Age-related changes in dynamic corneal backscatter observed in Scheimpflug imaging.

Corneal visualization Scheimpflug technology (Corvis ST) has the potential to indirectly provide information on corneal structure via the analysis of statistical properties of the backscatter. The aim of this work was to ascertain whether there are age-related changes in the dynamics of corneal backscatter during an air-puffed induced corneal deformation. Retrospective data from Corvis ST measurements of 151 young subjects (19-30 years) and 82 older subjects (50-87 years) were considered. Each measurement consisted of 140 frames (sampling frequency: 4330 fps). For every frame the cornea was first segmented, then regions of interest, encompassing temporal, central and nasal parts of cornea were selected, to which the parameters of Weibull distribution (scale and shape) were fitted, leading to time series of the estimated parameters. Apparent differences were found between the parameters of Weibull distribution between the two considered groups that manifest themselves mostly in the nasal region of the cornea. However, those differences cannot be attributed to the age alone. For this, a normalization method is proposed that leads to a much better separation between the groups in all considered regions. Clinical Relevance- The parameters of the corneal backscat-ter are widely used to asses corneal clarity (so-called corneal densitometry). Recently the parameters of Weibull distribution fitted to the corneal backscatter data have been used to support diagnosis of keratoconus. This work contributes to the assessment of corneal clarity by identifying the apparent age-related differences in those parameters when dynamic raw data is considered highlighting the need for such parameters to be appropriately normalized. Further it shown that the shape parameter of Weibull distribution unlike the scale parameter carries that information already for the raw non-normalized data.

Spectral characteristics of longitudinal corneal apex velocities and their relation to the cardiopulmonary system.

PURPOSE: To study the naturally occurring kinetic characteristics of corneal surface. METHODS: The right eyes of three subjects (young, early presbyope, and presbyope) were examined. Cardiac signal and longitudinal corneal apex movements were simultaneously measured with electrocardiography (ECG) and a high-speed videokeratoscope, respectively. Time, frequency, and combined time-frequency representations of the acquired signals were derived to establish their temporal and spectral contents. Coherence analysis was used to assess the correlation between the corneal apex velocities and the cardiopulmonary system. RESULTS: In all measurements, longitudinal corneal apex velocity signals showed close correlation with the corresponding ECG signals. The signatures of the pulse frequency, which was inferred from the ECG spectra and their variations in time, were clearly visible in the spectral content of corneal apex velocities. For the young subject, the correlation was the strongest and all of the spectral content of the pulse signal including the harmonics was propagating to the corneal apex velocities. For the other two subjects, there was a clear propagation of the pulse signal itself but not of all pulse harmonics. CONCLUSIONS: Longitudinal movements of the corneal apex are closely related to the cardiopulmonary system. The differences in propagation of pulse harmonics to the corneal apex velocities for different subjects suggest that the frequency characteristics of apex velocity could be related to pulsative variations in the intraocular pressure and biomechanical properties of the eye. These findings could potentially be used in noninvasive assessment of the hemodynamic status of the eye with high-speed videokeratoscopy.

Dynamics of ocular surface topography.

PURPOSE: To investigate fluctuations in the ocular surface, we used high-speed videokeratoscopy (50 Hz) to measure the dynamics of the ocular surface topography. METHODS: Ocular surface height difference maps were computed to illustrate the changes in the tear film in the inter-blink interval. Topography data were used to derive the ocular surface wavefront aberrations up to the fourth radial order of the Zernike polynomial expansion. We examined the ocular surface dynamics and temporal changes in the ocular surface wavefront aberrations in the inter-blink interval. RESULTS: During the first 0.5 s following a blink, the ocular surface height at the upper edge of the topography map increased by about 2 mum. Temporal changes occurred for some ocular surface wavefront aberrations and appeared to be related to changes in the distribution of tear film. CONCLUSION: In the clinical measurement of ocular surface topography using videokeratoscopy or optics of the eye using wavefront sensors, care should be taken to avoid the initial tear film build-up phase following a blink to achieve more consistent results.

The stability of corneal topography in the post-blink interval.

PURPOSE: Videokeratoscopes provide a wealth of information about the topography of the ocular surface. Although there have been numerous studies of the accuracy and precision of videokeratoscopes with inanimate test objects, little information exists on their precision (repeatability) for real eyes. METHODS: To investigate the stability of the ocular surface in the inter-blink period, 10 patients were recruited for videokeratoscopy. Tear break-up time was measured and videokeratographs were acquired immediately post-blink and again at 4, 8, and 12 seconds post-blink. To permit statistical inferences to be drawn from the data, we acquired 24 videokeratographs for each of the four post-blink intervals. The videokeratograph data were interpolated (bilinear) to a common grid, and average and standard deviation (SD) maps were derived for each post-blink condition. t Tests were used to test the significance of changes observed in the topography. RESULTS: The instantaneous power SD maps showed increasing variation toward the periphery, with most maps showing less than +/-0.5 diopters (D) of SD in the central 4 to 5 mm and variation in the periphery often reaching more than +/-1 D SD at the edge of an 8-mm diameter. When the 4-, 8-, and 12-second average maps were subtracted from the average map acquired immediately after blinking, regions of statistically significant ( p < 0.001) change were apparent in the upper and lower regions of the maps. The upper and lower bands of change were found to correlate with the natural position of the patients' lid margins. CONCLUSIONS: For normal eyes, the central regions of videokeratographs show high stability in the inter-blink period. However, the upper and lower edges of 8-mm diameter maps show statistically significant variability, which appears to be related to the effects of eyelid pressure.

Optimal modeling of corneal surfaces with Zernike polynomials.

Zernike polynomials are often used as an expansion of corneal height data and for analysis of optical wavefronts. Accurate modeling of corneal surfaces with Zernike polynomials involves selecting the order of the polynomial expansion based on the measured data. We have compared the efficacy of various classical model order selection techniques that can be utilized for this purpose, and propose an approach based on the bootstrap. First, it is shown in simulations that the bootstrap method outperforms the classical model order selection techniques. Then, it is proved that the bootstrap technique is the most appropriate method in the context of fitting Zernike polynomials to corneal elevation data, allowing objective selection of the optimal number of Zernike terms. The process of optimal fitting of Zernike polynomials to corneal elevation data is discussed and examples are given for normal corneas and for abnormal corneas with significant distortion. The optimal model order varies as a function of the diameter of the cornea.