An integrated model of the human cornea as a linear biaxial birefringent medium.

A novel model of human corneal birefringence is presented. The cornea is treated as a homogeneous biaxial linear birefringent medium in which the values of the binormal axes angle and organization of the main refractive indices vary continuously from the apex to the limbus. In its central part, the angle between binormal axes is 35°, and para centrally, it smoothly increases to 83.7°. The values of the main refractive indices (nx, ny, nz) change, as well as their order, from nx < nz < ny to nz < nx < ny. The transition between these two states was described with a normal distribution (µ = 0.45, σ = 0.1). The presented model corresponds with the experimental results presented in the literature. To our knowledge, it is the first model that presents the anisotropic properties' distributions of the entire cornea. The presented model facilitates a better understanding of the corneal birefringence phenomenon directly related to its lamellar structure.

Imaging fine structures of the human trabecular meshwork in vivo using a custom design goniolens and OCT gonioscopy.

The trabecular meshwork (TM), located within the iridocorneal angle, is a target for many glaucoma treatments aimed at controlling intraocular pressure. However, structural variations between individuals are poorly understood. We propose a newly designed gonioscopic lens optimized for high-resolution imaging to image fine structures of the human TM in vivo. The body of the new lens is index-matched to the human cornea and includes a choice of two gonioscopic mirrors (59° and 63°) and matching air-spaced doublets placed on the anterior surface of the goniolens. The new design allows a diffraction-limited image plane at the iridocorneal angle structures. The goniolens design was built and then placed on the subjects eyes coupled to the cornea with goniogel and a 3D adjustable mount. Images were obtained using a commercially available OCT device (Heidelberg Spectralis). The optical resolution was measured in a model eye as 40.32 and 45.25 cy/mm respectively for each mirror angle. In humans, dense OCT scans with minimum spacing oriented tangential to the iris and ICA were performed on 7 healthy subjects (23-73 yrs). The TM was successfully imaged in all subjects. The custom goniolens improved the contrast of the uveoscleral meshwork structures and corneoscleral meshwork revealing limbus parallel striations, not visible with previous goniolens designs. Transverse OCT images were constructed along the segmentation line, providing an enface image of the TM structures including corneoscleral beams, previously only imaged in vivo using custom adaptive optics systems.

The effect of pupil size on the measurement of corneal birefringence properties: preliminary study.

We used a partial Mueller matrix polarimeter to measure the corneal anisotropic properties at three pupil sizes (dilated, natural, and constricted). The geometrical parameters of first order isochromes were described by quadrilaterals. These parameters are statistically significantly different between the three pupil sizes. The pupillary size changes do not influence the azimuth angle distribution α. The retardation R and birefringence distributions show asymmetry in the nasal-temporal cross-section. There are differences between pupil sizes for both nasal and temporal parts of the cornea for these distributions. Iridial light scattering and diffraction might be the reason for these differences.

Does body position, age, and heart rate induce IOP's changes?

OBJECTIVES: The main goal of this research was to determine the differences between the values of intraocular pressure (IOP) in the supine and sitting positions, and to assess the effect of age and cardiovascular parameters. METHODS: Seventy-two healthy adults were enrolled and classified into age groups: 20-30 years (group A), 31-40 years (group B), and 41-71 years (group C). Corneal biometry and cardiovascular parameters, such as heart rate (HR), were measured. IOP measurements were taken in the sitting position (IOPS) and in the supine position (IOPL) using the iCare® Pro tonometer. RESULTS: A significant difference between the IOPS and IOPL in the entire cohort was found (p < 0.001). Regarding the age subgroups, a significant difference (p < 0.001) between the IOPS and IOPL was obtained in group A (2.6 ± 1.6 mmHg) and group C (1.5 ± 1.3 mmHg). There were no significant differences in the IOPS between groups. The highest IOP values were obtained for group A. The correlations between HR and IOPS are statistically significant for group A and group B, and for HR and IOPL-S for group B only. Multivariate analysis showed that HR has a significant influence on the difference in IOP in the two body positions. CONCLUSION: A statistically significant difference between the effect of age and the values of IOPS and IOPL was shown. Cardiovascular parameters showed some relevant statistical dependencies, but with a rather marginal significance in young people. The influence of body position for the measurement of IOP for healthy subjects does not seem to matter, despite the fact that there are some dependencies that are statistically significant.

In vivo measurements of corneal birefringence properties using the one-way reflective Mueller polarimetry.

This work presents the results of in vivo measurements of human corneal birefringence properties using the one-way reflective polariscope, in which the same module is used to generate and analyze the light polarization state. Data analysis was performed with the use of Mueller polarimetry techniques. The distribution of the azimuth angle and the phase retardation was determined on the paracentral and limbal areas. The results indicate growth of the phase retardation magnitude and the radial orientation of the azimuth angle in the cornea's peripheral region, which confirms our assumptions and the results presented by other researchers.

Comparative analysis of the corneal birefringence pattern in healthy children and adults.

PURPOSE: To undertake a comparative analysis of the corneal shape, thickness and isochromatics in the eyes of children and adults in order to determine the extent of similarities and differences between the cohorts. METHODS: The study involved 24 children (aged 8 years) and 37 young White adults (aged between 22-24 years) with no apparent or known health or ocular conditions. Measurements were made of corneal radius of curvature, both central (CCT) and paracentral (PCT) corneal thickness and intraocular pressure (IOP). Images of the isochromatics were captured using a slit lamp and a circular polarizer. The geometry of fringe I and II of the isochromatics was analysed. RESULTS: Statistically significant differences were found between CCT and PCT in nasal and temporal regions for both the children and adult cohorts. The same trends were observed in the radii of the cornea. Statistically significant differences between side lengths and angles of isochromatic fringes were found. No differences in asymmetry of shape for fringe I between adults and children were detected; greater symmetry was seen in fringe II in children than for adults. CONCLUSIONS: The asymmetry in corneal shape and curvature contributes to the shape of the isochromatic fringes. This is likely linked to the orientation and parameters of the collagen fibres and to the muscles' forces, and be relevant for surgical procedures such as corneal transplantation.

Birefringent properties of the cornea measured by a Mueller type polarimeter in healthy adults and children.

Mueller type polarimeter was used for in vivo measurements of the anisotropic parameters (retardation and azimuth angle) of corneas. To determine birefringence, corneal thickness was measured with a Scheimpflug camera (Corvist ST). The retardation distributions in the nasal-temporal cross-section in both children (N=7) and adults (N=38) groups occurred asymmetrical. The asymmetry in birefringence distributions was observed only in adults group. The geometrical analysis of the first order isochromes in both age groups showed the asymmetry of its shapes. The changes of symmetry in birefringent properties with age may have potential relationship with changing corneal biometry.

Polarimeter for measuring the properties of birefringent media in reflective mode.

This work presents a description of a polarimetric system for measuring the properties of birefringent media. In our reflection system the applied Stokes polarimeter acts both as a generator of the light's selected polarization states as well as a light analyzer leaving the examined medium. The method is based on six intensity distribution measurements realized in six different configurations of polarizers/analyzers: four linear and two circular ones. Thus, we have achieved parallel polariscope for linear polarizers and the crossed polariscope for circular polarizers. Such a setup can be easily applied for linearly birefringent media properties measurements including dichroic ones. This measurement setup and the measurement method were successfully tested in a homogeneous medium and a medium with variable phase difference.

Analysis of torsional eye movements using the corneal birefringence pattern.

The literature mentions several invasive methods to measure the degree of the compensatory torsional eye movement during a head-tilt. Nevertheless, none of them have yielded universally clinical tests. This study focuses on an optical system (with a circular polarizer) for noninvasive acquisition of corneal birefringence patterns (isochromes). The acquired isochromes are quadrangular in shape and unique for each eye, as well as independent of the head-rotation angle. The results obtained suggest that isochrome orientation analysis could be an effective method to accurately measure the degree of compensatory torsional eye movement.

Data analysis of the ocular response analyzer for improved distinction and detection of glaucoma.

The purpose of this study was to evaluate the clinical utility of the output parameters of the ocular response analyzer (ORA) and those calculated from the raw ORA in subjects with healthy eyes and those with suspected glaucoma, and in patients with two types of glaucoma. The raw ORA data were analyzed using a custom software that included the Gaussian filtering of applanation curves for three different window sizes. To the best of our knowledge, these findings present a novel means of optimizing the use of measurements from the ORA, which can refine the characteristics of corneal biomechanics, enabling a distinction between the types of glaucoma and leading to an improvement in diagnosing and early detection.