Data-Driven Biomechanical Simulation of Eye Movement and Strabismus

摘要 斜视是一种常见的双眼视觉障碍，涉及眼睛的神经肌肉异常，影响18岁 百万美国人。这种疾病会导致复视、双眼混乱、眼睛疲劳和其他症状 使日常活动复杂化。斜视的治疗通常基于手术直觉和传统， 但报道的成功率令人失望，从30%到80%不等。我们建议开发一种新的数据- 斜视桥式斜视神经生物力学仿真建模与仿真框架 实验研究和临床应用，以提高我们对斜视的认识和治疗。我们会 建立第一个三维眼动系统生物力学模型，将最新的 眼外肌滑车和肌室的发现。使用来自多个个体的临床数据 作为对该模型的有力检验，我们将制定通用的诊断策略和新的治疗方法 适用于需要改进管理的常见但有问题的斜视类别(原型)。这个 从这种系统研究中获得的知识可以直接应用于临床，以帮助未来 相似患者的评估和量化手术剂量，而不是模拟每个患者。的成功之处 所提出的科学指导的斜视治疗方法可用于其他类型的斜视。 以及其他眼球运动障碍，以改善临床结果。 我们将进行三组相关分析。在目标1中，我们将开发一种新的计算模型 能够模拟双眼三维运动的眼睛，克服了现有眼睛的局限性 模特们。第一次，关于眼外肌功能分区的最新研究成果 并将主动控制的滑轮结缔组织万向架系统纳入生物力学模型。 开发的模型将根据经验和临床数据进行验证，以便它可以在 临床模拟。在目标2和目标3中，我们将利用目标1中开发的模型来执行特定于患者的操作 结合临床数据的斜视模拟。区间化在两种疾病病理生理学中的作用 常见类型的旋转性垂直斜视、上斜肌麻痹和下垂眼症候群将被检查。 治疗这些疾病的不同手术干预将在患者特定的眼眶模型上模拟，以 评估这些外科手术的有效性。 该项目的成果将是一个数据驱动的真实神经生物力学眼动模拟器，有用 用于科学研究、临床洞察和对常见形式的不同类型外科手术方法的评估 斜视的症状。这样的模型可能会提高我们对眼外肌功能的理解 正常眼球运动和斜视时的分区。它还可以提供定量评估 手术干预效果，为斜视的非手术治疗提供参考。

SUMMARY Strabismus, a common binocular vision disorder that involves neuromuscular abnormality of the eyes, affects 18 million Americans. The disorder causes double vision, binocular confusion, eyestrain, and other symptoms that complicate daily activities. Strabismus is commonly treated surgically based on surgical intuition and tradition, but with reported disappointing success rates ranging from 30% to 80%. We propose to develop a novel data- driven modeling and simulation framework to simulate the neuro-biomechanics of strabismus that can bridge experimental studies and clinical application to advance our understanding and treatment of strabismus. We will develop the first three dimensional biomechanical model of the oculomotor system that incorporates recent findings on extraocular muscle pulleys and muscle compartments. Using clinical data from multiple individual cases as strong tests of the model, we will then develop generalized strategies for diagnosis and novel treatment for common but problematic classes (archetypes) of strabismus that require improved management. The knowledge gained from such systematic investigation can be directly applied clinically to assist future assessment and quantitative surgical dosing of similar patients without simulating every patient. The success of the proposed science-guided strabismus treatment approach could be utilized for other archetypes of strabismus as well as other oculomotor disorders to improve clinical outcomes. We will perform three sets of related analyses. In Aim 1, we will develop a novel computational model of the eyes capable of simulating binocular eye movement in three dimensions and overcoming limitations of existing models. For the first time, latest research findings on the functional compartmentalization of extraocular muscles and the actively-controlled pulley connective tissue gimbal system will be included in the biomechanical model. The developed model will be validated against empirical and clinical data so that it can be used rigorously in clinical simulation. In Aim 2 and Aim 3, we will leverage the model developed in Aim 1 to perform patient-specific strabismus simulation incorporating clinical data. The role of compartmentalization in the pathophysiology of two common types of cyclovertical strabismus, superior oblique palsy and sagging eye syndrome, will be examined. Different surgical interventions on treating these conditions will be simulated on patient-specific orbit models to assess the effectiveness of these surgical procedures. The outcome of this project will be a data-driven realistic neuro-biomechanical eye movement simulator, useful for scientific research, clinical insights, and evaluation of different types of surgical approaches to common forms of strabismus. Such a model can potentially improve our understanding of the functions of extraocular muscle compartmentalization in normal eye movements and in strabismus. It can also provide quantitative assessment of surgical intervention effectiveness and shed light on nonsurgical therapy of strabismus.