The Role of Corneal Biomechanics as a Predictor of Choroidal Neovascular Membranes in Myopic Eyes

Authors

  • Pedro Manuel Baptista Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal; Serviço de Oftalmologia, Centro Hospitalar Universitário do Porto, Porto, Portugal https://orcid.org/0000-0001-8285-1084
  • João Heitor Marques Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal https://orcid.org/0000-0001-6487-7950
  • Paulo Sousa Serviço de Oftalmologia, Centro Hospitalar Universitário do Porto, Porto, Portugal
  • Saul Pires Serviço de Oftalmologia, Centro Hospitalar Universitário do Porto, Porto, Portugal
  • Maria João Furtado Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal; Serviço de Oftalmologia, Centro Hospitalar Universitário do Porto, Porto, Portugal https://orcid.org/0000-0003-2319-105X
  • Miguel Ribeiro Lume Serviço de Oftalmologia, Centro Hospitalar Universitário do Porto, Porto, Portugal https://orcid.org/0000-0002-8629-1288
  • Angelina Meireles Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal; Serviço de Oftalmologia, Centro Hospitalar Universitário do Porto, Porto, Portugal https://orcid.org/0000-0001-9148-2786
  • Renato Ambrósio Rio de Janeiro Corneal Tomography and Biomechanics Study Group, Rio de Janeiro, Brazil; Department of Cornea and Refractive Surgery, Instituto de Olhos Renato Ambrósio, Rio de Janeiro, Brazil; Department of Opthalmology, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil; Federal University of São Paulo (UNIFESP), São Paulo, Brazil; Brazilian Study Group of Artificial Intelligence and Corneal Analysis - BrAIN, Rio de Janeiro & Maceió, Brazil https://orcid.org/0000-0001-6919-4606
  • Pedro Menéres Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal; Serviço de Oftalmologia, Centro Hospitalar Universitário do Porto, Porto, Portugal https://orcid.org/0000-0002-1989-3465
  • João Melo Beirão Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal; Serviço de Oftalmologia, Centro Hospitalar Universitário do Porto, Porto, Portugal https://orcid.org/0000-0001-8642-7010

DOI:

https://doi.org/10.48560/rspo.28312

Keywords:

Biomechanical Phenomena, Bruch Membrane, Choroidal Neovascularization, Cornea, Myopia, Vascular Endothelial Growth Factor

Abstract

INTRODUCTION: Myopic maculopathy in the form of choroidal neovascularization (mCNV) may display a significant impact in visual function, frequently in active young patients. The present work was aimed to describe corneal biomechanics in myopic eyes with history of mCNV treated with intravitreal anti-vascular endothelial growth factor (VEGF) and compare it with the fellow eyes. Secondary purposes were to make subgroup analysis within the group of mCNV eyes and to address predictors of disease and treatment response.
METHODS: Single center observational cross-sectional case-control study including individuals above 18 years old with myopia and history of mCNV treated with intravitreal anti-VEGF in one eye in Centro Hospitalar e Universitário do Porto. Data from clinical records was taken regarding treatment-related information. A questionnaire including personal demographic, biometric and lifestyle related data was performed. Biomechanical assessment was made by means of Scheimpflug camera, through Corvis ST® (OCULUS). Ocular biometric parameters were addressed by Anterion® (Heidelberg). Data from Macular anatomical assessments were performed through the OCT platform Spectralis® (Heidelberg).
RESULTS: Sixty four eyes from 32 patients were included, 87.5% females, with a mean age of 62.5+-13.3 years old. A tendency to lower HC-time was found in eyes with mCNV. Eyes with macular bruch membrane holes (MBMH) showed higher WEM Max time and TBI and belonged to individuals with more physical activity and more UV-light exposure. Several biomechanical parameters correlated with lifestyle habits. Membrane diameter was moderate-to-strongly correlated with softer biomechanical behavior, while number of intravitreal anti-VEGF injections associated without a consistent pattern. A pure biomechanical model was built to predict the presence of MBMH, including the WEM Max time and the TBI, with an AUROC of 0.808 and with no influence from AL or intraocular pressure.
CONCLUSION: To the authors knowledge, this is the first study evaluating in vivo ocular biomechanics in mCNV. Biomechanics showed promising results as a predictor of mCNV, more specifically of MBMH. It seems to be associated with lifestyle factors and future studies should be performed to confirm our findings, paving the way to the introduction of a dynamic paradigm in mCNV risk assessment of myopic eyes.

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Published

2024-03-24

How to Cite

Baptista, P. M., Heitor Marques, J., Sousa, P., Pires, S., Furtado, M. J. ., Ribeiro Lume, M., Meireles, A., Ambrósio, R., Menéres, P., & Melo Beirão, J. . (2024). The Role of Corneal Biomechanics as a Predictor of Choroidal Neovascular Membranes in Myopic Eyes. Revista Sociedade Portuguesa De Oftalmologia, 48(1), 36–48. https://doi.org/10.48560/rspo.28312

Issue

Vol. 48 No. 1 (2024)

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Original Article

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