Corneal Biomechanics in Ocular Disease

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ABSTRACT The purpose of the proposed renewal is to add a longitudinal component for the purpose of generating risk models to predict progression in ocular diseases that include biomechanical metrics established at baseline. A novel metric of Corneal Contribution to Stress was developed at baseline that represents long-term adaptation to asymmetric biomechanical properties in keratoconus which we propose will predict progression over the follow-up period. An additional metric of cornea compressibility will be included in the progression model. In Diabetes without retinopathy, we propose that scleral stiffness will predict development of diabetic retinopathy during the follow-up period, and that increased scleral stiffness is a cumulative indicator of long-term hyperglycemia which we attribute to the formation of non- enzymatic cross-links in the sclera. Hemoglobin A1c will be included in the model as a discrete indicator of hyperglycemia. Finally, we propose to add elastic and viscoelastic biomechanical metrics to the risk model from the Ocular Hypertension Treatment Study to predict the conversion from ocular hypertension to glaucoma. Elastic parameters include corneal stiffness and scleral stiffness, and the viscoelastic parameter is corneal hysteresis. Once completed, these risk models can be translated to the clinic as new tools to aid in the management of multiple ocular conditions. .