$\bf{Purpose}$: To assess whether Growth & Remodeling (G&R) theory could explain staphyloma formation from a local scleral weakening. $\bf{Methods}$: A finite element model of a healthy eye was reconstructed, including the following connective tissues: the lamina cribrosa, the peripapillary sclera, and the peripheral sclera. The scleral shell was modelled as a constrained mixture, consisting of an isotropic ground matrix and two collagen fiber families (circumferential and meridional). The homogenized constrained mixture model was employed to simulate the adaptation of the sclera to alterations in its biomechanical environment over a duration of 13.7 years. G&R processes were triggered by reducing the shear stiffness of the ground matrix in the peripapillary sclera and lamina cribrosa by 85%. Three distinct G&R scenarios were investigated: (1) low mass turnover rate in combination with transmural volumetric growth; (2) high mass turnover rate in combination with transmural volumetric growth; and (3) high mass turnover rate in combination with mass density growth. $\bf{Results}$: In scenario 1, we observed a significant outpouching of the posterior pole, closely resembling the shape of a Type-III staphyloma. Additionally, we found a notable change in scleral curvature and a thinning of the peripapillary sclera by 84%. In contrast, scenarios 2 and 3 exhibited less drastic deformations, with stable posterior staphylomas after approximately 7 years. $\bf{Conclusions}$: Our framework suggests that local scleral weakening is sufficient to trigger staphyloma formation under normal intraocular pressure. With patient-specific scleral geometries (obtainable via wide-field optical coherence tomography), our framework could aid in identifying individuals at risk of developing posterior staphylomas.

翻译：$\bf{目的}$：评估生长与重塑理论能否解释局部巩膜薄弱导致的葡萄肿形成。$\bf{方法}$：重建健康眼的有限元模型，包括以下结缔组织：筛板、视盘旁巩膜及周边巩膜。巩膜壳被建模为受限混合物，包含各向同性基质和两组胶原纤维（环向与经向）。采用均质化受限混合物模型模拟巩膜在13.7年内对其生物力学环境变化的适应过程。通过将视盘旁巩膜和筛板基质的剪切刚度降低85%触发生长与重塑过程。研究三种不同生长与重塑场景：（1）低质量周转率联合穿壁体积生长；（2）高质量周转率联合穿壁体积生长；（3）高质量周转率联合质量密度生长。$\bf{结果}$：场景1中，观察到后极显著隆起，形态与III型葡萄肿高度相似。同时发现巩膜曲率显著变化，视盘旁巩膜变薄84%。相比之下，场景2和3的变形程度较小，约7年后形成稳定的后葡萄肿。$\bf{结论}$：本框架表明，在正常眼压下，局部巩膜薄弱足以触发葡萄肿形成。结合患者特异性巩膜几何结构（可通过广域光学相干断层扫描获取），本框架可帮助识别后葡萄肿高风险个体。