Julia Arciero

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  Assessing vascular risk factors for glaucoma using a mathematical model of blood flow in the retina
  Julia Arciero

  Glaucoma is the second leading cause of blindness in the world and is characterized by progressive retinal ganglion cell death and irreversible visual field loss. Although elevated intraocular pressure has been identified as the primary risk factor for glaucoma and is the main target of glaucoma treatments, several vascular risk factors that lead to impaired retinal blood flow have also been correlated with the progression and incidence of glaucoma. Here, a multi-scale mathematical model is used to investigate the relative contributions of vascular risk factors on flow regulation and tissue oxygenation in the retina. A previously-developed fluid-structure interaction system modeling the central retinal artery is coupled to a vascular wall mechanics model for the vessels of the retinal microcirculation. Under normal conditions, the model predicts a 14% decrease in retinal perfusion if oxygen demand is decreased by 50% and a 33% increase in perfusion if demand is increased by 50%. These responses are impaired significantly if the metabolic or carbon dioxide mechanisms of retinal blood flow autoregulation are impaired. Changes in oxygen saturation levels in the retinal vascular network are also assessed as levels of mean arterial pressure, oxygen demand, and intraocular pressure are varied. Overall, the model results suggest that impaired autoregulation might increase the risk of retinal ischemic damage, as would occur in glaucoma, under conditions of elevated metabolic demand or decreased mean arterial pressure.