The aqueous humour dynamics in primary angle closure disease: a computational study

Area of Science:

• Ophthalmology
• Biomedical Engineering
• Fluid Dynamics

Background:

• Primary angle closure disease (PACD) is a significant cause of vision loss.
• Understanding aqueous humor (AH) dynamics is crucial for managing PACD.
• Current models often lack detailed fluid dynamics analysis.

Purpose of the Study:

• To develop a computational fluid dynamics (CFD) model of the ocular anterior segment for PACD.
• To investigate aqueous humor (AH) dynamics across various angle closure ranges (ACRs).

Main Methods:

• Created a 3D CFD model of the anterior segment using SOLIDWORKS and COMSOL Multiphysics.
• Simulated AH dynamics using Navier-Stokes equations with varying AOD750 to represent different ACRs.
• Validated CFD pressure results with an in vitro simulation model.

Main Results:

• A non-linear association was found between ACR, maximum flow velocity (MFV), and intraocular pressure (IOP).
• MFV and pressure elevated significantly when ACR exceeded 180° and dramatically above 270°.
• In vitro validation confirmed the CFD model's accuracy for pressure changes.

Conclusions:

• The relationship between ACR, MFV, and pressure follows an ascending curve in PACD.
• ACR thresholds of 180° and 270° represent critical turning points in AH dynamics.
• Findings support clinical observations and can guide PACD management strategies.