Quantitative Assessment of Biomechanical Properties of the Human Keratoconus Cornea Using Acoustic Radiation Force Optical Coherence Elastography

PURPOSE: Quantification of biomechanical properties of keratoconus (KC) corneas has great significance for early diagnosis and treatment of KC, but the corresponding clinical measurement remains challenging. Here, we developed an acoustic radiation force (ARF) optical coherence elastography technique and explored its potential for evaluating biomechanical properties of KC corneas. METHODS: An ARF system was used to induce the tissue deformation, which was detected by an optical coherence tomography system, and thus the localized point-by-point Young's modulus measurements were achieved. Then, two healthy rabbit eyes were imaged to test the system, after which the human keratoconus cornea was evaluated by using the same method. Three regions were selected for biomechanics analysis: the conical region, the transitional region, and the peripheral region. RESULTS: Young's moduli of transitional region ranged from 53.3 to 58.5 kPa. The corresponding values for the peripheral region were determined to be 58.6 kPa and 63.2 kPa, respectively. Young's moduli of the conical region were gradually increased by 18.3% from the center to the periphery, resulting in the minimum and maximum values of 44.9 kPa and 53.1 kPa, respectively. Furthermore, Young's moduli of the anterior and posterior of the center were determined to be 44.9 kPa and 50.7 kPa, respectively. CONCLUSIONS: Differences in biomechanical properties between the three regions and slight variations within the conical region were clearly distinguished. Biomechanical weakening of the keratoconus cornea was mainly localized in the conical region, especially in the vertex position. TRANSLATIONAL RELEVANCE: The system may provide a promising clinical tool for the noninvasive evaluation of local corneal biomechanics and thus may have potential applications in early keratoconus detection with further optimization.