MIMetiCO · Multiscale Integrative Approach for Corneal Biomechanics to Assess Corneal Crosslinking
Horizon 2020 — Marie Skłodowska-Curie Actions
- Duration
- 2018-09-01 → 2020-08-31
- EU contribution
- €175,420
- Participants
- 1
- Scheme
- MSCA-IF-EF-ST
Lines connect the coordinator with its partners.
Results in brief
Multiscale Integrative Approach for Corneal Biomechanics to Assess Corneal Crosslinking
Degradation or loss of vision greatly impacts quality of life. Almost 250 million people worldwide are visually impaired, which in 2009 had an estimated economic impact of $268.8B. The shape and optical properties of the cornea are determined by the mechanical balance between intraocular pressure and the internal stresses of corneal tissue. Interventions such as refractive surgery and pathologies such as keratoconus (KC) can alter this balance and compromise visual acuity. Mechanical imbalance can be caused by the ablation of corneal tissue in laser refractive surgery, or by the loss of the organization of corneal collagen in incurable KC disease. In both cases, a corneal protrusion, ectasia, can occur due to the mechanical weakening of the tissue. Corneal crosslinking (CXL) is a widespread clinical treatment that affects corneal tissue without inducing mechanical weakening. In CXL, ultraviolet (UV) light activates a photosensitizer (riboflavin) generating oxygen species that induce covalent bonds (crosslinks) between corneal collagen fibrils and within the proteoglycan coating surrounding them. Due to this micromechanical modification, overall mechanical stiffness increases. At present, CXL is used to halt KC’s progression, and is regarded as the future of noninvasive refractive surgery. However, CXL micro/nano-mechanisms are still not completely understood. Treatments often rely on statistical and experimental nomograms (look-up tables), and little patient-specific information is taken into account. Not surprisingly, outcomes such as under/over-correction of visual acuity, or the progression of KC can ensue. MIMetiCO aims at obtaining a better understanding and characterization of corneal biomechanics before and after CXL, which includes morphological, biochemical, and mechanical information at different scales. Based on this characterization, MIMetiCO will align with H2020’s societal challenges regarding in silico and personalized medicine by developing an experiment-based, computational model to test potential CXL strategies.
Data: CORDIS, © European Union
Project objective
Approximately 250 million people worldwide are visually impaired, and this has great economic and social impact. One of the pathologies of vision loss is keratoconus, in which the mechanical balance of the cornea depending on intraocular pressure and internal stresses in corneal tissue becomes imbalanced, which can result in a corneal protrusion.Corneal crosslinking (CXL) is a clinical treatment that increases the overall mechanical stiffness of the cornea by inducing chemical bounding between collagen molecules. CXL is the present of halting corneal ectasias, and the future of noninvasive refractive surgery. However, its micro/nano-mechanisms are not completely understood. Moreover, CXL is usually applied uniformly in corneal treatments, which can result in over-stiffening and unexpected postsurgical outcomes.Ophthalmology can benefit from in silico modeling to plan and improve such interventions. However, current computational models are mainly macroscopic and cannot simulate complex phenomena involved in CXL. Multiscale computational models could improve clinical strategies by including information at different scales.MIMetiCO’s goal is to combine experiments and modelling at different scales to provide a multiscale characterization of corneal biomechanics before and after CXL. This characterization will rely on both ground-breaking and well-established technologies that include confocal microscopy, biochemical assessment, and mechanical inflation tests to determine morphological (orientation and density of fibrils), biochemical (amount of intermolecular crosslinks), and mechanical features of the cornea.MIMetiCO will use this information to calibrate the first in silico model of the cornea using a multiscale structural approach to build a virtual framework to simulate potential CXL treatments.MIMetiCO is the next step in ophthalmology, which has the potential to bring into being a new generation of clinical assessment.
Original text from CORDIS.
Participants
- UNIVERSITAET BERN · BernCoordinatorSwitzerland
Links
Data: CORDIS, © European Union