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Subclinical Keratoconus Detection and Characterization Using Motion-Tracking Brillouin Microscopy.
J Bradley Randleman1, Hongyuan Zhang2, Lara Asroui2
1Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio.
Ophthalmology
|October 15, 2023
Summary
Motion-tracking Brillouin microscopy effectively detects subtle biomechanical changes in subclinical keratoconus (SKC). This advanced technique accurately differentiates SKC eyes from healthy controls, outperforming traditional Scheimpflug tomography methods.
Area of Science:
- Ophthalmology
- Biomedical Optics
- Corneal Biomechanics
Background:
- Subclinical keratoconus (SKC) presents diagnostic challenges due to minimal early changes.
- Accurate detection of SKC is crucial for timely intervention and preventing vision loss.
Purpose of the Study:
- To utilize motion-tracking (MT) Brillouin microscopy for characterizing focal biomechanical alterations in SKC.
- To assess the efficacy of MT Brillouin metrics in distinguishing SKC eyes from normal control eyes.
Main Methods:
- A prospective cross-sectional study involving 30 eyes (15 SKC, 15 controls).
- Corneal biomechanics assessed using custom MT Brillouin microscopy and Scheimpflug tomography.
- Analysis of MT Brillouin values (plateau and anterior 150 μm) and Scheimpflug metrics (e.g., Kmax, thinnest corneal thickness, IS value).
- Receiver operating characteristic (ROC) curve analysis to determine diagnostic performance (AUC, sensitivity, specificity).
Main Results:
- MT Brillouin metrics demonstrated significant differences between SKC and control eyes (P < 0.0001 for all plateau and anterior 150 μm metrics).
- All MT Brillouin metrics achieved perfect discrimination (AUC = 1.0).
- Scheimpflug metrics showed significant differences for thinnest corneal thickness, IS value, IVA, and keratoconus index, but with lower AUC values (best: keratoconus index, AUC = 0.91).
Conclusions:
- MT Brillouin microscopy effectively characterizes focal corneal biomechanical changes in SKC.
- MT Brillouin metrics provide superior differentiation of SKC eyes compared to conventional Scheimpflug tomography.
- This technology offers a promising tool for early and accurate SKC diagnosis.
