In vivo measurements of prelamina and lamina cribrosa biomechanical properties in humans

Purpose: To develop and use a custom virtual fields method (VFM) to assess the biomechanical properties of human prelamina and lamina cribrosa (LC) in vivo. Methods: Clinical data of 20 healthy, 20 ocular hypertensive (OHT), 20 primary open-angle glaucoma, and 16 primary angle-closure glaucoma eyes were analyzed. For each eye, the intraocular pressure (IOP) and optical coherence tomography (OCT) images of the optic nerve head (ONH) were acquired at the normal state and after acute IOP elevation. The IOP-induced deformation of the ONH was obtained from the OCT volumes using a three-dimensional tracking algorithm and fed into the VFM to extract the biomechanical properties of the prelamina and the LC in vivo. Statistical measurements and P values from the Mann-Whitney-Wilcoxon tests were reported. Results: The average shear moduli of the prelamina and the LC were 64.2 ± 36.1 kPa and 73.1 ± 46.9 kPa, respectively. The shear moduli of the prelamina of healthy subjects were significantly lower than those of the OHT subjects. Comparisons between healthy and glaucoma subjects could not be made robustly due to a small sample size. Conclusions: We have developed a methodology to assess the biomechanical properties of human ONH tissues in vivo and provide preliminary comparisons in healthy and OHT subjects. Our proposed methodology may be of interest for glaucoma management

In Vivo 3-Dimensional Strain Mapping of the Optic Nerve Head Following Intraocular Pressure Lowering by Trabeculectomy

International audiencePurpose: To map the 3-dimensional (3D) strain of the optic nerve head (ONH) in vivo after intraocular pressure (IOP) lowering by trabeculectomy (TE) and to establish associations between ONH strain and retinal sensitivity.Design: Observational case series.Participants: Nine patients with primary open-angle glaucoma (POAG) and 3 normal controls.Methods: The ONHs of 9 subjects with POAG (pre-TE IOP: 25.3 +/- 13.9 mmHg; post-TE IOP: 11.8 +/- 8.6 mmHg) were imaged (1 eye per subject) using optical coherence tomography (OCT) (Heidelberg Spectralis, Heidelberg Engineering GmbH, Heidelberg, Germany) before ( 0.05), suggesting biomechanical variability across subjects. The LC displaced posteriorly, anteriorly, or not at all. Furthermore, we found linear associations between retinal sensitivity and LC effective strain relief (P < 0.001; high strain relief associated with low retinal sensitivity).Conclusions: We demonstrate that ONH displacements and strains can be measured in vivo and that TE can relieve ONH strains. Our data suggest a wide variability in ONH biomechanics in the subjects examined in this study. We further demonstrate associations between LC effective strain relief and retinal sensitivity

Spectrally encoded extended source optical coherence tomography

We have developed an extended source optical coherence tomography (SEES-OCT) technique in an attempt to improve signal strength for ophthalmic imaging. A line illumination with a visual angle of 7.9 mrad is produced by introducing a dispersive element in the infinity space of the sample arm. The maximum permissible exposure (MPE) of such an extended source is 3.1 times larger than that of a ‘standard’ point source OCT, which corresponds to sensitivity improvement of 5-dB. The advantage of SEES-OCT in providing superior penetration depth over a point source system is demonstrated using swine eye tissues ex vivo.NMRC (Natl Medical Research Council, S’pore)Accepted versio