Advances in glaucoma biomechanics from 2000 to 2024: a bibliometric study and visualization analysis

Glaucoma is an irreversible progressive optic neuropathy characterized by neurodegeneration of retinal ganglion cells. Elevated intraocular pressure induces mechanical stress and strain at the optic nerve head, impairing axonal function and contributing to the onset and progression of glaucoma. This study aims to generalize and visualize the dynamic evolution and research hotspots of glaucoma biomechanics through bibliometric methods.

All documents about glaucoma biomechanics research in 2000-2024 were extracted from two databases (Web of Science Core Collection and PubMed). The hotspots and frontiers of research in terms of remarkable countries, authors, journals, keywords, and cited references were analyzed using CiteSpace and VOSviewer programs.

A collection of 1,655 English articles was included, with a steady increase in annual publications. 4,464 authors from 51 countries/regions were identified, led by the United States. Ethier CR was the most prolific contributor, while Downs JC was the most commonly cited author. Among 203 journals, Investigative Ophthalmology & Visual Science both led in publications and citations. In the domain of glaucoma biomechanics, keywords "lamina cribrosa," "open angle glaucoma," and "biomechanical properties" exhibited the significant centrality. The cited references formed 7 clusters, namely #0 (optic nerve head), #1 (ocular response analyzer), #2 (sclera), #3 (tonometry), #4 (lamina cribrosa), #5 (trabecular meshwork), and #6 (corneal biomechanics).

Our study employed bibliometric and visualization analyses to state the biomechanical mechanisms underlying intraocular pressure regulation and optic nerve damage, offering the development in the field of glaucoma biomechanics. Future directions may focus on the interdisciplinary applications of artificial intelligence, tissue engineering and novel biomaterials in glaucoma pathogenesis and therapies.