臺灣博碩士論文加值系統

本文主要探討隅角閉鎖型青光眼在不同的杯盤比下，對眼球內神經盤的損害，隅角閉鎖型青光眼是由於房水與虹膜之間的流動受阻造成眼壓急遽升高，升高的壓力傳遞到後面的結構體，導致視神經盤受損，造成杯盤比的提高，進而影響到視野缺損的情形。本研究設計一個完整的眼球模型，藉由隅角閉鎖型青光眼的併發機制進行模擬與分析，來探討視神經盤在不同杯盤比情況下的受損情形。
本研究針對杯盤比及人種和年齡層三個影響因素來做獨立探討，探討相同眼球結構和年齡層的情況下而不同的杯盤比的應力分佈，杯盤比較高的病患在視神經盤、篩板周圍的應力更為集中明顯。以及在相同杯盤比和年齡層的情況下，不同的眼球結構所造成的凹陷面積，對於眼球內部結構的應力分部影響，最後，探討在相同眼球結構及杯盤比的情況下，因為不同的年齡層所造成的應力分布影響，本研究模擬分析的結果，能提供往後相關研究一個重要的依據。

This study explores the damage of optic disc in different Cup-disc ratio due to Angle-closure Glaucoma. When aqueous fluid gets blocked in floating across Iris, intraocular pressure will increase sharply. After this, the increased intraocular pressure transfers to posterior part of eye, injuring optic disc, raising the Cup-disc ratio, and then causing visual defect. This study includes comprehensive design of an eye model. According to concurrency mechanism of Angle-closure Glaucoma, I conduct simulation to discuss the damage of optic disc in different Cup-disc ratio.
This study explores that for different Cup-disc ratio and different race of people, when under the same eye structure, the stress distribution differs in different Cup-disc ratio. If the patient has higher Cup-disc ratio degree, the stress around his lamina cribrosa and optic disc will become more concentrated. Also, when under the same Cup-disc ratio, the different surface depression area in different eye structure will affect the stress distribution in posterior part of an eye. The result of this study can offer an important reference to the related study in the future.

第一章 序論 1
1-1 前言 1
1-2研究背景與動機 3
1-3隅角閉鎖型青光眼 6
1-4文獻回顧 7
第二章 研究方法 13
2-1 有限元素法概論 13
2-2 應用軟體 14
2-3 研究過程 16
第三章 分析理論 18
3-1 連續性方程式( Continuity Equation ) 19
3-2 動量方程式( Momentum Equation ) 20
3-3 可壓縮能量方程式( Compressible Energy Equation ) 21
3-4 壓力方程式( Pressure ) 22
3-5 收斂檢測 23
第四章 參數條件設定 24
4-1 定義分析元素 24
4-1-1 流體元素分析 24
4-1-2 結構體元素分析 24
4-2 材料性質 25
4-3 模型建立 28
4-4 初始條件設定 31
4-5 負載條件設定 32
第五章 數值模型分析結果 33
5-1 結果分析 33
5-1-1 流體分析結果 33
5-1-2 結構體分析結果 36
5-2 結果驗證 38
5-3 結果討論 49
5-3-1 視神經杯盤比的差異 50
5-3-2 不同人種的視神經盤結構差異 55
第六章 結論與未來展望 59
6-1結論 63
6-2 未來展望 65
參考文獻 66
圖目錄
圖1- 1青光眼視野缺損示意圖 3
圖1- 2房水流動示意圖 5
圖1- 3視神經杯、盤示意圖[12] 5
圖1- 4隅角閉鎖型青光眼病發機制示意圖[11] 6
圖2- 1研究過程流程圖 17
圖4- 1結構頗面圖 30
圖4- 2 完整眼球3D模型圖 30
圖4- 3 房水流場設定圖 31
圖4- 4 邊界條件示意圖 32
圖5- 1隅角閉鎖型青光眼前後房壓力分布剖面圖 34
圖5- 2 隅角閉鎖型青光眼前後房流場分布剖面圖 35
圖5- 3 隅角閉鎖型青光眼前後房流線分布剖面圖 35
圖5- 4 隅角閉鎖型青光眼之應力分布圖 37
圖5- 5 隅角閉鎖型青光眼之應變分布圖 37
圖5- 6正常人眼壓前後房壓力剖面圖 40
圖5- 7正常人眼壓之結構體應力數值示意圖 40
圖5- 8隅角閉鎖型青光眼前後房壓力剖面圖 41
圖5- 9隅角閉鎖型青光眼之結構體應力數值示意圖 41
圖5- 10 文獻[37]Min 應變峰值對照圖 44
圖5- 11 文獻[37]Min 應力峰值對照圖 44
圖5- 12 文獻[37]Min 應變均值對照圖 45
圖5- 13 文獻[37]Min 應力均值對照圖 45
圖5- 14 文獻[37]Max 應變峰值對照圖 46
圖5- 15文獻[37]Max 應力峰值對照圖 46
圖5- 16文獻[37]Max 應變均值對照圖 47
圖5- 17 文獻[37]Max 應力均值對照圖 47
圖5- 18 文獻[57]分析應力圖 48
圖5- 19 杯盤比0.3應力分析結果圖 50
圖5- 20 杯盤比0.35應力分析結果圖 51
圖5- 21 杯盤比0.4應力分析結果圖 51
圖5- 22 杯盤比0.45應力分析結果圖 52
圖5- 23 杯盤比0.5應力分析結果圖 52
圖5- 24 杯盤比0.55應力分析結果圖 53
圖5- 25杯盤比0.6應力分析結果圖 53
圖5- 26杯盤比0.65應力分析結果圖 54
圖5- 27 杯盤比0.7應力分析結果圖 54
圖5- 28白種人、亞洲人及非洲人眼球結構體應力分佈比較圖 57
圖5- 29視神經盤周圍局部放大應力分佈比較圖 58
圖5 30 白種人三個年齡層應力分佈圖 60
圖5- 31 亞洲人三個年齡層應力分佈圖 61
圖5- 32 非洲人三個年齡營應力分佈圖 62

表目錄
表5- 1 隅角閉鎖型青光眼與文獻[22]之尺寸對照表 39
表5- 2 隅角閉鎖型青光眼與文獻[22]之楊氏係數對照表 39
表5- 3隅角閉鎖型青光眼與文獻[22]之結果倍數比較表 39
表5- 4 對文獻[37]所修改的模型條件 42
表5- 5文獻[37]分析結果數值表 43
表5- 6 與文獻[57]分析應力結果對照 48
表5- 7 白種人、亞洲人及非洲人視神經盤大小對照表 56
表5- 8 三個人種各年齡層差異 59

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