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Determining the Tractional Forces on Vitreoretinal Interface Using a Computer Simulation Model in Abusive Head

Donny W Suh1, Helen H Song2, Hozhabr Mozafari3

  • 1Section of Ophthalmology, Children's Hospital and Medical Center, Omaha, Nebraska, USA; Ophthalmology and Visual Sciences, Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska, USA.

American Journal of Ophthalmology
|July 15, 2020
PubMed
Summary

Computer simulations explain retinal hemorrhages in abusive head trauma (AHT). The model shows vitreoretinal traction forces correlate with hemorrhage patterns, aiding understanding of AHT ocular injuries.

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Area of Science:

  • Ophthalmology
  • Biomechanical Engineering
  • Pediatric Traumatology

Background:

  • Abusive head trauma (AHT) is a primary cause of infant mortality and severe injury.
  • The ocular manifestations of AHT, particularly retinal hemorrhages (RH), are not fully understood.
  • Vitreoretinal traction is a proposed mechanism for AHT-related retinal findings.

Purpose of the Study:

  • To develop a computer simulation model to evaluate vitreoretinal traction during shaking.
  • To determine if force distribution in retinal layers can explain AHT-associated RH patterns.

Main Methods:

  • A computer simulation model of a pediatric eye was created.
  • The model assessed stresses in preretinal, intraretinal, and subretinal layers during simulated shaking.
  • Forces on various blood vessel segments were analyzed.

Main Results:

  • Simulated stress values at the vitreoretinal interface ranged from 3-16 kPa.
  • Maximal stress occurred at the retinal periphery and posterior pole.
  • Stress distribution was consistent across all three retinal layers.

Conclusions:

  • The computer model's predicted stress patterns align with typical AHT retinal hemorrhage locations (peripheral and posterior pole).
  • The model supports the hypothesis that vitreoretinal traction contributes to AHT-related RH.
  • Findings suggest that similar stress forces across retinal layers explain the multi-layered nature of RH in AHT.