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Motion-Tracking Brillouin Microscopy for Keratoconus Suspect Identification: Comparison With Multimodal Corneal
Hongyuan Zhang1, Bassel Hammoud1, Bianca N Susanna2
1From the Cole Eye Institute (H.Z., B.H., B.N.S., B.A.L.D., J.B.R.), Cleveland Clinic, Cleveland, Ohio, USA.
American Journal of Ophthalmology
|February 27, 2026
Summary
Motion-tracking Brillouin microscopy excels at identifying keratoconus suspects by detecting focal corneal weakening. This advanced technique significantly outperforms other imaging methods in distinguishing between keratoconus suspect and normal eyes.
Area of Science:
- Ophthalmology
- Biomedical Optics
- Medical Imaging
Background:
- Keratoconus suspect (KCS) identification relies on accurate diagnostic tools.
- Multimodal corneal imaging is currently used, but novel methods are needed for improved efficacy.
Purpose of the Study:
- To compare the diagnostic performance of motion-tracking (MT) Brillouin microscopy against established multimodal corneal imaging techniques for KCS identification.
Main Methods:
- A prospective, cross-sectional study evaluated 56 eyes (28 KCS, 28 controls).
- Techniques included MT Brillouin microscopy, Scheimpflug tomography, AS-OCT, and Corvis ST.
- Sensitivity, specificity, and AUROC were calculated for all modalities.
Main Results:
- MT Brillouin metrics (MTB-min and MTB-mean) demonstrated superior diagnostic performance compared to all multimodal imaging metrics.
- MTB-min achieved 100% sensitivity and 96% specificity (AUC=0.999), outperforming indices like TBI, PRFI, KI, and IHD.
- Epithelial metrics showed poor performance in differentiating groups.
Conclusions:
- Motion-tracking Brillouin microscopy effectively identifies focal corneal weakening in KCS.
- MT Brillouin microscopy significantly outperforms current multimodal imaging techniques in differentiating KCS from normal eyes.
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