CAJ | 학술논문

背景：视乳头形状变化的准确测量及预测是青光眼的早期诊断及病程预测的关键，因此高眼压下视乳头形状的测量与分析具有重要意义。 　　目的：建立视乳头三维有限元模型，并分析急性高眼压下视乳头形状及视网膜厚度的变化。 　　方法：利用前房灌注的方法建立急性高眼压动物模型，利用光相干断层扫描仪获得猫在正常眼压及5320，7980，10640，13300，15960 Pa眼压时的断层图片，测量视网膜特征点处厚度的变化；基于正常眼压猫眼视乳头的断层数据，利用MIMICS软件获得视网膜及脉络膜的三维结构，并进行组装获得视乳头三维模型；利用有限元软件ABAQUS分析高眼压状态下视乳头的形状变化及视网膜厚度变化，并与实验测试结果进行比较。 　　结果与结论：随着眼压的升高，发现视网膜厚度逐渐变薄，视乳头深度及视乳头宽度均逐渐增加，视乳头宽度与深度的比值也逐渐增加。提示急性高眼压导致视网膜变薄，视乳头宽度增大，视乳头深度增大。结果证明，利用光学相干断层扫描仪进行活体视乳头建模和分析是可行的，力学分析可预测视乳头的形状变化，对进一步确定青光眼的病理进程有一定的指导意义。
배경：시유두형상변화적준학측량급예측시청광안적조기진단급병정예측적관건，인차고안압하시유두형상적측량여분석구유중요의의。 　　목적：건립시유두삼유유한원모형，병분석급성고안압하시유두형상급시망막후도적변화。 　　방법：이용전방관주적방법건립급성고안압동물모형，이용광상간단층소묘의획득묘재정상안압급5320，7980，10640，13300，15960 Pa안압시적단층도편，측량시망막특정점처후도적변화；기우정상안압묘안시유두적단층수거，이용MIMICS연건획득시망막급맥락막적삼유결구，병진행조장획득시유두삼유모형；이용유한원연건ABAQUS분석고안압상태하시유두적형상변화급시망막후도변화，병여실험측시결과진행비교。 　　결과여결론：수착안압적승고，발현시망막후도축점변박，시유두심도급시유두관도균축점증가，시유두관도여심도적비치야축점증가。제시급성고안압도치시망막변박，시유두관도증대，시유두심도증대。결과증명，이용광학상간단층소묘의진행활체시유두건모화분석시가행적，역학분석가예측시유두적형상변화，대진일보학정청광안적병리진정유일정적지도의의。
BACKGROUND:The measure and prediction of the shape of optic nerve head are the key issues for early diagnosis and duration prediction of glaucoma. Therefore, it is significant to research the shape variation of optic nerve head under high intraocular pressure. OBJECTIVE:To establish three-dimensional finite element model of optic nerve head and to analyze the deformation of optic nerve head and the change in retina thickness after acute high intraocular pressure. METHODS:Animal model of acute ocular hypertension was established by methods of anterior chamber perfusion. The tomographic images of the optic nerve head of a cat were obtained at the normal intraocular pressure and 5 320 Pa, 7 980 Pa, 10 640 Pa, 13 300 Pa, 15 960 Pa intraocular pressures using optical coherence tomography. Then, we measured the variation of retinal thickness at typical location. Basing on the tomographic images of optic nerve head of a cat at normal intraocular pressure, we obtained three-dimensional structure of retina and choroid using software MIMICS. Then three-dimensional model of optic nerve head was established by assembling the retina and choroid. The deformation of optic nerve head and the change in retinal thickness under high intraocular pressure were observed using software ABAQUS. The effectiveness of the model was verified by the experimental result. RESULTS AND CONCLUSION:With the increase of intraocular pressure, the retinal thickness is thinner, the optic nerve head depth, width and the ratio of the depth to width are gradual y increased. It suggests that the acute high intraocular pressure causes retinal thinning, optic nerve head widening and deepening. It is feasible to establish optic nerve head modeling in vivo by using optical coherence tomography, mechanical analysis can be applied to predict the shape variation of optic nerve head, which is significant to further deduce the pathological process of glaucoma.