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A Mechanistic Model of Aqueous Humor Flow to Study Effects of Angle Closure on Intraocular Pressure

PURPOSE: To study the relationship between the circumferential extent of angle closure and elevation in intraocular pressure (IOP) using a novel mechanistic model of aqueous humor (AH) flow. METHODS: AH flow through conventional and unconventional outflow pathways was modeled using the unified Stoke...

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Autores principales: Murgoitio-Esandi, Javier, Xu, Benjamin Y., Song, Brian J., Zhou, Qifa, Oberai, Assad A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Association for Research in Vision and Ophthalmology 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9838584/
https://www.ncbi.nlm.nih.gov/pubmed/36622686
http://dx.doi.org/10.1167/tvst.12.1.16
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author Murgoitio-Esandi, Javier
Xu, Benjamin Y.
Song, Brian J.
Zhou, Qifa
Oberai, Assad A.
author_facet Murgoitio-Esandi, Javier
Xu, Benjamin Y.
Song, Brian J.
Zhou, Qifa
Oberai, Assad A.
author_sort Murgoitio-Esandi, Javier
collection PubMed
description PURPOSE: To study the relationship between the circumferential extent of angle closure and elevation in intraocular pressure (IOP) using a novel mechanistic model of aqueous humor (AH) flow. METHODS: AH flow through conventional and unconventional outflow pathways was modeled using the unified Stokes and Darcy equations, which were solved using the finite element method. The severity and circumferential extent of angle closure were modeled by lowering the permeability of the outflow pathways. The IOP predicted by the model was compared with biometric and IOP data from the Chinese American Eye Study, wherein the circumferential extent of angle closure was determined using anterior segment OCT measurements of angle opening distance. RESULTS: The mechanistic model predicted an initial linear rise in IOP with increasing extent of angle closure which became nonlinear when the extent of closure exceeded around one-half of the circumference. The nonlinear rise in IOP was associated with a nonlinear increase in AH outflow velocity in the open regions of the angle. These predictions were consistent with the nonlinear relationship between angle closure and IOP observed in the clinical data. CONCLUSIONS: IOP increases rapidly when the circumferential extent of angle closure exceeds 180°. Residual AH outflow may explain why not all angle closure eyes develop elevated IOP when angle closure is extensive. TRANSLATIONAL RELEVANCE: This study provides insight into the extent of angle closure that is clinically relevant and confers increased risk of elevated IOP. The proposed model can be utilized to study other mechanisms of impaired aqueous outflow.
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spelling pubmed-98385842023-01-14 A Mechanistic Model of Aqueous Humor Flow to Study Effects of Angle Closure on Intraocular Pressure Murgoitio-Esandi, Javier Xu, Benjamin Y. Song, Brian J. Zhou, Qifa Oberai, Assad A. Transl Vis Sci Technol Glaucoma PURPOSE: To study the relationship between the circumferential extent of angle closure and elevation in intraocular pressure (IOP) using a novel mechanistic model of aqueous humor (AH) flow. METHODS: AH flow through conventional and unconventional outflow pathways was modeled using the unified Stokes and Darcy equations, which were solved using the finite element method. The severity and circumferential extent of angle closure were modeled by lowering the permeability of the outflow pathways. The IOP predicted by the model was compared with biometric and IOP data from the Chinese American Eye Study, wherein the circumferential extent of angle closure was determined using anterior segment OCT measurements of angle opening distance. RESULTS: The mechanistic model predicted an initial linear rise in IOP with increasing extent of angle closure which became nonlinear when the extent of closure exceeded around one-half of the circumference. The nonlinear rise in IOP was associated with a nonlinear increase in AH outflow velocity in the open regions of the angle. These predictions were consistent with the nonlinear relationship between angle closure and IOP observed in the clinical data. CONCLUSIONS: IOP increases rapidly when the circumferential extent of angle closure exceeds 180°. Residual AH outflow may explain why not all angle closure eyes develop elevated IOP when angle closure is extensive. TRANSLATIONAL RELEVANCE: This study provides insight into the extent of angle closure that is clinically relevant and confers increased risk of elevated IOP. The proposed model can be utilized to study other mechanisms of impaired aqueous outflow. The Association for Research in Vision and Ophthalmology 2023-01-09 /pmc/articles/PMC9838584/ /pubmed/36622686 http://dx.doi.org/10.1167/tvst.12.1.16 Text en Copyright 2023 The Authors https://creativecommons.org/licenses/by/4.0/This work is licensed under a Creative Commons Attribution 4.0 International License.
spellingShingle Glaucoma
Murgoitio-Esandi, Javier
Xu, Benjamin Y.
Song, Brian J.
Zhou, Qifa
Oberai, Assad A.
A Mechanistic Model of Aqueous Humor Flow to Study Effects of Angle Closure on Intraocular Pressure
title A Mechanistic Model of Aqueous Humor Flow to Study Effects of Angle Closure on Intraocular Pressure
title_full A Mechanistic Model of Aqueous Humor Flow to Study Effects of Angle Closure on Intraocular Pressure
title_fullStr A Mechanistic Model of Aqueous Humor Flow to Study Effects of Angle Closure on Intraocular Pressure
title_full_unstemmed A Mechanistic Model of Aqueous Humor Flow to Study Effects of Angle Closure on Intraocular Pressure
title_short A Mechanistic Model of Aqueous Humor Flow to Study Effects of Angle Closure on Intraocular Pressure
title_sort mechanistic model of aqueous humor flow to study effects of angle closure on intraocular pressure
topic Glaucoma
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9838584/
https://www.ncbi.nlm.nih.gov/pubmed/36622686
http://dx.doi.org/10.1167/tvst.12.1.16
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