Guidoboni Giovanna, Harris Alon, Arciero Julia C, Siesky Brent A, Amireskandari Annahita, Gerber Austin L, Huck Andrew H, Kim Nathaniel J, Cassani Simone, Carichino Lucia
Department of Mathematical Sciences, Indiana University-Purdue University at Indianapolis, 402 N. Blackford St., Indianapolis, IN, 46202, USA ; Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, 1160 W. Michigan St., Indianapolis, IN, 46202, USA.
Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, 1160 W. Michigan St., Indianapolis, IN, 46202, USA.
J Coupled Syst Multiscale Dyn. 2013 Apr 1;1(1):1-21. doi: 10.1166/jcsmd.2013.1004.
Open angle glaucoma (OAG) is a severe ocular disease characterized by progressive and irreversible vision loss. While elevated intraocular pressure (IOP) is a well-established risk factor for OAG, the progression of OAG in many cases, despite IOP treatment, suggests that other risk factors must play significant roles in the development of the disease. For example, various structural properties of the eye, ocular blood flow properties, and systemic conditions have been identified as risk factors for OAG. Ethnicity has also been indicated as a relevant factor that affects the incidence and prevalence of OAG; in fact, OAG is the leading cause of blindness among people of African descent. Numerous clinical studies have been designed to examine the possible correlation and causation between OAG and these factors; however, these studies are met with the challenge of isolating the individual role of multiple interconnected factors. Over the last decade, various mathematical modeling approaches have been implemented in combination with clinical studies in order to provide a mechanical and hemodynamical description of the eye in relation to the entire human body and to assess the contribution of single risk factors to the development of OAG. This review provides a summary of the clinical evidence of ocular structural differences, ocular vascular differences and systemic vascular differences among people of African and European descent, describes the mathematical approaches that have been proposed to study ocular mechanics and hemodynamics while discussing how they could be used to investigate the relevance to OAG of racial disparities, and outlines possible new directions of research.
开角型青光眼（OAG）是一种严重的眼部疾病，其特征是视力进行性且不可逆丧失。虽然眼内压（IOP）升高是OAG公认的危险因素，但在许多情况下，尽管进行了眼压治疗，OAG仍会进展，这表明其他危险因素在该疾病的发展中必定起重要作用。例如，眼睛的各种结构特性、眼部血流特性和全身状况已被确定为OAG的危险因素。种族也被认为是影响OAG发病率和患病率的一个相关因素；事实上，OAG是非洲裔人群失明的主要原因。许多临床研究旨在检验OAG与这些因素之间可能的相关性和因果关系；然而，这些研究面临着分离多个相互关联因素各自作用的挑战。在过去十年中，各种数学建模方法已与临床研究相结合，以便从与整个人体相关的角度对眼睛进行力学和血液动力学描述，并评估单个危险因素对OAG发展的影响。本综述总结了非洲裔和欧洲裔人群眼部结构差异、眼部血管差异和全身血管差异的临床证据，描述了为研究眼部力学和血液动力学而提出的数学方法，同时讨论了如何利用这些方法研究种族差异与OAG的相关性，并概述了可能的新研究方向。
