Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji, Yoshida, Fukui, 910-1193, Japan.
Prometech Software Inc, Round Terrace Fushimi, 3F, 17-26, Nishiki 1-chome, Naka-ku, Nagoya, 460-0003, Japan.
Sci Rep. 2022 Feb 2;12(1):1735. doi: 10.1038/s41598-022-05886-5.
Silicone oil (SO) is a safe and widely used intraocular tamponade agent for treating complicated vitreoretinal diseases, such as retinal detachments (RRDs) with inferior proliferative vitreoretinopathy (PVR). However, as the human vitreous cavity is irregularly shaped, it is difficult to predict the area of the inferior retina covered with SO and the retro-oil fluid currents in each patient. Here, we performed fluid simulation analysis using the moving particle semi-implicit method on the oil cover rates and absolute velocity gradient of retro-oil fluid to the retina using vitreous cavity models derived from magnetic resonance imaging of patients to determine the appropriate amount of SO and postoperative position to achieve a sufficient tamponade effect on the inferior retina. In all seven vitreous cavity models tested, the inferior quadrant of the retina was completely covered by SO in more positions and the absolute velocity gradient of the retro-oil fluid in contact with the retinal wall caused by eye and head movements was lower when the vitreous cavity was filled with 95% SO and 5% retro-oil fluid versus 80% SO and 20% retro-oil fluid. Taken together, these findings have clinical implications for the treatment of complicated RRDs with inferior PVR requiring SO tamponade.
硅油 (SO) 是一种安全且广泛应用于治疗复杂玻璃体视网膜疾病的眼内填塞剂,例如伴有下方增生性玻璃体视网膜病变 (PVR) 的视网膜脱离 (RRD)。然而,由于人眼玻璃体腔呈不规则形状,因此很难预测每个患者中 SO 覆盖的下方视网膜区域以及视网膜后油液的流场。在这里,我们使用动粒子半隐式方法对从患者磁共振成像中获得的玻璃体腔模型进行油液覆盖率和视网膜后油液绝对速度梯度的流体模拟分析,以确定适当的 SO 用量和术后位置,从而对下方视网膜实现充分的填塞效果。在所有测试的七个玻璃体腔模型中,当玻璃体腔中填充 95% SO 和 5% 反油液与 80% SO 和 20% 反油液相比时,SO 能覆盖视网膜下方更多位置,并且眼球和头部运动引起的视网膜壁接触的反油液绝对速度梯度更低。总的来说,这些发现对需要 SO 填塞的伴有下方 PVR 的复杂 RRD 的治疗具有临床意义。