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Laws of physics help explain capillary non-perfusion in diabetic retinopathy.

Accepted version
Peer-reviewed

Type

Article

Change log

Authors

Stefánsson, E 
Chan, YK 
Bek, T 
Hardarson, SH 
Wong, D 

Abstract

The purpose is to use laws of physics to elucidate the mechanisms behind capillary non-perfusion in diabetic retinopathy. In diabetic retinopathy, loss of pericytes weakens capillary walls and the vessel dilates. A dilated capillary has reduced resistance to flow, therefore increased flow in that vessel and decreased in adjoining capillaries. A preferential shunt vessel is thus formed from the dilated capillary and the adjacent capillaries become non-perfused. We apply the laws of Laplace and Hagen-Poiseuille to better understand the phenomena that lead to capillary non-perfusion. These laws of physics can give a foundation for physical or mathematical models to further elucidate this field of study. The law of Laplace predicts that a weaker vessel wall will dilate, assuming constant transmural pressure. The Hagen-Poiseuille equation for flow and the Ostwald-de Waele relationship for viscosity predict that a dilated vessel will receive a higher portion of the fluid flow than the adjoining capillaries. Viscosity will decrease in the dilated vessel, furthering the imbalance and resulting in a patch of non-perfused capillaries next to the dilated 'preferential' shunt vessel. Physical principles support or inspire novel hypotheses to explain poorly understood phenomena in ophthalmology. This thesis of pericyte death and capillary remodelling, which was first proposed by Cogan and Kuwabara, already agrees with histological and angiographical observations in diabetic retinopathy. We have shown that it is also supported by classical laws of physics.

Description

Keywords

Capillaries, Diabetic Retinopathy, Humans, Microaneurysm, Models, Theoretical, Physics, Retinal Vessels

Journal Title

Eye (Lond)

Conference Name

Journal ISSN

0950-222X
1476-5454

Volume Title

32

Publisher

Springer Science and Business Media LLC