青光眼发病机理--筛板变形研究进展
PATHOGENETIC MECHANISMS OF GLAUCOMA------RESEARCH PROCESS ON THE DEFORMATION OF LAMINA CRIBROSA
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摘要: 青光眼是世界上第一大不可逆致盲眼病.其病变与眼内压直接相关,控制眼内压是目前控制青光眼发展的唯一有效途径,但发病的确切机制尚未明确.现已证实,青光眼的原发部位是巩膜筛板:由筛板前后分别承受的眼内压与颅内压产生的压力差会导致筛板结构与形态发生变化,进而挤压穿过筛板的视觉神经,造成视觉神经损伤,产生不可逆的视觉损失.因此,青光眼的发病机理与筛板的力学特性及其周围的力学环境密切相关.自从筛板被确定为青光眼视神经损害的原发部位,筛板便成为该领域的研究热点.其中,通过建立筛板力学模型,研究眼内压与颅内压作用下筛板的受力变形,进而分析筛板变形对视神经的损伤,有助于揭示青光眼视神经损伤机制及青光眼的发病机理.本文将从相关实验、理论和计算以及临床等方面介绍青光眼发病机理中筛板变形的研究进展以及目前存在的问题.Abstract: Glaucoma is the first cause of irreversible blinding eye disease in the world. Glaucomatous optic nerve damage is directly associated with the intraocular pressure, and tight control of intraocular pressure is still the only therapeutic approach available for the treatment of glaucoma, while the pathogenesis of glaucoma remains unknown. It has now been confirmed that the primary site of glaucoma is the lamina cribrosa: the pressure difference between the intraocular pressure and intracranial pressure respectively exerted on the anterior and posterior surfaces of lamina cribrosa can cause the change in the structure and morphology of lamina cribrosa, then the deformation of lamina cribrosa squeezes the optic nerves passing through the lamina cribrosa to make their damages; and finally, the damages produce irreversible visual loss. As a result, the pathogenesis of glaucoma is essentially associated with the mechanical properties of lamina cribrosa and mechanical environment surrounding the lamina cribrosa. Since lamina cribrosa was identified as the primary site of glaucomatous optic nerve damage, it has become the hot spot of glaucomatous optic nerve damage research. As an effective method, we can study the deformation of lamina cribrosa under the effect of intraocular pressure and intracranial pressure by developing mechanical model of lamina cribrosa, and analyze the effect of the deformation of lamina cribrosa on the optic nerve damage. This method has helped us to reveal the mechanism of glaucomatous optic nerve damage and the pathogenesis of glaucoma to some extent. This review will introduce the research progress and the present existing problems on the deformation of lamina cribrosa during glaucoma from the related experimental, theoretical, computational and clinical aspects.