Glaucoma, the second most common cause of blindness worldwide, is an ocular disease characterized by progressive loss of retinal
ganglion cell (RGC) axons. Biomechanical factors are thought to play a central role in RGC loss, but the specific mechanism
underlying this disease remains unknown. Our goal was to characterize the biomechanical environment in the optic nerve head
(ONH)—the region where RGC damage occurs—in human eyes. Post mortem human eyes were imaged, fixed at either 5 or 50 mmHg pressure
and processed histologically to acquire serial sections through the ONH. Three-dimensional models of the ONH region were reconstructed
from these sections and embedded in a generic scleral shell to create a model of an entire eye. We used finite element simulations
to quantify the effects of an acute change in intraocular pressure from 5 to 50 mmHg on the ONH biomechanical environment.
Computed strains varied substantially within the ONH, with the pre-laminar neural tissue and the lamina cribrosa showing the
greatest strains. The mode of strain having the largest magnitude was third principal strain (compression), reaching 12–15%
in both the lamina cribrosa and the pre-laminar neural tissue. Shear strains were also substantial. The distribution of strains
in all ONH tissues was remarkably similar between eyes. Inter-individual variations in ONH geometry (anatomy) have only modest
effects on ONH biomechanics, and may not explain inter-individual susceptibility to elevated intraocular pressure. Consistent
with previous results using generic ONH models, the displacements of the vitreo-retinal interface and the anterior surface
of the lamina cribrosa can differ substantially, suggesting that currently available optical imaging methods do not provide
information of the acute deformations within ONH tissues. Predicted strains within ONH tissues are potentially biologically
significant and support the hypothesis that biomechanical factors contribute to the initial insult that leads to RGC loss
in glaucoma.
Keywords Biomechanics - Glaucoma - Optic nerve head - IOP - Finite elements - Strain - Sclera - Lamina cribrosa
Ian A. Sigal now a post-doctoral research fellow at Ocular Biomechanics Laboratory, Devers Eye Institute, Legacy Health Research.
Portland, OR, USA. (isigal@deverseye.org).