume: 20

Electronic Location Identifier: 422

Affiliations

[1 ]GRID grid.8547.e, ISNI 0000 0001 0125 2443, Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, , Fudan University, ; Shanghai, 200031 China

[2 ]GRID grid.8547.e, ISNI 0000 0001 0125 2443, NHC Key Laboratory of Myopia (Fudan University); Key Laboratoy of Myopia, Chinese Academy of Medical Sciences, ; Shanghai, 200031 China

[3 ]Shanghai Key Laboratoy of Visual Impairment and Restoration, Shanghai, 200031 China

[4 ]GRID grid.8547.e, ISNI 0000 0001 0125 2443, State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, , Fudan University, ; Shanghai, 200032 China

Article

Publisher ID: 1693

DOI: 10.1186/s12886-020-01693-6

PMC ID: 7576693

PubMed ID: 33081750

SO-VID: 68b803fa-19f1-4122-92ea-5766cb9b6acd

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 31 March 2020

Date accepted : 12 October 2020

Funding

Funded by: the National Science Foundation of China

Award ID: 81570887

Award ID: 81600730

Award Recipient : Na Wu Yuhong Chen

Funded by: the Shanghai Committee of Science and Technology

Award ID: 17410712500

Award Recipient : Xinghuai Sun

Funded by: the top priority of clinical medicine center of Shanghai

Award ID: 2017ZZ01020

Award Recipient : Xinghuai Sun

Custom metadata

ScienceOpen disciplines: Ophthalmology & Optometry

Keywords: prostaglandin analogue,corneal biomechanical properties,glaucoma,corvis st

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ScienceOpen disciplines: Ophthalmology & Optometry

Keywords: prostaglandin analogue, corneal biomechanical properties, glaucoma, corvis st

The changes of corneal biomechanical properties with long-term treatment of prostaglandin analogue measured by Corvis ST

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Abstract

Background

Methods

Results

Conclusions

Related collections

Karger: Ophthalmology

Most cited references 28

Central corneal thickness and corneal hysteresis associated with glaucoma damage.

Factors influencing optic nerve head biomechanics.

Corneal deformation measurement using Scheimpflug noncontact tonometry.

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