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New Trends in Ocular Imaging for Corneal Diseases Diagnosis

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: closed (15 December 2021) | Viewed by 19556

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Special Issue Editors

Prof. Dr. Francisco Cavas Martínez

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Department of Structures, Construction and Graphic Expression, Technical University of Cartagena, 30202 Cartagena, Spain
Interests: design, computational modeling, and simulation; CAD, CAE, CAM, and BIM; geometric modeling and analysis; creativity and sustainability; innovative design; additive manufacturing; biomechanical engineering; engineering methods in human-related applications; biomedical engineering; big data and artificial intelligence; digital manufacturing for industry 4.0
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Prof. Dr. David Piñero

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Department of Optics, Pharmacology and Anatomy, University of Alicante, 03690 Alicante, Spain
Interests: cornea; refractive surgery; cataract; ocular surface; ocular imaging
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Prof. Dr. Jorge L. Alió del Barrio

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Faculty of Medicine (Ophthalmology) at Miguel Hernández University & Cornea, Cataract and Refractive Surgery unit, Vissum Miranza, Alicante, Spain
Interests: cornea; refractive surgery; cataract; ocular surface; ocular imaging

Special Issue Information

Dear Colleagues,

Corneal diseases are among the main causes of blindness and visual impairment in the general population. Vision loss can have a devastating impact on affected people, causing high social and economic burden. Corneal diseases can be congenital/hereditary or acquired with a great variety of clinical manifestations that can be detected with the latest technologies advances in imaging analysis of the corneal structure. The pathophysiological characteristics of these diseases may vary significantly, leading to different patterns of progression over time that have been mathematically chracterized in most of cases. In the end, these processes cause vision impairment or loss.

Although much remains to be discovered about the causes of different corneal pathologies, the idea that new diagnostic and therapeutic approaches are needed to provide substantial benefits has been established in recent years. Researchers are indeed actively studying corneal pathologies with a variety of ocular imaging techniques to identify common pathogenetic mechanisms and to evaluate the effectiveness of treatments.

In this Special Issue, we are collecting reviews or original papers including new findings in the field of corneal diseases. New and original studies highlighting molecular mechanisms involved in the pathogenesis of corneal disorders, new diagnostic criteria according to the latest technologies, new mathematical approaches to analyze the corneal structure and its changes as well as new treatment possibilities, will be welcome. The aim is to broaden the knowledge of the diagnostic and therapeutic methods that may be used in the detection, diagnosis and treatment of corneal diseases.

This Special Issue will publish original contributions related but not limited to the topics described in the keywords.

Prof. Dr. Francisco Cavas Martínez
Prof. Dr. David Piñero
Prof. Dr. Jorge L. Alió del Barrio
Guest Editors

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Keywords

Cornea
Corneal tomography
Keratoconus
Corneal ectasia
Corneal topography
Corneal biomechanics
Refractive surgery
Intracorneal rings
Corneal collagen cross-linking
Numerical simulation
Intraocular pressure

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Published Papers (7 papers)

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Research

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10 pages, 1007 KiB

Open AccessArticle

Optical Impact of Corneal Clearance in Healthy Eyes Fitted with Scleral Contact Lenses: A Pilot Study

by María Villa, Francisco Cavas and David P. Piñero

J. Clin. Med. 2022, 11(12), 3424; https://doi.org/10.3390/jcm11123424 - 14 Jun 2022

Cited by 3 | Viewed by 2028

Abstract

This pilot study was conducted to evaluate the effect on refraction and optical quality of the increase in the corneal clearance after fitting a specific model of scleral contact lens (ScCL) in healthy subjects. A total of 15 eyes from 15 subjects were enrolled in the study, with evaluation of refraction, ocular aberrations and central corneal clearance with the same model of ScCL (ICD Toric, Paragon Vision Science, Gilbert, AZ, USA), but using 3 different sagittal heights: 4200, 4500 and 4800 µm. Mean values of corneal clearance for each ScCL fitted were 418.1 ± 112.1, 706.5 ± 120.3 and 989.9 ± 117.0 µm, respectively. Significant changes were detected in the spherical equivalent and high-order aberrations, especially coma and spherical aberration, when fitting ScCLs of increasing sagittal heights compared to the pre-fitting values. In conclusion, the increase in central corneal clearance when fitting ScCLs affects refraction, leading to a more myopic refractive error, and inducing an increase in different ocular HOAs. This should be considered when fitting ScCLs, especially multifocal designs. Full article

(This article belongs to the Special Issue New Trends in Ocular Imaging for Corneal Diseases Diagnosis)

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11 pages, 14757 KiB

Open AccessArticle

Effect of Pterygium Removal Combined with Conjunctival Autograft on Corneal Parameters in Swept-Source Imaging

by Marta P. Wiącek, Monika Kuśmierz-Wojtasik, Bogna Kowalska and Anna Machalińska

J. Clin. Med. 2022, 11(2), 329; https://doi.org/10.3390/jcm11020329 - 10 Jan 2022

Cited by 4 | Viewed by 2057

Abstract

Background: Both pterygium ingrowth and excision determine alterations in corneal topography. The aim of this study was to evaluate the influence of pterygium removal combined with conjunctival autografts in addition to the use of human fibrin tissue glue on changes in corneal parameters as measured by 3-D swept-source anterior segment optical coherence tomography (AS-OCT) imaging. Methods: Sixteen eyes (16 patients) with pterygium that qualified for surgical treatment were enrolled in this study. Eye examination, slit lamp, and 3-D AS-OCT (CASIA 2) assessment were performed before the surgery and 7 days, 1 month, and 6 months after pterygium excision. Topographic parameters of both anterior and posterior surfaces of the cornea were analysed at each follow-up visit. Results: The gradual decrease in total astigmatism power from preoperative median 2.75 (6.15) D to 1.2 (1.1) D at 6-month follow-up (p = 0.034) was noted from the day 7 visit. Values were strongly influenced by variations of anterior cornea astigmatism. In contrast, a gradual total HOA reduction at the 1-month (from median 0.79 (1.3) D to 0.44 (0.27) D; p = 0.038) and at 6-month visits (0.25 (0.09); p = 0.001) was observed. Similarly, values were strongly influenced by variations of the anterior. Additionally, total average keratometry values increased from preoperative 44.05 (2.25) D to 44.6 (1.9) (p = 0.043) 1 month after the surgery. Conclusions: Significant steepening of the anterior cornea and a reduction in both astigmatism and HOA were observed after pterygium excision. The anterior corneal surface was an essential component of the total postoperative corneal topography values. Three-dimensional swept-source AS-OCT imaging seems to be a valuable tool for monitoring both the progression of the disease and postoperative effects in pterygium eyes. Full article

(This article belongs to the Special Issue New Trends in Ocular Imaging for Corneal Diseases Diagnosis)

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5 pages, 539 KiB

Open AccessArticle

Evaluation of Demarcation Line after Epithelium-Off Iontophoresis Corneal Collagen Cross-Linking for Progressive Keratoconus

by Francesco D’Oria, Pasquale Puzo, Cosimo Incandela, Alessandra Sborgia, Samuele Gigliola, Francesco Boscia and Giovanni Alessio

J. Clin. Med. 2021, 10(15), 3295; https://doi.org/10.3390/jcm10153295 - 26 Jul 2021

Cited by 1 | Viewed by 2234

Abstract

The aim of the study was to visualize and evaluate the characteristics and depth of the demarcation line with anterior segment optical coherence tomography (AS-OCT) after epithelium-off iontophoresis corneal collagen cross-linking (epi-off I-CXL). In this prospective, consecutive, single center study 18 eyes of 18 patients with keratoconus were involved. One month after epi-off I-CXL, all the patients underwent an AS-OCT scan to search for a demarcation line and its characteristics. The corneal stromal demarcation line was identified in all the eyes. Mean depth of the corneal stromal demarcation line was 261.8 ± 46.7 μm (range: 184 to 362 μm), at 56.7 ± 12% corneal depth. In conclusion, epi-off I-CXL determines a demarcation line that can be visualized with AS-OCT, which seems clearly distinguishable and similar to that created in standard CXL. Full article

(This article belongs to the Special Issue New Trends in Ocular Imaging for Corneal Diseases Diagnosis)

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15 pages, 2580 KiB

Open AccessArticle

Forecasting Progressive Trends in Keratoconus by Means of a Time Delay Neural Network

by Marta Jiménez-García, Ikram Issarti, Elke O. Kreps, Sorcha Ní Dhubhghaill, Carina Koppen, David Varssano, Jos J. Rozema and on behalf of The REDCAKE Study Group

J. Clin. Med. 2021, 10(15), 3238; https://doi.org/10.3390/jcm10153238 - 22 Jul 2021

Cited by 12 | Viewed by 3800

Abstract

Early and accurate detection of keratoconus progression is particularly important for the prudent, cost-effective use of corneal cross-linking and judicious timing of clinical follow-up visits. The aim of this study was to verify whether a progression could be predicted based on two prior tomography measurements and to verify the accuracy of the system when labelling the eye as stable or suspect progressive. Data from 743 patients measured by Pentacam (Oculus, Wetzlar, Germany) were available, and they were filtered and preprocessed to data quality needs. The time delay neural network received six features as input, measured in two consecutive examinations, predicted the future values, and determined the classification (stable or suspect progressive) based on the significance of the change from the baseline. The system showed a sensitivity of 70.8% and a specificity of 80.6%. On average, the positive and negative predictive values were 71.4% and 80.2%. Including data of less quality (as defined by the software) did not significantly worsen the results. This predictive system constitutes another step towards a personalized management of keratoconus. While the results obtained were modest and perhaps insufficient to decide on a surgical procedure, such as cross-linking, they may be useful to customize the timing for the patient’s next follow-up. Full article

(This article belongs to the Special Issue New Trends in Ocular Imaging for Corneal Diseases Diagnosis)

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8 pages, 240 KiB

Open AccessArticle

Analysis of Corneal Distortion after Myopic PRK

by Michele Lanza, Luigi De Rosa, Sandro Sbordone, Rosa Boccia, Ugo Antonello Gironi Carnevale and Francesca Simonelli

J. Clin. Med. 2021, 10(1), 82; https://doi.org/10.3390/jcm10010082 - 28 Dec 2020

Cited by 3 | Viewed by 1793

Abstract

The purpose of the study is to evaluate the corneal biomechanical properties (CBP) and their behaviors after myopic refractive surgery both with Ocular Response Analyzer (ORA) and Corvis ST (CST). This retrospective study included 145 eyes of 145 patients with a mean age of 33.13 ± 9.24 years, who underwent myopic photorefractive keratectomy (PRK) for a refractive defect, measured as spherical equivalent, of mean −4.69 ± 2.04 D and have been evaluated before surgery and at 1, 3 and 6 months follow-up. Corneal hysteresis (CH) and corneal resistance factor (CRF) values significantly decreased after 1 month and remained statistically stable during further follow-ups. CST parameters had a different evolution: only second applanation time (AT2) differences showed a significant variation after 1 month that did not statistically change over time. Highest concavity deformation amplitude (HCDA), highest concavity peak distance (HCPD), first applanation time (AT1) and velocity (AV1) showed continuous significant differences both after 3 and after 6 months. This study suggests that after central surface ablation surgery, such as myopic PRK, corneal shape is remodeling, and its deformation parameters are going to change even at 6 months follow-up. This indicates that it should be important to evaluate refractive surgery patients during a longer follow-up because this could allow earlier diagnosis and better management of late-onset complications. Full article

(This article belongs to the Special Issue New Trends in Ocular Imaging for Corneal Diseases Diagnosis)

11 pages, 874 KiB

Open AccessArticle

Relationship between Tube Parameters and Corneal Endothelial Cell Damage after Ahmed Glaucoma Valve Implantation: A Comparative Study

by Han Min Lee, Kyoung Nam Kim, Kee Sup Park, Nam Ho Lee, Sung Bok Lee and Chang-Sik Kim

J. Clin. Med. 2020, 9(8), 2546; https://doi.org/10.3390/jcm9082546 - 6 Aug 2020

Cited by 10 | Viewed by 2731

Abstract

Purpose: We compared the clinical factors, including anterior chamber tube parameters, in patients with and without corneal endothelial cell damage after Ahmed glaucoma valve (AGV) implantation. Methods: In this retrospective and comparative case series, patients who underwent AGV implantation were enrolled consecutively. Serial specular microscopy was performed before and after AGV implantation. Patients were divided into two groups depending on whether there was a significant decrease in corneal endothelial cell density (ECD), which was determined by each patient’s rate of ECD change (%/year), calculated using linear regression analyses. Tube parameters such as the tube-cornea distance (TCD) and tube-cornea angle (TCA) were measured with anterior segment optical coherence tomography. Clinical factors related to the rate of ECD change were evaluated with regression analyses and compared between the two groups. The tipping point at which tube parameters became significantly associated with the rate of ECD change was identified with broken stick regression analyses. Results: There were 30 eyes (32.3%) with ECD damage (group 1) and 63 eyes (67.7%) without damage (group 2). The mean rate of ECD change (%/year) was −18.82 ± 22.97 and 2.14 ± 2.93 in groups 1 and 2, respectively (p < 0.001). The TCA was the only clinical factor associated with the rate of ECD change (regression coefficient, β = 1.254, p < 0.001). The tipping point in the TCA was 26.70° (95% confidence interval, CI: 23.75–29.64°). The mean TCD (mm) was 0.98 ± 0.38 and 1.26 ± 0.39 (p = 0.002), and the mean TCA (degrees) was 28.67 ± 7.79 and 36.35 ± 5.35 (p < 0.001) in groups 1 and 2, respectively. Conclusions: A wider TCA was protectively associated with the rate of ECD change, and the TCA was significantly narrower in patients with ECD damage. When inserting a tube into the anterior chamber, surgeons should therefore try to secure a wide TCA of about 30°. In patients with a narrow TCA after AGV implantation, increased attention should be directed toward whether ECD decreases continuously. Full article

(This article belongs to the Special Issue New Trends in Ocular Imaging for Corneal Diseases Diagnosis)

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Review

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9 pages, 8442 KiB

Open AccessReview

The Value of Anterior Segment Optical Coherence Tomography in Different Types of Corneal Infections: An Update

by Ahmed A. Abdelghany, Francesco D’Oria, Jorge Alio Del Barrio and Jorge L. Alio

J. Clin. Med. 2021, 10(13), 2841; https://doi.org/10.3390/jcm10132841 - 27 Jun 2021

Cited by 8 | Viewed by 3595

Abstract

Anterior segment optical coherence tomography (AS-OCT) is a modality that uses low-coherence interferometry to visualize and assess anterior segment ocular features, offering several advantages of being a sterile and noncontact modality that generates high-resolution cross-sectional images of the tissues. The qualitative and quantitative information provided by AS-OCT may be extremely useful for the clinician in the assessment of a wide spectrum of corneal infections, guiding in the management and follow-up of these patients. In clinical practice, infections are routinely evaluated with slit-lamp biomicroscopy, an examination and imaging modality that is limited by the physical characteristics of light. As a consequence, the depth of pathology and the eventually associated corneal edema cannot be accurately measured with the slit-lamp. Therefore, it represents a limit for the clinician, as in vivo information about corneal diseases and the response to treatment is limited. Resolution of corneal infection is characterized by an early reduction in corneal edema, followed by a later reduction in infiltration: both parameters can be routinely measured with standardized serial images by AS-OCT. Full article

(This article belongs to the Special Issue New Trends in Ocular Imaging for Corneal Diseases Diagnosis)

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