Pregnancy-Induced Changes in Ocular Biomechanics Are Related to Maternal Hormone Levels in Healthy Chinese Pregnant Women

Background: To explore the changes in ocular biomechanics during pregnancy and the postpartum period and their association with maternal hormone level changes. Methods: In a prospective cohort study, 24 eyes of 12 pregnant women were enrolled and monitored throughout pregnancy and after delivery (6 weeks). Intraocular pressure (IOP), central corneal thickness (CCT), corneal endothelium cell (CEC), axial length (AL), corneal curvature (K1, K2), anterior chamber depth (ACD), central subfield thickness (CST), macular volume (MV), cube average thickness (CAT), retinal nerve fibre layer (RNFL), tear meniscus height (TMH), and breaking up time (BUT) were measured throughout pregnancy, and blood plasma levels of maternal hormones were determined at the same time points. Results: A gradual decrease in IOP values was observed as gestation progressed, and there was a statistically significant difference in IOP between the 3rd trimester and the 1st and 2nd trimester and postpartum (p = 0.002, p = 0.006, p = 0.050). There was a significant difference between the 1st and 2nd trimesters in terms of MV (p = 0.023). The difference in RNFL in the 3rd trimester and postpartum was significant (p = 0.011). The levels of the β-hCG showed a significant correlation with K2, ACD, and TMH only in the 2nd trimester (r = 0.588, p = 0.045;r = - 0.740, p = 0.006;r = 0.642, p = 0.024). Regarding luteinizing hormone, there was a negative correlation with MV in the 1st and 2nd trimesters (r = - 0.598, p = 0.040;r = - 0.672, p = 0.017) and CAT in the 1st and 2nd trimesters (r = - 0.599, p = 0.040;r = - 0.655, p = 0.021). Luteinizing hormone levels were correlated with ACD (r = - 0.702, p = 0.011) in the 2nd trimester and K2 (r = 0.585, p = 0.046) in the 3rd trimester. A correlation was found between follicle-stimulating hormone levels and CEC, MV and CAT in the 1st trimester (r = - 0.677, p = 0.016;r = - 0.602, p = 0.039;r = - 0.584, p = 0.046) and AL in the 3rd trimester (r = - 0.618, p = 0.032). The correlation between oestradiol and CST in the 1st trimester (r = - 0.621, p = 0.031) and RNFL (r = 0.594, p = 0.041) in the postpartum. A statistically significant correlation between progesterone and MV (r = 0.583, p = 0.047) and TMH (r = 0.762, p = 0.004) was observed in the 1st trimester. No significant intergroup correlation was observed postpartum (p > 0.05). Conclusion: Ophthalmological parameters showed physiological changes induced by hormone levels in pregnancy and returned to baseline levels after delivery.

Ocular biomechanical measurements on post- keratoplasty corneas using a Scheimpflug-based noncontact device

AIM： To analyse ocular biomechanical properties, central corneal thickness （CCT） and intraocular pressure （lOP） in post-keratoplasty eyes, as compared to normal subjects, with a new Scheimpflug-based technology. Moreover, biomechanical data were correlated with the size and age of the donor and recipient corneas. METHODS： Measurements were conducted on 46 eyes of 46 healthy patients without any corneal pathology （age： 53.83 ±20.8y） and 30 eyes of 28 patients after penetrating keratoplasty （age： 49.43 ±21.34y）. Ten biomechanical parameters, the CCT and lOP were recorded by corneal visualization Scheimpflug technology （CorVis ST） using high-speed Scheimpflug imaging. Keratometry values were also recorded using Pentacam HR system. Scheimpflug measurements were performed after 43.41± 40.17mo （range： 11-128mo） after the keratoplasty and after 7.64±2.34mo （range： 5-14mo） of suture removal. RESULTS： Regarding the device-specific biomechanical parameters, the highest concavity time and radius values showed a significant decrease between these two groups （P=0.01 and P 〈0.001）. None of other biomechanical parameters disclosed a significant difference. The CCT showed a significant difference between post keratoplasty eyes as compared to normal subjects （P= 0.003） using the CorVis ST device. The lOP was within the normal range in both groups （P=0.84）. There were no significant relationships between the keratometric data, the size of the donor and recipient, age of the donor and recipient and biomechanical properties obtained by CorVis ST. CONCLUSION： The ocular biomechanics remain stable after penetrating keratoplasty according to the CorVis ST measurements. Only two from the ten device-specific parameters have importance in the follow-up period after penetrating keratoplasty.

Ex vivo testing of intact eye globes under inflation conditions to determine regional variation of mechanical stiffness

Background:The eye globe exhibits significant regional variation of mechanical behaviour.The aim of this present study is to develop a new experimental technique for testing intact eye globes in a form that is representative of in vivo conditions,and therefore suitable for determining the material properties of the complete outer ocular tunic.Methods:A test rig has been developed to provide closed-loop control of either applied intra-ocular pressure or resulting apical displacement;measurement of displacements across the external surface of the eye globe using high-resolution digital cameras and digital image correlation software;prevention of rigid-body motion and protection of the ocular surface from environmental drying.The method has been demonstrated on one human and one porcine eye globe,which were cyclically loaded.Finite element models based on specimen specific tomography,free from rotational symmetry,were used along with experimental pressure-displacement data in an inverse analysis process to derive the mechanical properties of tissue in different regions of the eye’s outer tunic.Results:The test method enabled monitoring of mechanical response to intraocular pressure variation across the surface of the eye globe.For the two eyes tested,the method showed a gradual change in the sclera’s stiffness from a maximum at the limbus to a minimum at the posterior pole,while in the cornea the stiffness was highest at the centre and lowest in the peripheral zone.Further,for both the sclera and cornea,the load–displacement behaviour did not vary significantly between loading cycles.Conclusions:The first methodology capable of mechanically testing intact eye globes,with applied loads and boundary conditions that closely represent in vivo conditions is introduced.The method enables determination of the regional variation in mechanical behaviour across the ocular surface.