Cornea biomechanical analysis with Brillouin microscopy

使用布里渊显微镜进行角膜生物力学分析

• 批准号: 10333338
• 负责人: James Bradley Randleman
• 金额: $ 38.62万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-02-01 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10333338
• 关键词: 3-Dimensional; Address; Air; Behavior; Biomechanics; Blindness; Clinic; Clinical; Cornea; Corneal Diseases; Cross-Sectional Studies; Data; Development; Diagnosis; Disease; Early identification; Elasticity; Elements; Equilibrium; Evaluation; Eye; Failure; Feedback; Goals; Imaging Techniques; In Vitro; Incidence; Individual; Keratoconus; Keratoplasty; Knowledge; Laser In Situ Keratomileusis; Lasers; Lead; Longitudinal Studies; Maps; Measurement; Measures; Mechanics; Microscopy; Modeling; Modulus; Morphology; Myopia; Operative Surgical Procedures; Optics; Outcome; Pathological Dilatation; Patients; Photorefractive Keratectomy; Physical shape; Plant Roots; Population; Postoperative Period; Procedures; Property; Public Health; Quantitative Evaluations; Research; Resolution; Risk; Role; Safety; Severities; Shapes; Surgical complication; Techniques; Technology; Testing; Thick; Time; Tissue Sample; Treatment Protocols; Treatment outcome; Validation; Vision; base; biomechanical test; clinical practice; clinical translation; clinically relevant; computer studies; crosslink; improved; in vivo; mechanical properties; novel; predictive modeling; pressure; programs; response; safety outcomes; screening; surgical risk; treatment planning; young adult

PROJECT SUMMARY: Keratoconus and related corneal ectasias are a major cause of vision loss in young adults, the primary concern during refractive surgery screening to treat myopia, and the leading indication for corneal transplantation in the US. These conditions are known to be triggered by the disruption of the mechanical balance between corneal strength and intraocular outward pressure, which can occur naturally in ectatic disorders or can be triggered by refractive surgery procedures. While it is critical to identify weakened (ectatic) corneas at their earliest time point, current imaging techniques are unable to do that, as they only assess corneal morphology (shape) and not corneal biomechanics. This leaves doctors and patients with limited information when diagnosing keratoconus, or when planning surgeries. To overcome current corneal screening limitations, we have developed an optical technology, Brillouin microscopy, which can measure corneal stiffness at high 3- dimensional resolution without contacting or perturbing the eye. The overall goal of this research program is to improve diagnosis and management of corneal ectatic disorders and to improve the safety and outcome of refractive surgery procedures by introducing novel biomechanical profiling of the cornea. Our central hypothesis is that spatially localized changes in mechanical properties of the cornea are critical drivers of the morphological behavior observed in the clinic. This hypothesis is driven by strong preliminary data showing remarkable region dependent changes in ectatic corneas in vivo. The proposed research will pursue three specific aims: 1) Validate Brillouin measurements for mechanical evaluation of the cornea; 2) Characterize focal Brillouin modulus changes in subclinical keratoconus; 3) Determine the mechanical impact of refractive surgery and cross-linking procedures on the cornea. The research is significant because elasticity-based metrics will enable early identification of corneal ectasia patients when treatments are maximally beneficial, proper screening of individuals at risk of developing post-operative ectasia that might otherwise undergo LASIK, and objective assessment of the mechanical degradation involved with refractive procedures. Ultimately, the knowledge gained from this research is likely to lead to the development of individualized refractive surgery and cross-linking treatment plans based on the patient's underlying biomechanical status.

项目概要： 圆锥角膜和相关的角膜扩张是年轻人视力丧失的主要原因， 在屈光手术筛选治疗近视，并在角膜移植的主要适应症， 我们已知这些病症是由角膜间的机械平衡的破坏引发的。 强度和眼内向外压，这可以在扩张性疾病中自然发生，也可以由 屈光手术。虽然尽早识别弱化（扩张）的角膜至关重要 目前的成像技术无法做到这一点，因为它们只能评估角膜形态（形状）， 而不是角膜生物力学。这使得医生和患者在诊断时信息有限 圆锥角膜或计划手术时。为了克服目前角膜筛查的局限性，我们 开发了一种光学技术，布里渊显微镜，可以测量角膜硬度在高3- 在不接触或干扰眼睛的情况下实现三维分辨率。该研究项目的总体目标是 改善角膜扩张性疾病的诊断和管理，并改善 通过引入新的角膜生物力学轮廓来进行屈光手术。我们的中央 假设是角膜的机械性质的空间局部化变化是角膜变形的关键驱动因素。 在临床上观察到的形态学行为。这一假设是由强有力的初步数据驱动的， 在体内扩张角膜中的显著区域依赖性变化。该研究计划将继续 三个具体目标：1）用于角膜机械评估的布里渊测量; 2） 表征亚临床圆锥角膜的局灶布里渊模量变化; 3）确定机械冲击 角膜的屈光手术和交联手术。这项研究意义重大，因为 基于弹性的度量将使得能够在治疗时早期识别角膜扩张患者， 最大限度地受益，对有发生术后扩张风险的个体进行适当筛查， 否则接受LASIK，并客观评估与屈光相关的机械退化 程序.最终，从这项研究中获得的知识可能会导致 个性化屈光手术和基于患者基础的交叉治疗计划 生物力学状态