@article{HamouKotliarTanetal.2020, author = {Hamou, Hussam Aldin and Kotliar, Konstantin and Tan, Sonny Kian and Weiß, Christel and Blume, Christian and Clusmann, Hans and Schubert, Gerrit Alexander and Albanna, Walid}, title = {Surgical nuances and placement of subgaleal drains for supratentorial procedures—a prospective analysis of efficacy and outcome in 150 craniotomies}, series = {Acta Neurochirurgica}, volume = {2020}, journal = {Acta Neurochirurgica}, number = {162}, publisher = {Springer Nature}, address = {Cham}, issn = {0942-0940}, doi = {10.1007/s00701-019-04196-6}, pages = {729 -- 736}, year = {2020}, abstract = {Background For supratentorial craniotomy, surgical access, and closure technique, including placement of subgaleal drains, may vary considerably. The influence of surgical nuances on postoperative complications such as cerebrospinal fluid leakage or impaired wound healing overall remains largely unclear. With this study, we are reporting our experiences and the impact of our clinical routines on outcome in a prospectively collected data set. Method We prospectively observed 150 consecutive patients undergoing supratentorial craniotomy and recorded technical variables (type/length of incision, size of craniotomy, technique of dural and skin closure, type of dressing, and placement of subgaleal drains). Outcome variables (subgaleal hematoma/CSF collection, periorbital edema, impairment of wound healing, infection, and need for operative revision) were recorded at time of discharge and at late follow-up. Results Early subgaleal fluid collection was observed in 36.7\% (2.8\% at the late follow-up), and impaired wound healing was recorded in 3.3\% of all cases, with an overall need for operative revision of 6.7\%. Neither usage of dural sealants, lack of watertight dural closure, and presence of subgaleal drains, nor type of skin closure or dressing influenced outcome. Curved incisions, larger craniotomy, and tumor size, however, were associated with an increase in early CSF or hematoma collection (p < 0.0001, p = 0.001, p < 0.01 resp.), and larger craniotomy size was associated with longer persistence of subgaleal fluid collections (p < 0.05). Conclusions Based on our setting, individual surgical nuances such as the type of dural closure and the use of subgaleal drains resulted in a comparable complication rate and outcome. Subgaleal fluid collections were frequently observed after supratentorial procedures, irrespective of the closing technique employed, and resolve spontaneously in the majority of cases without significant sequelae. Our results are limited due to the observational nature in our single-center study and need to be validated by supportive prospective randomized design.}, language = {en} } @article{RamoshabaHuismanLammertynetal.2020, author = {Ramoshaba, Nthai E. and Huisman, Hugo W. and Lammertyn, Leandi and Kotliar, Konstantin and Schutte, Aletta E. and Smith, Wayne}, title = {Retinal microvasculature and masked hypertension in young adults: the African-PREDICT study}, series = {Hypertension Research}, journal = {Hypertension Research}, number = {43}, publisher = {Springer Nature}, address = {Osaka}, issn = {1348-4214}, doi = {10.1038/s41440-020-0487-0}, pages = {1231 -- 1238}, year = {2020}, abstract = {Masked hypertension is known to induce microvascular complications. However, it is unclear whether early microvascular changes are already occurring in young, otherwise healthy adults. We therefore investigated whether retinal microvascular calibers and acute responses to a flicker stimulus are related to masked hypertension. We used the baseline data of 889 participants aged 20-30 years who were taking part in the African Prospective study on the Early Detection and Identification of Cardiovascular Disease and Hypertension. Clinic and 24-h ambulatory blood pressure were measured. The central retinal artery equivalent (CRAE) and central retinal vein equivalent were calculated from fundus images, and retinal vessel dilation was determined in response to flicker light-induced provocation. A smaller CRAE was observed in those with masked hypertension vs. those with normotension (157.1 vs. 161.2 measuring units, P < 0.001). In forward multivariable-adjusted regression analysis, only CRAE was negatively related to masked hypertension [adjusted R² = 0.267, β = -0.097 (95\% CI = -0.165; -0.029), P = 0.005], but other retinal microvascular parameters were not associated with masked hypertension. In multivariable logistic regression analyses, masked hypertension [OR = 2.333, (95\% CI = 1.316; 4.241), P = 0.004] was associated with a narrower CRAE. In young healthy adults, masked hypertension was associated with retinal arteriolar narrowing, thereby reflecting early microvascular alterations known to predict cardiovascular outcomes in later life.}, language = {en} } @article{SmithKotliarLammertynetal.2020, author = {Smith, Wayne and Kotliar, Konstantin and Lammertyn, Leandi and Ramoshaba, Nthai E. and Vilser, Walthard and Huisman, Hugo W. and Schutte, Aletta E.}, title = {Retinal vessel caliber and caliber responses in true normotensive black and white adults: The African-PREDICT study}, series = {Microvascular Research}, volume = {128}, journal = {Microvascular Research}, number = {Article 103937}, publisher = {Elsevier}, address = {Amsterdam}, issn = {0026-2862}, doi = {10.1016/j.mvr.2019.103937}, year = {2020}, abstract = {Purpose Globally, a detrimental shift in cardiovascular disease risk factors and a higher mortality level are reported in some black populations. The retinal microvasculature provides early insight into the pathogenesis of systemic vascular diseases, but it is unclear whether retinal vessel calibers and acute retinal vessel functional responses differ between young healthy black and white adults. Methods We included 112 black and 143 white healthy normotensive adults (20-30 years). Retinal vessel calibers (central retinal artery and vein equivalent (CRAE and CRVE)) were calculated from retinal images and vessel caliber responses to flicker light induced provocation (FLIP) were determined. Additionally, ambulatory blood pressure (BP), anthropometry and blood samples were collected. Results The groups displayed similar 24 h BP profiles and anthropometry (all p > .24). Black participants demonstrated a smaller CRAE (158 ± 11 vs. 164 ± 11 MU, p < .001) compared to the white group, whereas CRVE was similar (p = .57). In response to FLIP, artery maximal dilation was greater in the black vs. white group (5.6 ± 2.1 vs. 3.3 ± 1.8\%; p < .001). Conclusions Already at a young age, healthy black adults showed narrower retinal arteries relative to the white population. Follow-up studies are underway to show if this will be related to increased risk for hypertension development. The reason for the larger vessel dilation responses to FLIP in the black population is unclear and warrants further investigation.}, language = {en} } @article{NeumaierKotliarHaerenetal.2021, author = {Neumaier, Felix and Kotliar, Konstantin and Haeren, Roel Hubert Louis and Temel, Yasin and L{\"u}ke, Jan Niklas and Seyam, Osama and Lindauer, Ute and Clusmann, Hans and Hescheler, J{\"u}rgen and Schubert, Gerrit Alexander and Schneider, Toni and Albanna, Walid}, title = {Retinal Vessel Responses to Flicker Stimulation Are Impaired in Ca v 2.3-Deficient Mice—An in- vivo Evaluation Using Retinal Vessel Analysis (RVA)}, series = {Frontiers in Neurology}, volume = {12}, journal = {Frontiers in Neurology}, publisher = {Frontiers}, doi = {10.3389/fneur.2021.659890}, pages = {1 -- 11}, year = {2021}, language = {en} } @inproceedings{SuryoputriGhaderiLinderetal.2017, author = {Suryoputri, Nathania and Ghaderi, Aydin and Linder, Peter and Kotliar, Konstantin and G{\"o}ttler, Jens and Sorg, Christian and Grimmer, Timo}, title = {Does hemodynamic response function change in Alzheimer disease?}, series = {2nd YRA MedTech Symposium 2017 : June 8th - 9th / 2017 / Hochschule Ruhr-West}, booktitle = {2nd YRA MedTech Symposium 2017 : June 8th - 9th / 2017 / Hochschule Ruhr-West}, editor = {Erni, Daniel and Fischerauer, Alice and Himmel, J{\"o}rg and Seeger, Thomas and Thelen, Klaus}, publisher = {Universit{\"a}t Duisburg-Essen}, address = {Duisburg}, organization = {MedTech Symposium}, isbn = {978-3-9814801-9-1}, doi = {10.17185/duepublico/43984}, pages = {92}, year = {2017}, language = {en} } @inproceedings{BlumAlbannaBenninghausetal.2019, author = {Blum, Yannik and Albanna, Walid and Benninghaus, Anne and Kotliar, Konstantin}, title = {Vasomotion in retinal vessels of patients presenting post hemorrhagic hydrocephalus following subarachnoid hemorrhage}, series = {3rd YRA MedTech Symposium 2019 : May 24 / 2019 / FH Aachen}, booktitle = {3rd YRA MedTech Symposium 2019 : May 24 / 2019 / FH Aachen}, editor = {Staat, Manfred and Erni, Daniel}, publisher = {Universit{\"a}t Duisburg-Essen}, address = {Duisburg}, organization = {MedTech Symposium}, isbn = {978-3-940402-22-6}, doi = {10.17185/duepublico/48750}, pages = {38 -- 39}, year = {2019}, abstract = {Clearance of blood components and fluid drainage play a crucial role in subarachnoid hemorrhage (SAH) and post hemorrhagic hydrocephalus (PHH). With the involvement of interstitial fluid (ISF) and cerebrospinal fluid (CSF), two pathways for the clearance of fluid and solutes in the brain are proposed. Starting at the level of capillaries, flow of ISF follows along the basement membranes in the walls of cerebral arteries out of the parenchyma to drain into the lymphatics and CSF [1]-[3]. Conversely, it is shown that CSF enters the parenchyma between glial and pial basement membranes of penetrating arteries [4]-[6]. Nevertheless, the involved structures and the contribution of either flow pathway to fluid balance between the subarachnoid space and interstitial space remains controversial. Low frequency oscillations in vascular tone are referred to as vasomotion and corresponding vasomotion waves are modeled as the driving force for flow of ISF out of the parenchyma [7]. Retinal vessel analysis (RVA) allows non-invasive measurement of retinal vessel vasomotion with respect to diameter changes [8]. Thus, the aim of the study is to investigate vasomotion in RVA signals of SAH and PHH patients.}, language = {en} } @inproceedings{ZingsheimGrimmerOrtneretal.2019, author = {Zingsheim, Jonas and Grimmer, Timo and Ortner, Marion and Schmaderer, Christoph and Hauser, Christine and Kotliar, Konstantin}, title = {Recognition of subjects with mild cognitive impairment (MCI) by the use of retinal arterial vessels.}, series = {3rd YRA MedTech Symposium 2019 : May 24 / 2019 / FH Aachen}, booktitle = {3rd YRA MedTech Symposium 2019 : May 24 / 2019 / FH Aachen}, editor = {Staat, Manfred and Erni, Daniel}, publisher = {Universit{\"a}t Duisburg-Essen}, address = {Duisburg}, organization = {MedTech Symposium}, isbn = {978-3-940402-22-6}, doi = {10.17185/duepublico/48750}, pages = {36 -- 37}, year = {2019}, language = {en} } @article{AlbannaConzenWeissetal.2016, author = {Albanna, Walid and Conzen, Catharina and Weiss, Miriam and Clusmann, Hans and Fuest, Matthias and Mueller, Marguerite and Brockmann, Marc Alexander and Vilser, Walthard and Schmidt-Trucks{\"a}ss, Arno and Hoellig, Anke and Seiz, Marcel and Thom{\´e}, Claudius and Kotliar, Konstantin and Schubert, Gerrit Alexander}, title = {Retinal Vessel Analysis (RVA) in the context of subarachnoid hemorrhage: A proof of concept study}, series = {PLoS ONE}, volume = {11}, journal = {PLoS ONE}, number = {7}, publisher = {PLOS}, address = {San Francisco}, issn = {1932-6203}, doi = {10.1371/journal.pone.0158781}, pages = {13 Seiten}, year = {2016}, abstract = {Background Timely detection of impending delayed cerebral ischemia after subarachnoid hemorrhage (SAH) is essential to improve outcome, but poses a diagnostic challenge. Retinal vessels as an embryological part of the intracranial vasculature are easily accessible for analysis and may hold the key to a new and non-invasive monitoring technique. This investigation aims to determine the feasibility of standardized retinal vessel analysis (RVA) in the context of SAH. Methods In a prospective pilot study, we performed RVA in six patients awake and cooperative with SAH in the acute phase (day 2-14) and eight patients at the time of follow-up (mean 4.6±1.7months after SAH), and included 33 age-matched healthy controls. Data was acquired using a manoeuvrable Dynamic Vessel Analyzer (Imedos Systems UG, Jena) for examination of retinal vessel dimension and neurovascular coupling. Results Image quality was satisfactory in the majority of cases (93.3\%). In the acute phase after SAH, retinal arteries were significantly dilated when compared to the control group (124.2±4.3MU vs 110.9±11.4MU, p<0.01), a difference that persisted to a lesser extent in the later stage of the disease (122.7±17.2MU, p<0.05). Testing for neurovascular coupling showed a trend towards impaired primary vasodilation and secondary vasoconstriction (p = 0.08, p = 0.09 resp.) initially and partial recovery at the time of follow-up, indicating a relative improvement in a time-dependent fashion. Conclusion RVA is technically feasible in patients with SAH and can detect fluctuations in vessel diameter and autoregulation even in less severely affected patients. Preliminary data suggests potential for RVA as a new and non-invasive tool for advanced SAH monitoring, but clinical relevance and prognostic value will have to be determined in a larger cohort.}, language = {en} } @article{BandlitzNakhoulKotliar2022, author = {Bandlitz, Stefan and Nakhoul, Makram and Kotliar, Konstantin}, title = {Daily variations of corneal white-to-white diameter measured with different methods}, series = {Clinical and experimental optometry}, journal = {Clinical and experimental optometry}, number = {14}, publisher = {Taylor \& Francis}, address = {London}, issn = {0816-4622}, doi = {10.2147/OPTO.S360651}, pages = {173 -- 181}, year = {2022}, abstract = {Purpose: A precise determination of the corneal diameter is essential for the diagnosis of various ocular diseases, cataract and refractive surgery as well as for the selection and fitting of contact lenses. The aim of this study was to investigate the agreement between two automatic and one manual method for corneal diameter determination and to evaluate possible diurnal variations in corneal diameter. Patients and Methods: Horizontal white-to-white corneal diameter of 20 volunteers was measured at three different fixed times of a day with three methods: Scheimpflug method (Pentacam HR, Oculus), placido based topography (Keratograph 5M, Oculus) and manual method using an image analysis software at a slitlamp (BQ900, Haag-Streit). Results: The two-factorial analysis of variance could not show a significant effect of the different instruments (p = 0.117), the different time points (p = 0.506) and the interaction between instrument and time point (p = 0.182). Very good repeatability (intraclass correlation coefficient ICC, quartile coefficient of dispersion QCD) was found for all three devices. However, manual slitlamp measurements showed a higher QCD than the automatic measurements with the Keratograph 5M and the Pentacam HR at all measurement times. Conclusion: The manual and automated methods used in the study to determine corneal diameter showed good agreement and repeatability. No significant diurnal variations of corneal diameter were observed during the period of time studied.}, language = {en} } @article{OrtnerHauserSchmadereretal.2019, author = {Ortner, Marion and Hauser, Christine and Schmaderer, Christoph and Muggenthaler, Claudia and Hapfelmeier, Alexander and Sorg, Christian and Diehl-Schmid, Janine and Kurz, Alexander and F{\"o}rstl, Hans and Ikenberg, Benno and Kotliar, Konstantin and Holger, Poppert and Grimmer, Timo}, title = {Decreased vascular pulsatility in Alzheimer's disease dementia measured by transcranial color-coded duplex sonography}, series = {Neuropsychiatric disease and treatment}, journal = {Neuropsychiatric disease and treatment}, number = {15}, publisher = {Dove Medical Press}, address = {Albany, Auckland}, issn = {1178-2021}, doi = {10.2147/NDT.S225754}, pages = {3487 -- 3499}, year = {2019}, abstract = {Purpose: Impaired paravascular drainage of β-Amyloid (Aβ) has been proposed as a contributing cause for sporadic Alzheimer's disease (AD), as decreased cerebral blood vessel pulsatility and subsequently reduced propulsion in this pathway could lead to the accumulation and deposition of Aβ in the brain. Therefore, we hypothesized that there is an increased impairment in pulsatility across AD spectrum. Patients and Methods: Using transcranial color-coded duplex sonography (TCCS) the resistance and pulsatility index (RI; PI) of the middle cerebral artery (MCA) in healthy controls (HC, n=14) and patients with AD dementia (ADD, n=12) were measured. In a second step, we extended the sample by adding patients with mild cognitive impairment (MCI) stratified by the presence (MCI-AD, n=8) or absence of biomarkers (MCI-nonAD, n=8) indicative for underlying AD pathology, and compared RI and PI across the groups. To control for atherosclerosis as a confounder, we measured the arteriolar-venular-ratio of retinal vessels. Results: Left and right RI (p=0.020; p=0.027) and left PI (p=0.034) differed between HC and ADD controlled for atherosclerosis with AUCs of 0.776, 0.763, and 0.718, respectively. The RI and PI of MCI-AD tended towards ADD, of MCI-nonAD towards HC, respectively. RIs and PIs were associated with disease severity (p=0.010, p=0.023). Conclusion: Our results strengthen the hypothesis that impaired pulsatility could cause impaired amyloid clearance from the brain and thereby might contribute to the development of AD. However, further studies considering other factors possibly influencing amyloid clearance as well as larger sample sizes are needed.}, language = {en} }