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Traditional applanation tonometry techniques lack the necessary accuracy and reliability for measuring the intraocular pressure (IOP), and there is still a need for a reliable technique for in vivo diagnosis. A single laser-induced cavitation bubble event was optically monitored in order to precisely measure the first collapse time of the cavitation bubble, which presents a direct dependence on the liquid pressure. This can certainly be done within the IOP range. We now extend the partial transmittance modulation (STM) technique to determine its feasibility for directly measuring the IOP by studying the nanosecond (ns) pulsed laser-induced cavitation bubble dynamics for an externally pressurized fresh ex vivo porcine eye. The results demonstrate that it is possible to monitor the IOP by detecting the light of a continuous-wave (CW) laser beam which is intensity modulated by the bubble itself. This technique currently presents a measurement resolution of about 4 mmHg in the 5 to 50 mmHg pressure range, indicating the feasibility of this approach for measuring IOP. This technique provides a direct measurement within the anterior eye chamber, avoiding common pitfalls in IOP diagnosis, such as errors due to patient movement, varying physical properties of the eye globe, or central cornea thickness (CCT) effects. [ABSTRACT FROM AUTHOR]

Featured Application: Characterization of the corneal nerve fibers is gaining popularity for objective assessment of anterior segment anomalies such as dry eye disease. Confocal microscopy provides high-resolution imaging of the sub-basal plexus; thus, several parameters such as corneal length, density or tortuosity can be analyzed. However, the analysis of these images is usually performed based on manual or semiautomated methods, many of which are subjective and time consuming. In this work, a fully automated tortuosity corneal nerve fiber analysis method is proposed. This new tool may be very useful to obtain an accurate evaluation of nerve alterations, to monitor changes over time and/or in response to treatment, to ensure comparisons across different studies or even to improve the diagnosis of ocular surface diseases. An automated tool for corneal nerve fiber tortuosity quantification from in vivo confocal microscopy (IVCM) is described and evaluated. The method is a multi-stage process based on the splitting of the corneal nerve fibers into individual segments, whose endpoints are an extreme or intersection of white pixels on a binarized image. Individual segment tortuosity is quantified in terms of the arc-chord ratio. Forty-three IVCM images from 43 laser-assisted in situ keratomileusis (LASIK) surgery patients were used for evaluation. Images from symptomatic dry eye disease (DED) post-LASIK patients, with ( n = 16 ) and without ( n = 7 ) ocular pain, and non-DED post-LASIK controls ( n = 20 ) were assessed. The automated tortuosity measure was compared to a manual grading one, obtaining a moderate correlation (Spearman's rank correlation coefficient = 0.49 , p = 0.0008 ). The new tortuosity index was significantly higher in post-LASIK patients with ocular pain than in control patients ( p = 0.001 ), while no significant differences were detected with manual measurement ( p > 0.28 ). The tortuosity quantification was positively correlated with the ocular surface disease index (OSDI) and a numeric rating scale (NRS) assessing pain ( p = 0.0012 and p = 0.0051 , respectively). The results show good performance of the proposed automated methodology for the evaluation of corneal nerve tortuosity. [ABSTRACT FROM AUTHOR]

Optisol-GS is the most widely used pharmaceutical composition to preserve corneas for transplantation. This systematic review investigated the effects of different cold corneal storage media (CCSM) compared with Optisol-GS on the quality of stored corneas. The literature was searched throughout May 2022 on six databases and grey literature. Studies including corneas (population) exposed to distinct cold storage media (exposure) and Optisol-GS (comparison) that reported qualitative and/or quantitative parameters of cornea quality (outcome) were included. Methodological quality was assessed using ToxRTool. From 4520 identified studies, fourteen were included according to the eligibility criteria, comprising 769 evaluated cornea samples comparing Optisol-GS with commercial and noncommercial media. All studies showed good methodological quality. Experimental times ranged from 1–28 days, mainly using 4 °C as the preservation temperature. Viable endothelial cell density (ECD) and endothelial cell morphology (EC) were the most assessed parameters. ECD results for Cornisol were higher than Optisol-GS in 10 days (p = 0.049) and favored Cornea ColdTM up to 4 weeks (p < 0.05), which also showed better qualitative results. While the standardization of test protocols could improve comparisons, evidence indicates that most CCSM present similar performances on cornea preservation for transplantation at seven days, while some formulations may increase preservation at extended times. [ABSTRACT FROM AUTHOR]

Presenting visual information, called phosphenes, is a critical method for providing information on the position of obstacles for users of walking support tools for the visually impaired. A previous study has established a method for presenting phosphenes to the right, center, and left of the visual field. However, a method for presenting information on the position of obstacles around the feet using phosphenes, which is essential for the visually impaired, has not been clarified. Therefore, in this study, a method for presenting phosphenes in the lower visual field is presented, towards the aim of realizing a safe walking support tool. Electrode placement is proposed in this paper for the presentation of phosphenes to the right, center, and left of the lower visual field based on the electrode placement method used in the previous study, which presents the phosphene in three locations of the visual field. In addition, electric field simulation is performed, focusing on the electric field value on the eyeball surface, in order to observe whether the proposed electrode placement is able to stimulate the intended region. As a result, it is shown that the intended region on the eyeball surface can be stimulated locally with each of the proposed electrode placements. [ABSTRACT FROM AUTHOR]

Quantitative measures of radiation-induced breast stiffness are required to support clinical studies of novel breast radiotherapy regimens and exploration of personalised therapy, however, variation between shear-wave elastography (SWE) machines may limit the usefulness of shear-wave speed (cs) for this purpose. Mean cs measured in four healthy volunteers' breasts and a phantom using 2D-SWE machines Acuson S2000 (Siemens Medical Solutions) and Aixplorer (Supersonic Imagine) were compared. Shear-wave speed was measured in the skin region, subcutaneous adipose tissue and parenchyma. cs estimates were on average 2.3% greater when using the Aixplorer compared to S2000 in vitro. In vivo, cs estimates were on average 43.7%, 36.3% and 49.9% significantly greater (p << 0.01) when using the Aixplorer compared to S2000, for skin region, subcutaneous adipose tissue and parenchyma, respectively. In conclusion, despite relatively small differences between machines observed in vitro, large differences in absolute measures of shear wave speed measured were observed in vivo, which may prevent pooling of cross-machine data in clinical studies of the breast. [ABSTRACT FROM AUTHOR]

Featured Application: This manuscript presents a critical analysis of intraocular pressure (IOP) measured by Goldmann applanation tonometry (GIOP), the gold standard technique for the measurement of intraocular pressure, compared to measurements obtained by a pressure transducer inserted in the ocular anterior chamber (TIOP). Data showed significant differences between GIOP and TIOP, more evident for softer and thinner corneas and suggest GIOP should be corrected on the basis of corneal biomechanical parameters. This evidence is crucial for the detection and prevention of glaucoma as one of the main causes of irreversible blindness worldwide. Glaucoma is the second cause of irreversible blindness in the world. Intraocular pressure (IOP) is a recognized major risk factor for the development and progression of glaucomatous damage. Goldmann applanation tonometry (GAT) is internationally accepted as the gold standard for the measurement of IOP. The purpose of this study was to search for correlations between Goldmann tonometry and corneal mechanical properties and thickness by means of in vitro tests. IOP was measured by the Goldmann applanation tonometer (GIOP), and by a pressure transducer inserted in the anterior chamber of the eye (TIOP), at increasing pressure levels by addition of saline solution in the anterior chamber of enucleated pig eyes (n = 49). Mechanical properties were also determined by inflation tests. The GAT underestimated the real measurements made by the pressure transducer, with most common differences in the range 15–28 mmHg. The difference between the two instruments, highlighted by the Bland–Altman test, was confirmed by ANOVA, normality tests, and Mann–Whitney's tests, both on the data arranged for infusions and for the data organized by pressure ranges. Pearson correlation tests revealed a negative correlation between (TIOP-GIOP) and both corneal stiffness and corneal thickness. In conclusion, data obtained showed a discrepancy between GIOP and TIOP more evident for softer and thinner corneas, that is very important for glaucoma detection. [ABSTRACT FROM AUTHOR]

To establish complementary information for the diagnosis and evaluation of ocular surface diseases, we developed a multi-modal, non-invasive optical imaging platform by combining ultra-high resolution optical coherence tomography (UHR-OCT) with a microvascular imaging system based on slit-lamp biomicroscopy. Our customized UHR-OCT module achieves an axial resolution of ≈2.9 μm in corneal tissue with a broadband light source and an A-line acquisition rate of 24 kHz with a line array CCD camera. The microvascular imaging module has a lateral resolution of 3.5 μm under maximum magnification of ≈187.5× with an imaging rate of 60 frames/s, which is sufficient to image the conjunctival vessel network and record the movement trajectory of clusters of red blood cells. By combining the imaging optical paths of different modules, our customized multi-modal anterior eye imaging platform is capable of performing real-time cross-sectional UHR-OCT imaging of the anterior eye, conjunctival vessel network imaging, high-resolution conjunctival blood flow videography, fluorescein staining and traditional slit-lamp imaging on a single device. With self-developed software, a conjunctival vessel network image and blood flow videography were further analyzed to acquire quantitative morphological and hemodynamics parameters, including vessel fractal dimensions, blood flow velocity and vessel diameters. The ability of our multi-modal anterior eye imager to provide both structural and functional information for ophthalmic clinical applications was demonstrated on a healthy human subject and a keratitis patient. [ABSTRACT FROM AUTHOR]

A study to compare femto-presbyLASIK to standard myopia femto-LASIK refractive surgical correction with a total of 45 candidates was performed. The goal was to identify a more specific set of indications for presbyopia LASIK treatments. The results showed thoroughly good uncorrected visual acuity for myopia (decimal: 1.01 ± 0.15) as well as for presbyLASIK (decimal: 0.78 ± 0.17) corrections. Astigmatism was comparable in both groups and did not change significantly from preoperative (0.98D ± 0.53 SD) to postoperative (1.01D ± 0.50 SD). Our study results suggest, that presbyLASIK treatment is as safe and effective as regular LASIK myopia correction and can hence be recommended to treat presbyopia. [ABSTRACT FROM AUTHOR]

Optical coherence tomography (OCT) is a high-speed and non-contact optical imaging technology widely used for noninvasive cross-sectional imaging of biological objects. Two main OCT technologies have been developed: time domain and Fourier domain technologies. The latter can be further divided into spectral domain OCT, which uses a broadband light source and a spectrometer as a detector, and swept source OCT, which employs a quickly-rotating laser source. Advances in OCT technology have made it one of the most helpful devices in ophthalmic practice. Fourier OCT has revolutionized imaging of the posterior segment of the eye, as well as of anterior structures and has enhanced the ability to diagnose and manage patients. It provides high-resolution information about the tear film, contact lens (CL), a qualitative and quantitative assessment of the anterior eye that is important in CL fitting, and allows possible eye surface changes while wearing CLs to be monitored. Potential swept source OCT technology applications include industrial processes of lens design and quality control. In this paper, we describe clinical applications ant outline a variety of multifunctional uses of OCT in the field of refractive error correction with CLs. [ABSTRACT FROM AUTHOR]