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Purpose Vascular risk factors and ocular perfusion are heatedly discussed in the pathogenesis of glaucoma. The retinal vessel analyzer (RVA, IMEDOS Systems, Germany) allows noninvasive measurement of retinal vessel regulation. Significant differences especially in the veins between healthy subjects and patients suffering from glaucoma were previously reported. In this pilot-study we investigated if localized vascular regulation is altered in glaucoma patients with altitudinal visual field defect asymmetry. Methods 15 eyes of 12 glaucoma patients with advanced altitudinal visual field defect asymmetry were included. The mean defect was calculated for each hemisphere separately (-20.99 ± 10.49 pro- found hemispheric visual field defect vs -7.36 ± 3.97 dB less profound hemisphere). After pupil dilation, RVA measurements of retinal arteries and veins were conducted using the standard protocol. The superior and inferior retinal vessel reactivity were measured consecutively in each eye. Results Significant differences were recorded in venous vessel constriction after flicker light stimulation and overall amplitude of the reaction (p \ 0.04 and p \ 0.02 respectively) in-between the hemispheres spheres. Vessel reaction was higher in the hemisphere corresponding to the more advanced visual field defect. Arterial diameters reacted similarly, failing to reach statistical significance. Conclusion Localized retinal vessel regulation is significantly altered in glaucoma patients with asymmetri altitudinal visual field defects. Veins supplying the hemisphere concordant to a less profound visual field defect show diminished diameter changes. Vascular dysregulation might be particularly important in early glaucoma stages prior to a significant visual field defect.
Background
Post-COVID-19 syndrome (PCS) is a lingering disease with ongoing symptoms such as fatigue and cognitive impairment resulting in a high impact on the daily life of patients. Understanding the pathophysiology of PCS is a public health priority, as it still poses a diagnostic and treatment challenge for physicians.
Methods
In this prospective observational cohort study, we analyzed the retinal microcirculation using Retinal Vessel Analysis (RVA) in a cohort of patients with PCS and compared it to an age- and gender-matched healthy cohort (n = 41, matched out of n = 204).
Measurements and main results
PCS patients exhibit persistent endothelial dysfunction (ED), as indicated by significantly lower venular flicker-induced dilation (vFID; 3.42% ± 1.77% vs. 4.64% ± 2.59%; p = 0.02), narrower central retinal artery equivalent (CRAE; 178.1 [167.5–190.2] vs. 189.1 [179.4–197.2], p = 0.01) and lower arteriolar-venular ratio (AVR; (0.84 [0.8–0.9] vs. 0.88 [0.8–0.9], p = 0.007). When combining AVR and vFID, predicted scores reached good ability to discriminate groups (area under the curve: 0.75). Higher PCS severity scores correlated with lower AVR (R = − 0.37 p = 0.017). The association of microvascular changes with PCS severity were amplified in PCS patients exhibiting higher levels of inflammatory parameters.
Conclusion
Our results demonstrate that prolonged endothelial dysfunction is a hallmark of PCS, and impairments of the microcirculation seem to explain ongoing symptoms in patients. As potential therapies for PCS emerge, RVA parameters may become relevant as clinical biomarkers for diagnosis and therapy management.
Investigation Of The Seismic Behaviour Of Infill Masonry Using Numerical Modelling Approaches
(2017)
Masonry is a widely spread construction type which is used all over the world for different types of structures. Due to its simple and cheap construction, it is used as non-structural as well as structural element. In frame structures, such as
reinforced concrete frames, masonry may be used as infill. While the bare frame itself is able to carry the loads when it comes to seismic events, the infilled frame is not able to warp freely due to the constrained movement. This restraint results in a complex interaction between the infill and the surrounding frame, which may lead to severe damage to the infill as well as the surrounding frame. The interaction is studied in different projects and effective approaches for the description of the behavior are still lacking. Experimental programs are usually quite expensive, while numerical models, once validated, do offer an efficient approach for the investigation of the interaction when horizontally loaded. In order to study the numerous parameters influencing the seismic load bearing behavior, numerical models may be used. Therefore, this contribution presents a numerical approach for the simulation of infill masonry in reinforced concrete frames. Both parts, the surrounding frame as well as the infill are represented by micro modelling approaches to correctly take into account the different types of failure. The adopted numerical model describes the inelastic behavior of the system, as indicated by the obtained results of the overall structural response as well as the formation of damage in the infilled wall. Comparison of the numerical and experimental results highlights the valuable contribution of numerical simulations in the study and design of infilled frames. As damage of the infill masonry may occur in-plane due to the interaction as well as out-of-plane due to the low vertical load, both directions of loading are investigated.