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A mechanical model of posterior vitreous detachment and generation of vitreoretinal tractions.
Biomechanics and Modeling in Mechanobiology ( IF 3.0 ) Pub Date : 2020-07-08 , DOI: 10.1007/s10237-020-01360-1
Federica Di Michele 1 , Amabile Tatone 2 , Mario R Romano 3 , Rodolfo Repetto 4
Affiliation  

We propose a mechanical model of generation of vitreoretinal tractions in the presence of posterior vitreous detachment (PVD). PVD is a common occurrence with aging, and it consists in the separation of the vitreous body from the retina at the back pole of the eye, due to progressive shrinking of the vitreous gel. During this separation process, vitreoretinal tractions are generated at regions of high adhesion between the vitreous and the retina. Such tractions are mainly responsible for the creation of retinal tears, which can lead to retinal detachment. We describe the PVD evolution developing a continuum model of a shrinking soft body, representing the vitreous humor gel phase. In the model, the vitreous is surrounded by a membrane, stiffer than the bulk, the vitreous cortex, and it is contained within a rigid spherical domain, the vitreous chamber. The membrane is attached to the spherical wall and the adhesion strength is spatially non-uniform, increasing from the back to the front of the chamber, according to clinical observations. During the shrinking process, the vitreous undergoes elastic distortions, owing to the spatially variable adhesion on the wall, and this produces boundary tractions. We also consider the clinically relevant case of anomalous PVD, in which regions of focal adhesion between the vitreous and the retina exist, leading to the generation of strong, localized tractions. The model reproduces a PVD evolution in good qualitative agreement with clinical observations and makes it possible to correlate the shape of the detached vitreous with the intensity of vitreoretinal tractions.



中文翻译:

玻璃体后脱离和玻璃体视网膜牵引的机械模型。

我们提出了一种在玻璃体后脱离 (PVD) 的情况下产生玻璃体视网膜牵引的机械模型。PVD 是随着年龄增长而常见的现象,它包括由于玻璃体凝胶的逐渐收缩导致玻璃体与眼睛后极处的视网膜分离。在此分离过程中,玻璃体和视网膜之间的高粘附区域会产生玻璃体视网膜牵引。这种牵引力主要是造成视网膜撕裂的原因,这会导致视网膜脱离。我们描述了 PVD ​​演变,开发了一个收缩软体的连续模型,代表玻璃体液凝胶阶段。在模型中,玻璃体被一层膜包围,比大部分玻璃体皮质更硬,它包含在刚性球形域中,玻璃体腔。根据临床观察,膜附着在球形壁上,粘附强度在空间上不均匀,从腔室的后部到前部增加。在收缩过程中,由于壁上空间可变的粘附力,玻璃体发生弹性变形,从而产生边界牵引。我们还考虑了异常 PVD ​​的临床相关病例,其中玻璃体和视网膜之间存在粘着斑区域,导致产生强烈的局部牵引。该模型再现了与临床观察结果具有良好定性一致性的 PVD ​​演变,并且可以将分离的玻璃体的形状与玻璃体视网膜牵引的强度相关联。根据临床观察,膜附着在球形壁上,粘附强度在空间上不均匀,从腔室的后部到前部增加。在收缩过程中,由于壁上空间可变的粘附力,玻璃体发生弹性变形,从而产生边界牵引。我们还考虑了异常 PVD ​​的临床相关病例,其中玻璃体和视网膜之间存在粘着斑区域,导致产生强烈的局部牵引。该模型再现了与临床观察结果具有良好定性一致性的 PVD ​​演变,并且可以将分离的玻璃体的形状与玻璃体视网膜牵引的强度相关联。根据临床观察,膜附着在球形壁上,粘附强度在空间上不均匀,从腔室的后部到前部增加。在收缩过程中,由于壁上空间可变的粘附力,玻璃体发生弹性变形,从而产生边界牵引。我们还考虑了异常 PVD ​​的临床相关病例,其中玻璃体和视网膜之间存在粘着斑区域,导致产生强烈的局部牵引。该模型再现了与临床观察结果具有良好定性一致性的 PVD ​​演变,并且可以将分离的玻璃体的形状与玻璃体视网膜牵引的强度相关联。根据临床观察。在收缩过程中,由于壁上空间可变的粘附力,玻璃体发生弹性变形,从而产生边界牵引。我们还考虑了异常 PVD ​​的临床相关病例,其中玻璃体和视网膜之间存在粘着斑区域,导致产生强烈的局部牵引。该模型再现了与临床观察结果具有良好定性一致性的 PVD ​​演变,并且可以将分离的玻璃体的形状与玻璃体视网膜牵引的强度相关联。根据临床观察。在收缩过程中,由于壁上空间可变的粘附力,玻璃体发生弹性变形,从而产生边界牵引。我们还考虑了异常 PVD ​​的临床相关病例,其中玻璃体和视网膜之间存在粘着斑区域,导致产生强烈的局部牵引。该模型再现了与临床观察结果具有良好定性一致性的 PVD ​​演变,并且可以将分离的玻璃体的形状与玻璃体视网膜牵引的强度相关联。我们还考虑了异常 PVD ​​的临床相关病例,其中玻璃体和视网膜之间存在粘着斑区域,导致产生强烈的局部牵引。该模型再现了与临床观察结果具有良好定性一致性的 PVD ​​演变,并且可以将分离的玻璃体的形状与玻璃体视网膜牵引的强度相关联。我们还考虑了异常 PVD ​​的临床相关病例,其中玻璃体和视网膜之间存在粘着斑区域,导致产生强烈的局部牵引。该模型再现了与临床观察结果具有良好定性一致性的 PVD ​​演变,并且可以将分离的玻璃体的形状与玻璃体视网膜牵引的强度相关联。

更新日期:2020-07-08
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