Mathematical modeling of the biomechanics of the lamina cribrosa under elevated intraocular pressures.

Comprehensive understanding of the biomechanical performance of the lamina cribrosa (LC) and the optic nerve head is central to understanding the role of elevated intraocular pressures (IOP) in chronic open angle glaucoma. In this paper, six closed-from mathematical models based on different idealizations of the LC are developed and compared. This approach is used to create further understanding of the biomechanical behavior by identifying the LC features and properties that have a significant effect on its performance under elevated IOP. The models developed are based on thin circular plate and membrane theories, and consider influences such as in-plane pretension caused by scleral expansion and large deflections. Comparing the results of the six models against a full ocular globe finite element model suggests the significance of the in-plane pretension and the importance of assuming that the sclera provides the LC with a clamped edge. The model that provided the most accurate representation of the finite element model was also used to predict the behavior of a number of LC experimental tests presented in the literature. In addition to the deflections under elevated IOP, the model predictions include the distributions of stress and strain, which are shown to be compatible with the progression of visual field loss experienced in glaucoma.