TY - JOUR
T1 - Non-dimensional analysis of retinal microaneurysms
T2 - Critical threshold for treatment
AU - Ezra, Elishai
AU - Keinan, Eliezer
AU - Mandel, Yossi
AU - Boulton, Michael E.
AU - Nahmias, Yaakov
PY - 2013/3
Y1 - 2013/3
N2 - Fluid dynamics play a fundamental role in the development of diabetic retinopathy, one of the leading causes of blindness in the Western world, affecting over 4 million people in the US alone. The disease is defined by microaneurysms, local expansions of capillaries that disturb the hemodynamic forces experienced by the endothelium leading to dysfunction, leakage and edema. Here we present a method to identify microaneurysms with a high risk of leakage based on a critical ratio of microaneurysm to vessel diameter. We derive this non-dimensional parameter from an analytical solution and generalize it using experimentally validated numerical methods. We show that this non-dimensional parameter defines the shear force experienced by endothelial cells, below which endothelial dysfunction is evident in vivo. Our results demonstrate the involvement of vWF in diabetic retinopathy, and explain a perceived disconnect between microaneurysm size and leakage. This method will allow experts to treat microaneurysms poising a high-risk of leakage, prior to edema, minimizing damage and saving vision.
AB - Fluid dynamics play a fundamental role in the development of diabetic retinopathy, one of the leading causes of blindness in the Western world, affecting over 4 million people in the US alone. The disease is defined by microaneurysms, local expansions of capillaries that disturb the hemodynamic forces experienced by the endothelium leading to dysfunction, leakage and edema. Here we present a method to identify microaneurysms with a high risk of leakage based on a critical ratio of microaneurysm to vessel diameter. We derive this non-dimensional parameter from an analytical solution and generalize it using experimentally validated numerical methods. We show that this non-dimensional parameter defines the shear force experienced by endothelial cells, below which endothelial dysfunction is evident in vivo. Our results demonstrate the involvement of vWF in diabetic retinopathy, and explain a perceived disconnect between microaneurysm size and leakage. This method will allow experts to treat microaneurysms poising a high-risk of leakage, prior to edema, minimizing damage and saving vision.
UR - http://www.scopus.com/inward/record.url?scp=84874810411&partnerID=8YFLogxK
U2 - 10.1039/c3ib20259c
DO - 10.1039/c3ib20259c
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C2 - 23371018
AN - SCOPUS:84874810411
SN - 1757-9694
VL - 5
SP - 474
EP - 480
JO - Integrative Biology (United Kingdom)
JF - Integrative Biology (United Kingdom)
IS - 3
ER -