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Diagnosis and management of corneal conditions based on its response to dynamic excitation by an external air puff


Project Description

This position will remain open until a suitable candidate has been found.

Keratoconus is a genetic condition that affects cornea’s microstructure and leads to progressive distortion in corneal surface and loss of clear vision. Early diagnosis of keratoconus (KC) is essential to stop geometric deterioration of corneal surface and maintain a good level of vision clarity. While it is relatively easy to diagnose moderate and severe KC through the associated surface distortion, it is difficult to identify the condition in its early stages where the cornea has undergone significant reductions in stiffness but has not yet experienced surface distortion. This project will use corneal deformation under the dynamic action of an external air puff to determine if the cornea has suffered from notable and local stiffness reductions. The project will start from the observation that stiffness reductions lead to deformation increases, and that these deformations will be asymmetric (due to the usual eccentric form of KC) and will be accompanied by larger longitudinal and lateral vibrations than what would be expected in healthy eyes. Additionally, the project aims to use the deformation and vibration profiles to locate the edge of the region in which the cornea’s stiffness has been affected. This outcome will have significant benefits in customising the cross-linking treatment commonly used in keratoconus patients to increase tissue stiffness and halt the disease progression. Knowing the level of stiffness reduction and the region over which this reduction has taken place will enable use or correct magnitude of cross-linking irradiation at the correct region. The project will rely on numerical modelling (using the finite element method) followed by experimental and clinical validation.

Funding Notes

Student will need to cover their own tuition fees and living expenses, research consumables costs will be covered by the research group.

References

Tian, L., Huang, Y.F., Wang, L.Q., Bai, H., Wang, Q., Jiang, J.J., Wu, Y. and Gao, M., 2014. Corneal biomechanical assessment using corneal visualization scheimpflug technology in keratoconic and normal eyes. Journal of ophthalmology, 2014.
Ali, N.Q., Patel, D.V. and McGhee, C.N., 2014. Biomechanical responses of healthy and keratoconic corneas measured using a noncontact scheimpflug-based tonometer. Investigative ophthalmology & visual science, 55(6), pp.3651-3659.
Tian, L., Ko, M.W., ke Wang, L., ying Zhang, J., jie Li, T., fei Huang, Y. and ping Zheng, Y., 2014. Assessment of ocular biomechanics using dynamic ultra high-speed Scheimpflug imaging in keratoconic and normal eyes. Journal of refractive surgery, 30(11), pp.785-791.
Vinciguerra, R., Ambrósio, R., Elsheikh, A., Roberts, C.J., Lopes, B., Morenghi, E., Azzolini, C. and Vinciguerra, P., 2016. Detection of keratoconus with a new biomechanical index. Journal of Refractive Surgery, 32(12), pp.803-810.
Ambrósio, R., Lopes, B.T., Faria-Correia, F., Salomão, M.Q., Bühren, J., Roberts, C.J., Elsheikh, A., Vinciguerra, R. and Vinciguerra, P., 2017. Integration of Scheimpflug-based corneal tomography and biomechanical assessments for enhancing ectasia detection. Journal of Refractive Surgery, 33(7), pp.434-443.
Roberts, C.J., Mahmoud, A.M., Bons, J.P., Hossain, A., Elsheikh, A., Vinciguerra, R., Vinciguerra, P. and Ambrósio, R., 2017. Introduction of Two Novel Stiffness Parameters and Interpretation of Air Puff–Induced Biomechanical Deformation Parameters With a Dynamic Scheimpflug Analyzer. Journal of Refractive Surgery, 33(4), pp.266-273.
Eliasy, A., Chen, K.J., Vinciguerra, R., Maklad, O., Vinciguerra, P., Ambrósio, R., Roberts, C.J. and Elsheikh, A., 2018. Ex-vivo experimental validation of biomechanically-corrected intraocular pressure measurements on human eyes using the CorVis ST. Experimental eye research.
Chen, K.J., Joda, A., Vinciguerra, R., Eliasy, A., Sefat, S.M.M., Kook, D., Geraghty, B., Roberts, C.J. and Elsheikh, A., 2018. Clinical evaluation of a new correction algorithm for dynamic Scheimpflug analyzer tonometry before and after laser in situ keratomileusis and small-incision lenticule extraction. Journal of Cataract & Refractive Surgery.

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