TY - CHAP A1 - Blum, Yannik A1 - Albanna, Walid A1 - Benninghaus, Anne A1 - Kotliar, Konstantin ED - Staat, Manfred ED - Erni, Daniel T1 - Vasomotion in retinal vessels of patients presenting post hemorrhagic hydrocephalus following subarachnoid hemorrhage T2 - 3rd YRA MedTech Symposium 2019 : May 24 / 2019 / FH Aachen N2 - 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. Y1 - 2019 SN - 978-3-940402-22-6 U6 - http://dx.doi.org/10.17185/duepublico/48750 SP - 38 EP - 39 PB - Universität Duisburg-Essen CY - Duisburg ER - TY - JOUR A1 - Conzen, Catharina A1 - Albanna, Walid A1 - Weiss, Miriam A1 - Kürten, David A1 - Vilser, Walthard A1 - Kotliar, Konstantin A1 - Zäske, Charlotte A1 - Clusmann, Hans A1 - Schubert, Gerrit Alexander T1 - Vasoconstriction and Impairment of Neurovascular Coupling after Subarachnoid Hemorrhage: a Descriptive Analysis of Retinal Changes JF - Translational Stroke Research N2 - Impaired cerebral autoregulation and neurovascular coupling (NVC) contribute to delayed cerebral ischemia after subarachnoid hemorrhage (SAH). Retinal vessel analysis (RVA) allows non-invasive assessment of vessel dimension and NVC hereby demonstrating a predictive value in the context of various neurovascular diseases. Using RVA as a translational approach, we aimed to assess the retinal vessels in patients with SAH. RVA was performed prospectively in 24 patients with acute SAH (group A: day 5–14), in 11 patients 3 months after ictus (group B: day 90 ± 35), and in 35 age-matched healthy controls (group C). Data was acquired using a Retinal Vessel Analyzer (Imedos Systems UG, Jena) for examination of retinal vessel dimension and NVC using flicker-light excitation. Diameter of retinal vessels—central retinal arteriolar and venular equivalent—was significantly reduced in the acute phase (p < 0.001) with gradual improvement in group B (p < 0.05). Arterial NVC of group A was significantly impaired with diminished dilatation (p < 0.001) and reduced area under the curve (p < 0.01) when compared to group C. Group B showed persistent prolonged latency of arterial dilation (p < 0.05). Venous NVC was significantly delayed after SAH compared to group C (A p < 0.001; B p < 0.05). To our knowledge, this is the first clinical study to document retinal vasoconstriction and impairment of NVC in patients with SAH. Using non-invasive RVA as a translational approach, characteristic patterns of compromise were detected for the arterial and venous compartment of the neurovascular unit in a time-dependent fashion. Recruitment will continue to facilitate a correlation analysis with clinical course and outcome. Y1 - 2018 U6 - http://dx.doi.org/10.1007/s12975-017-0585-8 SN - 1868-601X IS - 9 SP - 284 EP - 293 PB - Springer Nature CY - Cham ER - TY - JOUR A1 - Garhofer, Gerhard A1 - Bek, Toke A1 - Boehm, Andreas G. A1 - Gherghel, Doina A1 - Grundwald, Juan A1 - Jeppesen, Peter A1 - Kergoat, Hélène A1 - Kotliar, Konstantin A1 - Lanzl, Ines A1 - Lovasik, John V. A1 - Nagel, Edgar A1 - Vilser, Walthard A1 - Orgul, Selim A1 - Schmetterer, Leopold T1 - Use of the retinal vessel analyzer in ocular blood flow research JF - Acta Ophthalmol N2 - The present article describes a standard instrument for the continuous online determination of retinal vessel diameters, the commercially available retinal vessel analyzer. This report is intended to provide informed guidelines for measuring ocular blood flow with this system. The report describes the principles underlying the method and the instruments currently available, and discusses clinical protocol and the specific parameters measured by the system. Unresolved questions and the possible limitations of the technique are also discussed. Y1 - 2010 U6 - http://dx.doi.org/10.1111/j.1755-3768.2009.01587.x SN - 1755-3768 VL - 88 IS - 7 SP - 717 EP - 722 PB - Wiley-Blackwell CY - Oxford ER - TY - JOUR A1 - Attar, Mandana Hossein Zadeh A1 - Merk, Hans F. A1 - Kotliar, Konstantin A1 - Wurpts, Gerda A1 - Röseler, Stefani A1 - Moll-Slodowy, Silke A1 - Plange, Johann A1 - Baron, Jens Malte A1 - Balakirski, Galina T1 - The CD63 basophil activation test as a diagnostic tool for assessing autoimmunity in patients with chronic spontaneous urticaria JF - European Journal of Dermatology Y1 - 2019 U6 - http://dx.doi.org/10.1684/ejd.2019.3680 VL - 29 IS - 6 SP - 614 EP - 618 ER - TY - JOUR A1 - Kodomskoi, Leonid A1 - Kotliar, Konstantin A1 - Schröder, Andreas A1 - Weiss, Michael A1 - Hille, Konrad T1 - Suture-Probe Canaloplasty as an Alternative to Canaloplasty using the iTrack™ Microcatheter JF - Journal of Glaucoma Y1 - 2019 U6 - http://dx.doi.org/10.1097/IJG.0000000000001321 SN - 1057-0829 IS - Epub ahead of print PB - Lippincott Williams & Wilkins CY - Philadelphia ER - TY - JOUR A1 - Balakirski, Galina A1 - Kotliar, Konstantin A1 - Pauly, Karolin J. A1 - Krings, Laura K. A1 - Rübben, Albert A1 - Baron, Jens M. A1 - Schmitt, Laurenz T1 - Surgical Site Infections After Dermatologic Surgery in Immunocompromised Patients: A Single-Center Experience JF - Dermatologic Surgery N2 - BACKGROUND Immunosuppression is often considered as an indication for antibiotic prophylaxis to prevent surgical site infections (SSI) while performing skin surgery. However, the data on the risk of developing SSI after dermatologic surgery in immunosuppressed patients are limited. PATIENTS AND METHODS All patients of the Department of Dermatology and Allergology at the University Hospital of RWTH Aachen in Aachen, Germany, who underwent hospitalization for a dermatologic surgery between June 2016 and January 2017 (6 months), were followed up after surgery until completion of the wound healing process. The follow-up addressed the occurrence of SSI and the need for systemic antibiotics after the operative procedure. Immunocompromised patients were compared with immunocompetent patients. The investigation was conducted as a retrospective analysis of patient records. RESULTS The authors performed 284 dermatologic surgeries in 177 patients. Nineteen percent (54/284) of the skin surgery was performed on immunocompromised patients. The most common indications for surgical treatment were nonmelanoma skin cancer and malignant melanomas. Surgical site infections occurred in 6.7% (19/284) of the cases. In 95% (18/19), systemic antibiotic treatment was needed. Twenty-one percent of all SSI (4/19) were seen in immunosuppressed patients. CONCLUSION According to the authors' data, immunosuppression does not represent a significant risk factor for SSI after dermatologic surgery. However, larger prospective studies are needed to make specific recommendations on the use of antibiotic prophylaxis while performing skin surgery in these patients. The available data on complications after dermatologic surgery have improved over the past years. Particularly, additional risk factors have been identified for surgical site infections (SSI). Purulent surgical sites, older age, involvement of head, neck, and acral regions, and also the involvement of less experienced surgeons have been reported to increase the risk of the SSI after dermatologic surgeries.1 In general, the incidence of SSI after skin surgery is considered to be low.1,2 However, antibiotics in dermatologic surgeries, especially in the perioperative setting, seem to be overused,3,4 particularly regarding developing antibiotic resistances and side effects. Immunosuppression has been recommended to be taken into consideration as an additional indication for antibiotic prophylaxis to prevent SSI after skin surgery in special cases.5,6 However, these recommendations do not specify the exact dermatologic surgeries, and were not specifically developed for dermatologic surgery patients and treatments, but adopted from other surgical fields.6 According to the survey conducted on American College of Mohs Surgery members in 2012, 13% to 29% of the surgeons administered antibiotic prophylaxis to immunocompromised patients to prevent SSI while performing dermatologic surgery on noninfected skin,3 although this was not recommended by Journal of the American Academy of Dermatology Advisory Statement. Indeed, the data on the risk of developing SSI after dermatologic surgery in immunosuppressed patients are limited. However, it is possible that due to the insufficient evidence on the risk of SSI occurrence in this patient group, dermatologic surgeons tend to overuse perioperative antibiotic prophylaxis. To make specific recommendations on the use of antibiotic prophylaxis in immunosuppressed patients in the field of skin surgery, more information about the incidence of SSI after dermatologic surgery in these patients is needed. The aim of this study was to fill this data gap by investigating whether there is an increased risk of SSI after skin surgery in immunocompromised patients compared with immunocompetent patients. Y1 - 2018 U6 - http://dx.doi.org/10.1097/DSS.0000000000001615 IS - 44 (12) SP - 1525 EP - 1536 PB - Wolters Kluwer ER - TY - JOUR A1 - Hamou, Hussam Aldin A1 - Kotliar, Konstantin A1 - Tan, Sonny Kian A1 - Weiß, Christel A1 - Blume, Christian A1 - Clusmann, Hans A1 - Schubert, Gerrit Alexander A1 - Albanna, Walid T1 - Surgical nuances and placement of subgaleal drains for supratentorial procedures—a prospective analysis of efficacy and outcome in 150 craniotomies JF - Acta Neurochirurgica N2 - 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. Y1 - 2020 U6 - http://dx.doi.org/10.1007/s00701-019-04196-6 SN - 0942-0940 VL - 2020 IS - 162 SP - 729 EP - 736 PB - Springer Nature CY - Cham ER - TY - JOUR A1 - Pressler, Axel A1 - Esefeld, Katrin A1 - Scherr, Johannes A1 - Ali, Mohammad A1 - Hanssen, Henner A1 - Kotliar, Konstantin A1 - Lanzl, Ines A1 - Halle, Martin A1 - Kaemmerer, Harald A1 - Schmidt-Trucksäss, Arno A1 - Hager, Alfred T1 - Structural alterations of retinal arterioles in adults late after repair of aortic isthmic coarctation JF - The American Journal of Cardiology N2 - Patients after coarctation repair still have an increased risk of cardiovascular or cerebrovascular events. This has been explained by the persisting hypertension and alterations in the peripheral vessels. However, involvement of the central vessels such as the retinal arteries is virtually unknown. A total of 34 patients after coarctation repair (22 men and 12 women; 23 to 58 years old, age range 0 to 32 years at surgical repair) and 34 nonhypertensive controls underwent structural and functional retinal vessel analysis. Using structural analysis, the vessel diameters were measured. Using functional analysis, the endothelium-dependent vessel dilation in response to flicker light stimulation was assessed. In the patients after coarctation repair, the retinal arteriolar diameter was significantly reduced compared to that of the controls (median 182 μm, first to third quartile 171 to 197; vs 197 μm, first to third quartile 193 to 206; p <0.001). These findings were independent of the peripheral blood pressure and age at intervention. No differences were found for venules. The functional analysis findings were not different between the patients and controls (maximum dilation 3.5%, first to third quartile 2.1% to 4.5% vs 3.6%, first to third quartile 2.2% to 4.3%; p = 0.81), indicating preserved autoregulative mechanisms. In conclusion, the retinal artery diameter is reduced in patients after coarctation repair, independent of their current blood pressure level and age at intervention. As a structural marker of chronic vessel damage associated with past, current, or future hypertension, retinal arteriolar narrowing has been linked to stroke incidence. These results indicate an involvement of cerebral microcirculation in aortic coarctation, despite timely repair, and might contribute to explain the increased rate of cerebrovascular events in such patients. Y1 - 2010 U6 - http://dx.doi.org/10.1016/j.amjcard.2009.10.070 SN - 0002-9149 VL - 105 IS - 5 SP - 740 EP - 744 PB - Elsevier CY - Amsterdam ER - TY - JOUR A1 - Neumaier, Felix A1 - Kotliar, Konstantin A1 - Haeren, Roel Hubert Louis A1 - Temel, Yasin A1 - Lüke, Jan Niklas A1 - Seyam, Osama A1 - Lindauer, Ute A1 - Clusmann, Hans A1 - Hescheler, Jürgen A1 - Schubert, Gerrit Alexander A1 - Schneider, Toni A1 - Albanna, Walid T1 - Retinal Vessel Responses to Flicker Stimulation Are Impaired in Ca v 2.3-Deficient Mice—An in- vivo Evaluation Using Retinal Vessel Analysis (RVA) JF - Frontiers in Neurology Y1 - 2021 U6 - http://dx.doi.org/10.3389/fneur.2021.659890 VL - 12 SP - 1 EP - 11 PB - Frontiers ER - TY - JOUR A1 - Kotliar, Konstantin A1 - Vilser, Walthatd A1 - Nagel, Edgar A1 - Lanzl, Ines M. T1 - Retinal vessel reaction in response to chromatic flickering light / Kotliar, Konstantin E. ; Vilser, Walthard ; Nagel, Edgar ; Lanzl, Ines M. JF - Graefe's Archive for Clinical and Experimental Ophthalmology. 242 (2004), H. 5 Y1 - 2004 SN - 1435-702X SP - 377 EP - 392 PB - - ER -