Rai Rajat, Guidoboni Giovanna, Wikle Christopher K, Topouzis Fotis, Siesky Brent, Vercellin Alice Verticchio, Antman Gal, Harris Alon
Graduate School of Biomedical Sciences and Engineering, University of Maine, 5775 Stodder Hall, Orono, ME 04469, USA.
Maine College of Engineering and Computing, University of Maine, 5796 AMC Building, Orono, ME 04469, USA.
Mathematica (N Y). 2025 Mar;4(1):66-83. doi: 10.1007/s44007-024-00144-8. Epub 2024 Dec 23.
Primary open angle glaucoma (POAG) is a leading cause of irreversible blindness with risk factors including elevated intraocular pressure (IOP), and both high and low blood pressure (BP). This study investigates the joint influence of IOP and BP on retinal hemodynamics, emphasizing venous circulation. A synthetic dataset comprising 2500 eyes with varied IOP [5-45] mmHg, systolic BP (SBP) [90-200] mmHg and diastolic BP (DBP) [40-120] mmHg was created. Mean pressure , mean flow , and mean resistance , were estimated using a validated mathematical model. The values of these hemodynamic output variables were then analyzed in relation to different values of IOP and mean arterial pressure (MAP; MAP = 1/3 SBP + 2/3 DBP). Clinical data from a population-based Greek study were similarly analyzed. Differences in the simulated hemodynamic output variables and clinical markers between healthy and POAG eyes were then measured. Synthetic dataset analysis revealed that and vary significantly depending on different IOP-MAP combinations. Notably, eyes with low MAP and high IOP demonstrated a drastic increase in in the venules accompanied with a dramatic decrease in in the central retinal vein (CRV). Clinical data indicated that venules in POAG eyes had significantly higher than healthy eyes ( < 0.01), along with decreased in the CRV of POAG eyes compared to healthy eyes ( = 0.01). The study highlights the increased susceptibility to venous collapse in POAG eyes and the importance of considering the venous side of retinal circulation in the combined impact of risk factors in POAG.
原发性开角型青光眼（POAG）是不可逆性失明的主要原因，其风险因素包括眼压（IOP）升高以及高血压和低血压。本研究调查了眼压和血压对视网膜血流动力学的联合影响，重点关注静脉循环。创建了一个合成数据集，包含2500只眼睛，其眼压范围为[5 - 45] mmHg，收缩压（SBP）范围为[90 - 200] mmHg，舒张压（DBP）范围为[40 - 120] mmHg。使用经过验证的数学模型估计平均压力、平均流量和平均阻力。然后分析这些血流动力学输出变量的值与不同眼压值和平均动脉压（MAP；MAP = 1/3 SBP + 2/3 DBP）的关系。对一项基于希腊人群的研究中的临床数据进行了类似分析。然后测量了健康眼睛和POAG眼睛之间模拟的血流动力学输出变量和临床指标的差异。合成数据集分析表明，平均流量和平均阻力根据不同的眼压 - MAP组合有显著差异。值得注意的是，MAP低且眼压高的眼睛小静脉中的平均流量急剧增加，同时视网膜中央静脉（CRV）中的平均流量急剧下降。临床数据表明，POAG眼睛的小静脉平均流量显著高于健康眼睛（P < 0.01），并且与健康眼睛相比，POAG眼睛CRV中的平均流量降低（P = 0.01）。该研究强调了POAG眼睛对静脉塌陷的易感性增加，以及在POAG风险因素的综合影响中考虑视网膜循环静脉侧的重要性。
