Indirect Traumatic Optic Neuropathy Induced by Primary Blast: A Fluid–Structure Interaction Study

Tong, Junfei; Kedar, Sachin; Ghate, Deepta; Gu, Linxia

doi:10.1115/1.4043668

Cited by 15 publications

(8 citation statements)

References 61 publications

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“…Fourth, in the current form, we cannot use our model to accurately predict the ventricle ICP, as the material properties of the artificial cerebrospinal fluid used to perfuse the cadavers are not available. While the meninges could be possibly modeled as a viscous fluid with the material properties of water ( Singh et al, 2014 ), we do not expect such properties to significantly modify the simulated pressure-time profiles because other studies that approximated the meninges using the Mie-Gruneisen equation of state for water observed oscillations in the model-predicted ICP for blast-loading conditions ( Garimella et al, 2018 ; Tong et al, 2019 ). Finally, we assumed homogeneous properties for the brain tissue and necessarily excluded rate-dependent material properties specific to brain white matter ( Tse et al, 2017 ; Ramzanpour et al, 2020 ), which could possibly influence VMS and MPS values.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Vasculature Influences Blast-Induced Biomechanical Responses of Human Brain Tissue

Subramaniam

Unnikrishnan

Sundaramurthy

et al. 2021

Front. Bioeng. Biotechnol.

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Multiple finite-element (FE) models to predict the biomechanical responses in the human brain resulting from the interaction with blast waves have established the importance of including the brain-surface convolutions, the major cerebral veins, and using non-linear brain-tissue properties to improve model accuracy. We hypothesize that inclusion of a more detailed network of cerebral veins and arteries can further enhance the model-predicted biomechanical responses and help identify correlates of blast-induced brain injury. To more comprehensively capture the biomechanical responses of human brain tissues to blast-wave exposure, we coupled a three-dimensional (3-D) detailed-vasculature human-head FE model, previously validated for blunt impact, with a 3-D shock-tube FE model. Using the coupled model, we computed the biomechanical responses of a human head facing an incoming blast wave for blast overpressures (BOPs) equivalent to 68, 83, and 104 kPa. We validated our FE model, which includes the detailed network of cerebral veins and arteries, the gyri and the sulci, and hyper-viscoelastic brain-tissue properties, by comparing the model-predicted intracranial pressure (ICP) values with previously collected data from shock-tube experiments performed on cadaver heads. In addition, to quantify the influence of including a more comprehensive network of brain vessels, we compared the biomechanical responses of our detailed-vasculature model with those of a reduced-vasculature model and a no-vasculature model for the same blast-loading conditions. For the three BOPs, the predicted ICP values matched well with the experimental results in the frontal lobe, with peak-pressure differences of 4–11% and phase-shift differences of 9–13%. As expected, incorporating the detailed cerebral vasculature did not influence the ICP, however, it redistributed the peak brain-tissue strains by as much as 30% and yielded peak strain differences of up to 7%. When compared to existing reduced-vasculature FE models that only include the major cerebral veins, our high-fidelity model redistributed the brain-tissue strains in most of the brain, highlighting the importance of including a detailed cerebral vessel network in human-head FE models to more comprehensively account for the biomechanical responses induced by blast exposure.

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Section: Discussionmentioning

confidence: 99%

Cerebral Vasculature Influences Blast-Induced Biomechanical Responses of Human Brain Tissue

Subramaniam

Unnikrishnan

Sundaramurthy

et al. 2021

Front. Bioeng. Biotechnol.

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“…To date, the research about the vascular changes in optic neuropathies with OCT-A has been scarce. Chan et al [6] found that significant decrease in blood supply and oxygenation to the retina was associated with choroidal thinning in chronic ITON patients. Lee et al [31] reported that in early ITON, a significant thinning of macular ganglion cell complex (GCC) was observed, which implied that GCC loss may participate in the development of ITON.…”

Section: Discussionmentioning

confidence: 99%

“…The shock wave from concussive forces applied to the head or face is transmitted to the optic canal. It was hypothesized that swelling of the optic nerve within the fixed and limited cavity of the optic canal compromises blood supply, which exacerbates tissue ischemia and causes further damage to the injured optic nerve [4][5][6]. This pathophysiological hypothesis is commonly cited as a rationale for performing optic canal decompressive surgery.…”

Section: Introductionmentioning

confidence: 99%

The retinal vasculature pathophysiological changes in vision recovery after treatment for indirect traumatic optic neuropathy patients

Gao

et al. 2021

Graefes Arch Clin Exp Ophthalmol

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Purpose To evaluate the retinal vasculature pathophysiological changes of indirect traumatic optic neuropathy (ITON) patients after effective surgery. Methods Monocular ITON patients who underwent endoscopic trans-ethmosphenoid optic canal decompression (ETOCD) or conservative treatments in Zhongshan Ophthalmic Center from January 2017 to June 2020 were recruited. Visual acuity (VA), visual evoked potential (VEP), oxygen saturation of retinal blood vessels (SO2), and optical coherence tomography angiography (OCT-A) were measured. All patients were followed up at least 3 months after treatments. Results A total of 95 ITON patients were recruited, including 77 patients who underwent ETOCD and 18 patients who underwent conservative treatments. After treatments, more patients received ETOCD (59/77 = 76.6%) presented with improved VA compared with the patients with conservative treatments (6/18 = 33.3%). Compared with the pre-therapeutic measurements, VEP were significantly improved after surgery in ETOCD-treated patients (P < 0.05). Latent periods of P1 and N2, as well as amplitude of P2 of VEP parameters, showed more sensitive to vision recovery (P < 0.05). Retinal artery SO2 and the differences between arteries and veins were improved in ETOCD-treated patients (P < 0.05). Meanwhile, with OCT-A examination, the retinal thickness and retinal vessel density were notably better in ETOCD-treated patients after surgery than that in patients received conservative treatments (P < 0.05). Conclusions Vision recovery after effective treatment of ITON patients was associated with the increased oxygen saturation of retinal vessels, better availability of oxygen in the retina, greater vessel density, and thicker retinas, which might further underlie the vasculature mechanism of vision recovery in ITON patients.

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“…Sclera, vitreous, and retina were considered incompressible materials with a Poisson's ratio of 0.49. The sclera was modeled as a hyperelastic material based on the published uniaxial test data [16].…”

Section: Fe Analysismentioning

confidence: 99%

Rapid Prediction of Retina Stress and Strain Patterns in Soccer-Related Ocular Injury: Integrating Finite Element Analysis with Machine Learning Approach

et al. 2022

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Soccer-related ocular injuries, especially retinal injuries, have attracted increasing attention. The mechanics of a flying soccer ball have induced abnormally higher retinal stresses and strains, and their correlation with retinal injuries has been characterized using the finite element (FE) method. However, FE simulations demand solid mechanical expertise and extensive computational time, both of which are difficult to adopt in clinical settings. This study proposes a framework that combines FE analysis with a machine learning (ML) approach for the fast prediction of retina mechanics. Different impact scenarios were simulated using the FE method to obtain the von Mises stress map and the maximum principal strain map in the posterior retina. These stress and strain patterns, along with their input parameters, were used to train and test a partial least squares regression (PLSR) model to predict the soccer-induced retina stress and strain in terms of distributions and peak magnitudes. The peak von Mises stress and maximum principal strain prediction errors were 3.03% and 9.94% for the frontal impact and were 9.08% and 16.40% for the diagonal impact, respectively. The average prediction error of von Mises stress and the maximum principal strain were 15.62% and 21.15% for frontal impacts and were 10.77% and 21.78% for diagonal impacts, respectively. This work provides a surrogate model of FE analysis for the fast prediction of the dynamic mechanics of the retina in response to the soccer impact, which could be further utilized for developing a diagnostic tool for soccer-related ocular trauma.

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Indirect Traumatic Optic Neuropathy Induced by Primary Blast: A Fluid–Structure Interaction Study

Cited by 15 publications

References 61 publications

Cerebral Vasculature Influences Blast-Induced Biomechanical Responses of Human Brain Tissue

Cerebral Vasculature Influences Blast-Induced Biomechanical Responses of Human Brain Tissue

The retinal vasculature pathophysiological changes in vision recovery after treatment for indirect traumatic optic neuropathy patients

Rapid Prediction of Retina Stress and Strain Patterns in Soccer-Related Ocular Injury: Integrating Finite Element Analysis with Machine Learning Approach

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