Establishing Quantitative Functional Metrics to Evaluate the Efficacy of Corneal Crosslinking (CXL) Therapeutic Procedures

建立定量功能指标来评估角膜交联 (CXL) 治疗程序的疗效

• 批准号: 1935817
• 负责人: giuliano scarcelli
• 金额: $ 10.61万
• 依托单位: University of Maryland, College Park
• 依托单位国家: 美国
• 项目类别: Standard Grant
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-12-01 至 2020-11-30
• 项目状态: 已结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=1935817&HistoricalAwards=false
• 关键词: Establishing; Quantitative; Functional; Metrics; Evaluate

Keratoconus and related ectatic disorders are the leading indication for corneal transplantation and the primary concern of refractive surgery screening in the US. Corneal collagen crosslinking (CXL) has emerged as the only effective treatment to stop keratoconus progression by stiffening the corneal stroma. CXL safety and efficacy is determined by its mechanical outcome, but currently morphological not biomechanical parameters are used to characterize CXL. This proposal aims to establish novel functional metrics to quantify the mechanical outcome of corneal crosslinking (CXL) procedures to facilitate future evaluation of their safety and efficacy. The research is highly synergistic with the FDA collaborator Dr. Ilev, whose lab has been working to develop repeatable and optical radiation safe CXL procedures. To address this need, the lab has developed Brillouin microscopy which enables a CXL test methodology by characterizing corneal stiffness in situ and in vivo with three-dimensional resolution. Our central hypothesis is that the stiffening induced by CXL as evaluated by Brillouin microscopy can be used to predict corneal shape, i.e. visual outcome. To test this hypothesis, they will (1) validate Brillouin-derived mechanical metrics to gold-standard compressive mechanical tests; (2) correlate CXL-induced mechanical changes to cornea morphological behavior by inducing dynamic deformation of the cornea with air-puff; and (3) correlate Brillouin corneal profiles after CXL to morphological changes due to increasing intraocular pressure (IOP).This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.

圆锥角膜和相关的扩张性疾病是角膜移植的主要适应症，也是美国屈光手术筛查的主要关注点。 角膜胶原交联（CXL）已成为通过硬化角膜基质来阻止圆锥角膜进展的唯一有效治疗方法。 CXL 的安全性和有效性取决于其机械结果，但目前使用形态学参数而非生物力学参数来表征 CXL。 该提案旨在建立新颖的功能指标来量化角膜交联（CXL）手术的机械结果，以促进未来对其安全性和有效性的评估。该研究与 FDA 合作者 Ilev 博士高度协同，他的实验室一直致力于开发可重复且光辐射安全的 CXL 程序。为了满足这一需求，该实验室开发了布里渊显微镜，通过以三维分辨率表征原位和体内角膜硬度，从而实现 CXL 测试方法。我们的中心假设是，通过布里渊显微镜评估的 CXL 引起的硬化可用于预测角膜形状，即视觉结果。为了检验这一假设，他们将 (1) 将布里渊导出的机械指标验证为黄金标准压缩机械测试； (2) 通过吹气诱导角膜动态变形，将 CXL 引起的机械变化与角膜形态行为相关联； (3) 将 CXL 后的布里渊角膜轮廓与由于眼内压 (IOP) 增加而导致的形态变化相关联。该奖项反映了 NSF 的法定使命，并通过使用基金会的智力价值和更广泛的影响审查标准进行评估，被认为值得支持。

项目成果

Detecting Mechanical Anisotropy of the Cornea Using Brillouin Microscopy

使用布里渊显微镜检测角膜的机械各向异性

• DOI: 10.1167/tvst.9.7.26
• 发表时间: 2020-06
• 期刊: Translational Vision Science & Technology
• 影响因子: 3
• 作者: Webb, Joshua N.;Zhang, Hongyuan;Roy, Abhijit Sinha;Randleman, James Bradley;Scarcelli, Giuliano
• 通讯作者: Scarcelli, Giuliano