Data-Driven Biomechanical Simulation of Eye Movement and Strabismus

总结 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， 数百万美国人这种疾病会导致复视、双眼模糊、眼疲劳和其他症状， 使日常活动复杂化。斜视通常是根据手术直觉和传统进行手术治疗， 但报告的成功率从30%到80%不等，令人失望。我们建议开发一种新的数据- 驱动的建模和仿真框架，以模拟神经生物力学的斜视，可以桥接 实验研究和临床应用，以提高我们对斜视的认识和治疗。我们将 开发了第一个三维生物力学模型的眼系统，结合了最近的 眼外肌滑轮和肌间室的检查结果。使用来自多个个体的临床数据 病例作为模型的强有力检验，然后我们将开发诊断和新治疗的通用策略 常见但有问题的斜视类型（原型），需要改进的管理。的 从这种系统研究中获得的知识可以直接应用于临床， 类似患者的评估和定量手术给药，而无需模拟每个患者。的成功 所提出的科学指导的斜视治疗方法可以用于其他类型的斜视 以及其它眼科疾病以改善临床结果。 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， 能够在三维中模拟双眼眼球运动并克服现有 模型第一次，关于眼外肌功能分区的最新研究结果 主动控制滑轮结缔组织万向节系统将被包括在生物力学模型中。 开发的模型将根据经验和临床数据进行验证，以便它可以严格用于 临床模拟在目标2和目标3中，我们将利用目标1中开发的模型进行患者特异性 结合临床数据的斜视模拟。区室化在两种疾病病理生理学中的作用 将检查常见类型的旋转垂直斜视、上级斜肌麻痹和下垂眼综合征。 将在患者特定的眼眶模型上模拟治疗这些疾病的不同手术干预， 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逼真的神经生物力学眼动模拟器， 用于科学研究，临床见解，以及对常见形式的不同类型手术方法的评估 斜视这种模型可以潜在地提高我们对眼外肌功能的理解 正常眼球运动和斜视中的区室化。它还可以提供定量评估 探讨了手术干预的有效性，为斜视的非手术治疗提供了新的思路。

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.