PURPOSE. We aim to understand how mechanical causation influences retinal detachment and reattachment processes. In particular, myopes suffer retinal detachment more frequently than emmetropes, and following a retinal detachment, scleral buckling promotes retinal reattachment. We test the hypothesis that stresses arising from saccadic eye rotations are involved in the processes, and that the alteration in the stress due to the change in the vitreous chamber geometry is sufficient to explain the phenomena.
METHODS.The vitreous chamber of the eye has an approximately spherical shape and it is filled with vitreous humor. We developed a mathematical model, treating the vitreous chamber in emmetropic and myopic eyes as a spheroid and in eyes subjected to scleral buckling as a sphere with a circumferential indentation. We assume that the eye performs prescribed small-amplitude, periodic, torsional rotations and we solve semi-analytically for the fluid pressure, velocity, and stress distributions.
RESULTS.The shape of the vitreous chamber has a large effect on the retinal stress. The vitreous and the retina of a highly myopic eye continuously experience shear stresses significantly higher than those of an emmetropic eye. An eye fitted with a scleral buckle experiences large stress levels localized around the buckle.
CONCLUSIONS.Our results provide a mechanical explanation for the more frequent occurrence of posterior vitreous detachment and retinal detachment in myopic eyes. To understand how the stress distribution in a buckled eye facilitates reattachment, an additional model of the details of the reattachment process should be coupled to this model. (Invest Ophthalmol Vis Sci. 2012;53:6271-6281) DOI:10.1167/ iovs.11-9390 R etinal detachment (RD) is defined as a separation of the sensory part of the retina from the underlying retinal pigment epithelium, and often leads to sight loss. The most common type is rhegmatogeneous retinal detachment, in which, following liquefaction of the vitreous humor and the development of a tear in the retina, the subretinal space is filled with liquefied vitreous humor. In healthy young eyes, vitreous humor is a gel with complex mechanical properties, which have been studied experimentally by several authors. [1][2][3][4][5][6] The gel state is maintained by a network of collagen fibrils, which typically degrades with age, resulting in vitreous liquefaction. The mechanisms underlying this process are not fully understood.The incidence of myopia is correlated with an increased risk of RD, reported to be four times higher if the refractive error is between À1 and À3 diopters (D), and up to 10 times higher if the error is more than À3 D. 7 It is also known that both posterior vitreous detachment (PVD) and lattice degeneration, which are risk factors for RD, are more common in myopes. [8][9][10] To our knowledge, the reasons for these findings are not fully understood. Myopia is typically associated with a shape change in the vitreous chamber; in particular, myopic eyes are on average larg...