A Potential Role of Acute Choroidal Expansion in Nonarteritic Anterior Ischemic Optic Neuropathy.
A Potential Role of Acute Choroidal Expansion in Nonarteritic Anterior Ischemic Optic Neuropathy.
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DOI：
10.1167/iovs.63.4.23
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发表时间：
2022-04-01
影响因子：
4.4
通讯作者：
中科院分区：
文献类型：
--
作者：
非动脉炎性前部缺血性视神经病变（NAION）与视神经乳头（ONH）处的脉络膜增厚有关。在这里，我们使用计算建模，以更好地了解脉络膜扩张和脉络膜几何形状如何影响组织变形内的ONH相对于眼内压（IOP）和颅内压（ICP）的影响。使用包括巩膜、视乳头周围巩膜、环形环、软脑膜、硬脑膜、神经组织、布鲁赫膜、脉络膜和筛板的后眼模型，我们研究了在生理和超生理或“病理”条件下眼组织的不同材料特性如何影响ONH变形。我们考虑脉络膜扩张（c。35 μL扩张）、升高的IOP（30 mm Hg）和升高的ICP（20 mm Hg），并计算ONH相对于代表直立位个体的基线条件的峰值应变。超生理性脉络膜扩张对层前神经组织的应变影响最大。此外，与锥形脉络膜相比，ONH处的“钝”脉络膜插入导致更高的应变。升高的IOP和ICP分别引起筛板和板后神经组织内的最高应变。急性脉络膜扩张引起ONH的大变形，这些变形受到脉络膜几何形状的影响。这些结果与脉络膜几何形状和/或ONH扩张导致的筋膜室综合征导致NAION的概念一致。由于超生理负荷引起的长时间变形可能引起机械生物学反应或缺血，突出了脉络膜扩张对ONH生物力学应变的潜在影响。
Nonarteritic anterior ischemic optic neuropathy (NAION) has been associated with a thickened choroid at the optic nerve head (ONH). Here, we use computational modeling to better understand how choroidal expansion and choroidal geometry influence tissue deformation within the ONH relative to intraocular pressure (IOP) and intracranial pressure (ICP) effects. Using a model of the posterior eye that included the sclera, peripapillary sclera, annular ring, pia mater, dura mater, neural tissues, Bruch's membrane, choroid, and lamina cribrosa, we examined how varying material properties of ocular tissues influenced ONH deformations under physiological and supra-physiological, or “pathological,” conditions. We considered choroidal expansion (c. 35 µL of expansion), elevated IOP (30 mm Hg), and elevated ICP (20 mm Hg), and calculated peak strains in the ONH relative to a baseline condition representing an individual in the upright position. Supra-physiological choroidal expansion had the largest impact on strains in the prelaminar neural tissue. In addition, compared to a tapered choroid, a “blunt” choroid insertion at the ONH resulted in higher strains. Elevated IOP and ICP caused the highest strains within the lamina cribrosa and retrolaminar neural tissue, respectively. Acute choroidal expansion caused large deformations of the ONH and these deformations were impacted by choroid geometry. These results are consistent with the concept that compartment syndrome due to the choroid geometry and/or expansion at the ONH contributes to NAION. Prolonged deformations due to supra-physiological loading may induce a mechanobiological response or ischemia, highlighting the potential impact of choroidal expansion on biomechanical strains in the ONH.
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影响因子：
6.9
作者：
Candiello, Joseph;Cole, Gregory J.;Halfter, Willi
通讯作者：
Halfter, Willi
影响因子：
4.1
作者：
Khanna, RK;Pham, CJ;Rosenblum, ML
通讯作者：
Rosenblum, ML
影响因子：
4.4
作者：
Contreras, Ines;Rebolleda, Gema;Munoz-Negrete, Francisco J.
通讯作者：
Munoz-Negrete, Francisco J.
影响因子：
4.4
作者：
Feola, Andrew J.;Nelson, Emily S.;Samuels, Brian C.
通讯作者：
Samuels, Brian C.
影响因子：
4.1
作者：
Chan, C. K. M.;Cheng, A. C. O.;Lam, D. S. C.
通讯作者：
Lam, D. S. C.