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The Role of Retinal Plasticity in the Formation of Irreversible Retinal Deformations in Age-Related Macular
Daria Peretiahina1, Konstantin Shakun2, Vadym Ulianov3
1Ophthalmology Department, Odessa National Medical University, Odessa, Ukraine.
Purpose:
To construct a realistic physical model of viscoelastic retinal stretching and, on its basis, derive a universal quantitative criterion of irreversible retinal deformations during age-related macular degeneration.
Methods:
In this work, standard methods of nonlinear fracture mechanics of ductile and viscoelastic materials were applied to study the evolution of retinal deformation progress in patients with neovascular age-related macular degeneration in the area of large druses or subretinal or sub-retinal pigment epithelium fluid accumulation. A two-dimensional rhombic model of viscoelastic Kelvin-Feucht primitives was used to reconstruct the parameters included in the approximation of the creep strain growth rate. A clinical case of a patient with age-related macular degeneration and retinal pigment epithelium detachment in the macula was taken as a basis for theoretical research. The patient underwent retinal optical coherent tomography on DRI Swept-Source OCT.
Results:
A closed realistic theoretical model of retinal stretching in the projection of retinal pigment epithelium elevation due to its detachment or drusen based on a two-dimensional rhombic Kelvin-Feucht primitives model was constructed. The calculation of stress in the retinal tissue with consistent consideration of creep effects was performed.
Conclusions:
The time of critical retinal loading - a new quantitative criterion for the irreversibility of retinal stretching in age-related macular degeneration is proposed. This criterion allows the prediction of the functional outcome of antiangiogenic therapy in patients with age-related macular degeneration with identical initial retinal morphometric parameters.
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