本文主要研究隅角閉鎖型青光眼對眼球視神經盤的損害，隅角閉鎖型青光眼是由於房水與虹膜間流動受阻造成前房眼壓急遽升高，壓力傳遞到眼球視神經盤後導致受損，引發視野缺損的情形。本研究設計完整的眼球模型，藉由隅角閉鎖型青光眼的發病機制進行模擬與分析，進而觀察視神經盤的受損情形。
本研究針對白種人、亞洲人、非洲人三種人種的視神經盤特性做出相應的眼球模型，在觀察眼球內部應力分佈後發現，在單一探討視神經盤差異的情況下，非洲人較亞洲人及白種人受到的視神經盤損害最為嚴重，另外本文也模擬了三種人種在不同年齡層及不同眼壓下之眼球內部受力情形。本研究模擬隅角閉鎖型青光眼分析之結果，提供往後相關研究一個重要的依據。

In this study, research is focused mainly on injures to the eye ball due to angle-closure glaucoma. Due to blockage of the drainage system of the aqueous humor, the intraocular pressure of anterior chamber is elevated. Intraocular pressure transfers load in glaucoma patients, leading to the optic nerve suffering high pressures, yielding visual field defects. This study designed a complete eye model to analyze the pathogenesis of angle-closure glaucoma. The pressure values of the anterior chamber were obtained, and they conform to the range of accepted clinical pressure values. From the phenomenon of stress distribution inside the eye, the maximum stress concentration was found at the posterior sclera and optic disc.
In this study, we changed the models to reflect the characteristics of the optic discs of those of Asian, African and Caucasian descent. After observation of the stress distribution inside the eye, due to differences in size of the optic disc of each ethnicity, it was found that Africans suffered more serious damage to the optic disc than Asians or Caucasians. We also simulated the stress distribution inside the eye of each of the three ethnicities at different ages and different IOPs (intraocular pressure) under each situation. This study analyzes the results of angle-closure glaucoma, and offers important information for future research.

目錄
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	25
4-2 材料性質	26
4-3 模型建立	29
4-4 初始條件設定	33
4-5 負載條件設定	34
第五章數值模型分析結果	36
5-1 結果分析	36
5-1-1 流體分析結果	36
5-1-2 結構體分析結果	39
5-2 結果驗證	42
5-3 結果討論	48
5-3-1 白種人、亞洲人及非洲人視神經盤結構差異之討論	49
5-3-2白種人、亞洲人及非洲人不同眼壓影響之討論	54
5-3-3白種人、亞洲人及非洲人不同材料參數影響之討論	63
第六章結論與未來展望	78
6-1 結論	78
6-2 未來展望	80
參考文獻	81




























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[11]	5
圖1-3隅角閉鎖型青光眼房水流動示意圖[12]	6
圖2-1研究過程與流程圖	17
圖4-1 FLUID 142元素圖[41]	25
圖4-2 SOLID 45元素圖[41]	26
圖4-3眼球構造圖[50]	31
圖4-4眼球模型剖面圖	32
圖4-5完整眼球3D模型圖	32
圖4-6房水流場設定圖	33
圖4-7眼球結構示意圖[55]	35
圖4-8邊界條件示意圖	35
圖5-1隅角閉鎖型青光眼前後房壓力分布剖面圖	38
圖5-2隅角閉鎖型青光眼前後房流場剖面圖	38
圖5-3隅角閉鎖型青光眼前後房流線剖面圖	39
圖5-4隅角閉鎖型青光眼之應力分布圖	41
圖5-5隅角閉鎖型青光眼應變分布圖	41
圖5-6正常人眼壓前後房壓力剖面圖	44
圖5-7正常人眼壓之結構體應力數值示意圖	44
圖5-8隅角閉鎖型青光眼前後房壓力剖面圖	45
圖5-9隅角閉鎖型青光眼之結構體應力數值示意圖	45
圖5-10隅角閉鎖型青光眼與文獻[29]比較之應力分布圖	47
圖5-11白種人、亞洲人及非洲人眼球結構體應力分佈比較圖	51
圖5-13白種人、亞洲人及非洲人眼球結構體應變分佈比較圖	53
圖5-14白種人不同眼壓與相同材料參數之應力分布比較圖	57
圖5-15亞洲人不同眼壓與相同材料參數之應力分布比較圖	58
圖5-16非洲人不同眼壓與相同材料參數之應力分布比較圖	59
圖5-17白種人不同眼壓與相同材料參數之應變分布比較圖	60
圖5-18亞洲人不同眼壓與相同材料參數之應變分布比較圖	61
圖5-19非洲人不同眼壓與相同材料參數之應變分布比較圖	62
圖5-20白種人三年齡層眼壓10mmHg之應力分布比較圖	65
圖5-21亞洲人三年齡層眼壓10mmHg之應力分布比較圖	66
圖5-22非洲人三年齡層眼壓10mmHg之應力分布比較圖	67
圖5-23白種人三年齡層眼壓10mmHg之應變分布比較圖	68
圖5-24亞洲人三年齡層眼壓10mmHg之應變分布比較圖	69
圖5-25非洲人三年齡層眼壓10mmHg之應變分布比較圖	70
圖5-26白種人三年齡層眼壓50mmHg之應力分布比較圖	72
圖5-27亞洲人三年齡層眼壓50mmHg之應力分布比較圖	73
圖5-28非洲人三年齡層眼壓50mmHg之應力分布比較圖	74
圖5-29白種人三年齡層眼壓50mmHg之應變分布比較圖	75
圖5-30亞洲人三年齡層眼壓50mmHg之應變分布比較圖	76
圖5-31非洲人三年齡層眼壓50mmHg之應變分布比較圖	77









表目錄
表4-1房水材料參數表	26
表4-2模擬結構體眼球組織之材料參數表	29
表5-1隅角閉鎖型青光眼與文獻[21]之尺寸對照表	43
表5-2隅角閉鎖型青光眼與文獻[21]之楊氏係數對照表	43
表5-3隅角閉鎖型青光眼與文獻[21]之結果倍數比較表	43
表5-4隅角閉鎖型青光眼與文獻[28]之尺寸對照表	47
表5-5隅角閉鎖型青光眼與文獻[28]之楊氏係數對照表	47
表5-6白種人、亞洲人及非洲人視神經盤大小對照表	50
表5-7不同人種、眼壓與相同楊氏系數數據表	56
表5-8相同的眼壓與不同的楊氏係數數據表	64

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