High-frequency point-of-care quantitative ultrasound to assess myopia-induced microstructural changes in the anterior sclera in vivo

Abstract

The progression of myopia to advanced stages is a leading cause of blindness worldwide. Standard ophthalmic measurements can evaluate myopia level but cannot predict disease progression. Recent evidence suggests the microstructural properties of the anterior sclera may be altered by myopia. We have developed a high-frequency (80MHz) point-of-care (POC) ultrasound device to collect radiofrequency echo data from the anterior sclera and infer the microstructural and mechanical properties using quantitative ultrasound (QUS) techniques and passive elastography (PE), respectively. We hypothesized that QUS parameters derived from measurements of the backscatter coefficient (BSC) and shear-wave speed (SWS) estimated through PE correlate with myopia severity. Both eyes of 85 patients exhibiting varying levels of myopia were scanned with the POC device. Multilinear regression between the QUS parameters with refractive error or axial length demonstrated moderate correlation (p < 0.001). A logistic regression classifier trained using a subset of the QUS parameters to differentiate eyes based on myopia level achieved satisfactory performance as measured by area under the ROC curve (AUROC = 0.7). Results of this study suggest high-frequency QUS can detect myopia-induced microstructural changes of the anterior sclera and may pave the way toward a method to predict myopia progression in vivo.