Loveless Bosten A, Moin Kayvon A, Hoopes Phillip C, Moshirfar Majid
Ophthalmology, Hoopes Vision Research Center, Draper, USA.
Ophthalmology, Rocky Vista University College of Osteopathic Medicine, Ivins, USA.
Cureus. 2024 Jul 30;16(7):e65769. doi: 10.7759/cureus.65769. eCollection 2024 Jul.
Corneal biomechanical data has been used since 2005 to screen for keratoconus and corneal ectasia by corneal specialists. Older technology uses force applanation techniques over a 3 mm area in the central cornea, making it highly dependent on extraneous variables and unable to calculate the elasticity of the tissue. Brillouin microscopy is a newer method that uses a natural shift in the frequency of light as it passes through a material. This frequency shift can be used to estimate the viscoelasticity of the tissue. The advantage of Brillouin microscopy is that it can create a full three-dimensional (3D) map of the entire cornea without direct contact. A literature search was conducted using the databases PubMed, Google Scholar, and Ovid regarding the applications of Brillouin microscopy in corneal diagnostics. A final total of 16 articles was included describing the various ex vivo and in vivo studies conducted using Brillouin microscopy. Applications of this technology spanned from keratoconus diagnosis to post-corneal refractive surgery evaluation. All studies evaluated corneal biomechanics and other corneal properties through the quantification of Brillouin frequency shifts. Many of the studies found that this diagnostic device is capable of detecting subtle changes in corneal thickness and biomechanics in keratoconic corneas at a high level of specificity and sensitivity. However, limitations of Brillouin microscopy may include the duration of time required for use and fluctuations in accuracy depending on the corneal hydration state. Future technology seems to be geared toward a combination of optical coherence tomography (OCT) and Brillouin microscopy, using OCT as a three-dimensional pupil-tracking modality. Further research and understanding of the technology involved will lead to better care of patients in the field of ophthalmology.
自2005年以来，角膜生物力学数据一直被角膜专科医生用于圆锥角膜和角膜扩张症的筛查。较旧的技术在中央角膜的3毫米区域上使用压平技术，这使其高度依赖于外部变量，并且无法计算组织的弹性。布里渊显微镜检查是一种较新的方法，它利用光穿过材料时频率的自然变化。这种频率变化可用于估计组织的粘弹性。布里渊显微镜检查的优点是它可以在不直接接触的情况下创建整个角膜的完整三维（3D）地图。使用PubMed、谷歌学术和Ovid数据库对布里渊显微镜检查在角膜诊断中的应用进行了文献检索。最终共纳入16篇文章，描述了使用布里渊显微镜检查进行的各种离体和体内研究。该技术的应用范围从圆锥角膜诊断到角膜屈光手术后评估。所有研究都通过量化布里渊频移来评估角膜生物力学和其他角膜特性。许多研究发现，这种诊断设备能够以高度的特异性和敏感性检测圆锥角膜中角膜厚度和生物力学的细微变化。然而，布里渊显微镜检查的局限性可能包括使用所需的时间以及根据角膜水化状态而产生的准确性波动。未来的技术似乎倾向于将光学相干断层扫描（OCT）和布里渊显微镜检查相结合，将OCT用作三维瞳孔跟踪方式。对相关技术的进一步研究和理解将为眼科领域的患者带来更好的治疗。
