Overview
This pilot study evaluates the biomechanical properties of the cornea in glaucoma patients using Brillouin microscopy, a non-contact imaging technique. The study aims to compare corneal stiffness between patients with normal-tension glaucoma, high-tension glaucoma, and healthy controls, and to assess changes in corneal biomechanics following intraocular pressure (IOP)-lowering treatment. The goal is to determine whether Brillouin-derived biomechanical measurements can serve as biomarkers for glaucoma risk and progression.
Description
This study explores the biomechanical properties of the cornea in patients with glaucoma using a novel, non-contact imaging technique called Brillouin microscopy. The technology allows in vivo assessment of tissue stiffness without physical perturbation, potentially offering new insights into glaucoma risk and response to therapy.
The study includes two parts: a cross-sectional comparison between patients with normaland high-tension glaucoma and healthy controls, and a longitudinal analysis of biomechanical changes following IOP-lowering treatment with either prostaglandin analogs or beta blockers.
The goal is to determine whether corneal biomechanics can serve as a biomarker for glaucoma susceptibility and progression, and to evaluate the feasibility of integrating Brillouin imaging into clinical glaucoma care.
Eligibility
Inclusion Criteria:
- Age 18 years or older
Diagnosis of primary open angle glaucoma (POAG) or no history of glaucoma (for controls)
Open angle on gonioscopy (Shaffer grade 3 or 4)
Best-corrected visual acuity of 20/25 or better
Refractive error between +3.00 and -5.00 diopters
No prior use of topical glaucoma medications
Diagnosis of:
High Tension Glaucoma (IOP ≥ 22 mmHg on 3 visits)
Normal Tension Glaucoma (IOP ≤ 21 mmHg on 3 visits)
OR age-matched control with normal optic nerve and visual fields
Exclusion Criteria:
Corneal abnormalities or conditions interfering with Brillouin or applanation tonometry
Retinal diseases affecting RNFL (e.g., macular traction)
History of ocular surgery or laser
Diagnosis of diabetes
History of uveitis
History of prolonged steroid use
Neurodegenerative or systemic diseases (e.g., multiple sclerosis, Alzheimer's, Parkinson's, schizophrenia)
Unreliable visual fields
Contraindications to beta blockers (e.g., bradycardia, severe pulmonary disease)
Moderate to severe glaucoma (per Hodapp-Anderson-Parrish criteria)
History of contact lens use
Low blood pressure