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

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Authors
Stefánsson, E
Chan, Y K
Bek, T
Hardarson, S H
Wong, D
Wilson, D I
Issue Date
2018-02

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Citation
Laws of physics help explain capillary non-perfusion in diabetic retinopathy. 2018, 32 (2):210-212 Eye (Lond)
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.
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Additional Links
https://www.nature.com/articles/eye2017313.pdf
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Archived with thanks to Eye (London, England)
ae974a485f413a2113503eed53cd6c53
10.1038/eye.2017.313
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English Journal Articles (Peer Reviewed)

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