The promise of prediction: biomechanical analyses in neuro-ophthalmology.
The promise of prediction: biomechanical analyses in neuro-ophthalmology.
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预测的希望：神经眼科的生物力学分析。
DOI：
10.1097/wno.0000000000000192
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Downs,JCrawford
中科院分区：
文献类型：
--
作者：
Downs,JCrawford
生物力学是在生物学背景下研究固体和/或流体与内力和外力的机械相互作用的学科。长期以来，它一直是心血管和骨科领域的支柱，在这些领域，它被用于分析和预测骨折、硬组织和软组织重塑以及动脉支架和动脉瘤血流的机械和生物机制。生物力学技术是优化心脏和骨科植入物设计以获得最大临床疗效和寿命的关键。眼部生物力学主要集中在角膜、小梁网、巩膜和视神经头的疾病上，在玻璃体、晶状体和虹膜上的应用有限。它为各种眼病的疾病过程和手术结果提供了见解。例如，在青光眼中，眼部生物力学已被用于分析和预测巩膜在确定青光眼轴突损伤部位筛板生物力学中的重要性。生物力学工程师使用尖端的基于工程的计算和实验技术来研究眼组织与周围环境的相互作用，眼睛中常见的力是眼内压、拉伸和扭转肌肉牵引力、血流和血管压力、外部创伤力、脑脊液压力和组织生长压力。生物工程师使用的工具包括有限元建模，这是一种计算技术，可以将复杂的几何形状（如筛板）分割成规则形状的小元素，从而单独计算载荷、机械应力（力分布）和机械应变（局部变形）。然后将这些简单元素反应的结果加起来，或叠加到结构的总体反应中。组织在载荷下变形的实验测量现在可以通过成像技术获得，如超声生物显微镜、光学相干断层扫描和磁共振成像，这些观察结果可以用来验证计算生物力学模拟。
Biomechanics is the study of the mechanical interaction of solids and/or fluids with internal and external forces in the context of biology. It has long been a mainstay in the cardiovascular and orthopedic fields, where it has been used to analyze and predict the mechanical and biological mechanisms underlying bone fractures, hard and soft tissue remodeling, and blood flow through arterial stents and aneurysms. Biomechanical techniques are critical in optimizing cardiac and orthopedic implant designs for maximum clinical efficacy and life.Ocular biomechanics primarily has been focused on diseases of the cornea, trabecular meshwork, sclera, and optic nerve head with limited use in the vitreous, lens, and iris. It has provided insight into disease processes and surgical outcome in various eye disorders. For example, in glaucoma, ocular biomechanics has been used to analyze and predict the importance of the sclera in determining the biomechanics of the lamina cribrosa, the site of axonal damage in glaucoma. Biomechanical engineers use cutting-edge engineering-based computational and experimental techniques to investigate the interaction of ocular tissues with their surroundings, and the forces that are common in the eye are intraocular pressure, tensile and torsional muscle tractions, blood flow and vascular pressures, external traumatic forces, cerebrospinal fluid pressure, and tissue growth pressures. The tools bioengineers use include finite element modeling, a computational technique to split complex geometries such as the lamina cribrosa into small regularly shaped elements, for which loading, mechanical stress (force distribution), and mechanical strain (local deformation) are calculated individually. The results of each of these simple elemental responses are then added up, or superposed, into the overall response of the structure. Experimental measures of tissue deformation under load can now be obtained with imaging techniques, such as ultrasound biomicroscopy, optical coherence tomography, and magnetic resonance imaging, and these observations can be used to validate computational biomechanics simulations.
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