Purpose: To identify and rank the lamina cribrosa (LC) morphologic factors that influence LC microcapillary hemodynamics and oxygen concentrations using computational fluid dynamics (CFD).
Methods: We generated 12,000 'artificial' LC microcapillary networks and predicted blood flow velocities and oxygen concentrations within the microcapillaries using CFD. Across models, we varied the average pore size of the LC (5500 ± 2400 μm2), the microcapillary arrangement (radial, isotropic, or circumferential), the LC diameter (1.9 ± 0.3 mm), the inferior-superior curvature (340 ± 116 m-1), and the nasal-temporal curvature (-78 ± 130 m-1). We assumed that blood flow originated from the Circle of Zinn-Haller, fed the LC uniformly at its periphery, and was drained into the central retinal vein. Arterial (50 ± 6 mm Hg) and venous (17.7 ± 6 mm Hg) pressures were applied as boundary conditions and were also varied within our simulations. Finally, we performed linear regression analysis to rank the influence of each factor on LC hemodynamics and oxygen concentrations.
Results: The factors influencing LC hemodynamics and oxygen concentrations the most were: LC diameter, arterial pressure, and venous pressure, and to a lesser extent: the microcapillary arrangement (anisotropy) and nasal-temporal curvature. Lamina cribrosa pore size and superior-inferior curvature had almost no impact. Specifically, we found that LCs with a smaller diameter, a radial arrangement of the microcapillaries, an elevated arterial pressure and a decreased venous pressure had higher oxygen concentrations across their networks.
Conclusion: This study described LC hemodynamics using a computational modeling approach. Our study may provide clinically relevant information for the understanding of ischemia-induced neuronal cell death in optic neuropathies.