PURPOSE: To explore an alternative etiology for Purtscher retinopathy by literature review and fluid dynamic computational simulations of wall shear stress (WSS) profiles. METHODS: Computer simulations were developed, incorporating posterior pole retinal microvascular flow parameters, to demonstrate WSS profiles at 90° and 45° angle artery/arteriolar branching. RESULTS: Computer simulations reveal WSS profiles dependent on artery/arteriolar branching angles. At high flow rates an area of changed WSS and flow swirling and reversal was noted at the proximal fillet of the 90° arteriolar branching. These changes did not appear at the 45° arteriolar branching until the flow rate was increased an additional 30%. CONCLUSIONS: Computer simulation data, as well as review of the history and clinical findings of Purtscher and Purtscher-like retinopathy, present evidence that an additional etiology for Purtscher retinopathy may be a rheological event at a retinal posterior pole foci of vascular endothelial dysregulation, followed by downstream endothelin-induced vasculopathy.
PURPOSE: To explore an alternative etiology for Purtscher retinopathy by literature review and fluid dynamic computational simulations of wall shear stress (WSS) profiles. METHODS: Computer simulations were developed, incorporating posterior pole retinal microvascular flow parameters, to demonstrate WSS profiles at 90° and 45° angle artery/arteriolar branching. RESULTS: Computer simulations reveal WSS profiles dependent on artery/arteriolar branching angles. At high flow rates an area of changed WSS and flow swirling and reversal was noted at the proximal fillet of the 90° arteriolar branching. These changes did not appear at the 45° arteriolar branching until the flow rate was increased an additional 30%. CONCLUSIONS: Computer simulation data, as well as review of the history and clinical findings of Purtscher and Purtscher-like retinopathy, present evidence that an additional etiology for Purtscher retinopathy may be a rheological event at a retinal posterior pole foci of vascular endothelial dysregulation, followed by downstream endothelin-induced vasculopathy.
Authors: J E Ramos de Carvalho; R O Schlingemann; M Oranje; F J Bemelman; M J van Schooneveld Journal: Int Ophthalmol Date: 2017-03-08 Impact factor: 2.031