In vivo OCT elastography showed ability to differentiate keratoconic from healthy corneas

Key takeaways:

  • High-resolution OCT elastography shows potential in diagnosing and monitoring keratoconus.
  • This method may also offer the opportunity to determine the impact of corneal cross-linking.

VILAMOURA, Portugal — In a study performed for the first time in vivo, high-resolution OCT elastography showed the potential to become an additional diagnostic and monitoring tool for keratoconus.

At the European Society of Cataract and Refractive Surgeons winter meeting, Emilio Torres-Netto, MD, PhD, showed how the information provided by this novel technology differentiated keratoconic corneas from healthy corneas.

“High-resolution OCT elastography uses OCT, a technology many of us have readily available in clinics. It allows for noninvasive evaluation of biomechanical changes under close-to-physiologic conditions,” he said.

Elastography, he said, relies on speckle tracking to estimate relative motion of subsurface structures imaged under different applied stresses. The interface images acquired by OCT can be modeled approximately in the form of a convolution.

The Sabine Kling OCT elastography prototype was used in a group of eyes with keratoconus and a group of healthy eyes, applying a pressure variation of –6 mm Hg through a custom-built set of goggles.

“Over 2 seconds, several images of the cornea were obtained, and then the displacement between those images was calculated,” Torres-Netto said. “What we could observe is that in healthy eyes, the posterior and anterior part of the cornea, when you reduce the pressure, move as a whole. In keratoconus corneas, they move in different directions, one forward and one backward. This difference between a healthy and a keratoconus cornea is detectable in vivo with OCT in just 2 seconds.”

This method will open new horizons, he said, not just for the diagnosis and monitoring of keratoconus in progressive cases, but to determine the effects of corneal cross-linking.


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Torres-Netto E. High-resolution OCT elastography assessing biomechanics in normal and keratoconus subjects. Presented at: European Society of Cataract and Refractive Surgeons winter meeting; March 10-12, 2023; Vilamoura, Portugal.

Disclosures: Torres-Netto reports no relevant financial disclosures.


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