Dynamic topography analysis of the cornea and its application to the diagnosis of keratoconus

XueFei Li; ShengLong Luo; Zheng Wang; YuanYuan Miao; ManMan Zhu; XiaoBo Zheng; GuoXin Luo; FangJun Bao; ShiHao Chen; JunJie Wang

doi:10.1016/j.compbiomed.2023.106800

Dynamic topography analysis of the cornea and its application to the diagnosis of keratoconus

Comput Biol Med. 2023 May:158:106800. doi: 10.1016/j.compbiomed.2023.106800. Epub 2023 Mar 21.

Authors

XueFei Li¹, ShengLong Luo¹, Zheng Wang¹, YuanYuan Miao¹, ManMan Zhu¹, XiaoBo Zheng¹, GuoXin Luo², FangJun Bao³, ShiHao Chen⁴, JunJie Wang⁵

Affiliations

¹ National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China; National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China; NMPA Key Laboratory for Clinical Research and Evaluation of Medical Devices and Drug for Ophthalmic Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
² Department of Ophthalmology, Nanyang First People's Hospital Affiliated to Henan University, Nanyang, 473000, China.
³ National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China; National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China; NMPA Key Laboratory for Clinical Research and Evaluation of Medical Devices and Drug for Ophthalmic Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China. Electronic address: bfjmd@126.com.
⁴ National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China; National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China; NMPA Key Laboratory for Clinical Research and Evaluation of Medical Devices and Drug for Ophthalmic Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China. Electronic address: csh@eye.ac.cn.
⁵ National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China; National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China; NMPA Key Laboratory for Clinical Research and Evaluation of Medical Devices and Drug for Ophthalmic Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China. Electronic address: junjie.wang@wmu.edu.cn.

PMID: 36966554
DOI: 10.1016/j.compbiomed.2023.106800

Abstract

Propose: To establish a dynamic topography analysis method which simulates the dynamic biomechanical response of the cornea and reveals the variations of such response within the corneal surface, and thereafter to propose and clinically evaluate new parameters for the definite diagnosis of keratoconus.

Methods: 58 normal (Normal) and 56 keratoconus (KC) subjects were retrospectively included. Personalized corneal air-puff model was established using corneal topography data by Pentacam for each subject, and the dynamic deformation under air-puff loading was simulated using finite element method, which then enabled calculations of corneal biomechanical parameters of the entire corneal surface along any meridian. Variations in these parameters across different meridians and between different groups were explored by two-way repeated measurement analysis of variance. New dynamic topography parameters were proposed as the range of the calculated biomechanical parameters within the entire corneal surface, and the AUC of ROC curve was used to compare the diagnostic efficiency of newly proposed and existing parameters.

Results: Corneal biomechanical parameters measured in different meridians varied significantly which were more pronounced in KC group due to its irregularity in corneal morphology. Considering such between-meridian variations thus led to improved diagnostic efficiency of KC as presented by the proposed dynamic topography parameter rIR with an AUC of 0.992 (sensitivity: 91.1%, specificity: 100%), significantly better than the current topography and biomechanical parameters.

Conclusions: The diagnosis of keratoconus may be affected by the significant variations of corneal biomechanical parameters due to corneal morphology irregularity. By considering such variations, the current study established the dynamic topography analysis process which benefits from the high accuracy of (static) corneal topography measurement while improving its diagnosis capacity. The proposed dynamic topography parameters, especially the rIR parameter, showed comparable or better diagnostic efficiency for KC than existing topography and biomechanical parameters, which can be of great clinical significance for clinics without access to instrument for biomechanical evaluations.

Keywords: Corneal topography; Dynamic deformation; Keratoconus; Numerical simulation; Ocular biomechanics.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Biomechanical Phenomena
Cornea
Corneal Topography / methods
Humans
Keratoconus* / diagnosis
ROC Curve
Retrospective Studies