Central corneal thickness and corneal hysteresis associated with glaucoma damage.

PURPOSE:

We sought to measure the impact of central corneal thickness (CCT), a possible risk factor for glaucoma damage, and corneal hysteresis, a proposed measure of corneal resistance to deformation, on various indicators of glaucoma damage.

DESIGN:

Observational study.

METHODS:

Adult patients of the Wilmer Glaucoma Service underwent measurement of hysteresis on the Reichert Ocular Response Analyzer and measurement of CCT by ultrasonic pachymetry. Two glaucoma specialists (H.A.Q., N.G.C.) reviewed the chart to determine highest known intraocular pressure (IOP), target IOP, diagnosis, years with glaucoma, cup-to-disk ratio (CDR), mean defect (MD), pattern standard deviation (PSD), glaucoma hemifield test (GHT), and presence or absence of visual field progression.

RESULTS:

Among 230 subjects, the mean age was 65 +/- 14 years, 127 (55%) were female, 161 (70%) were white, and 194 (85%) had a diagnosis of primary open-angle glaucoma (POAG) or suspected POAG. In multivariate generalized estimating equation models, lower corneal hysteresis value (P = .03), but not CCT, was associated with visual field progression. When axial length was included in the model, hysteresis was not a significant risk factor (P = .09). A thinner CCT (P = .02), but not hysteresis, was associated with a higher CDR at the most recent examination. Neither CCT nor hysteresis was associated with MD, PSD, or GHT "outside normal limits."

CONCLUSIONS:

Thinner CCT was associated with the state of glaucoma damage as indicated by CDR. Axial length and corneal hysteresis were associated with progressive field worsening.

Test-retest variability in structural and functional parameters of glaucoma damage in the glaucoma imaging longitudinal study.

PURPOSE:

To determine the test-retest variability in perimetric, optic disc, and macular thickness parameters in a cohort of treated patients with established glaucoma.

PATIENTS AND METHODS:

In this cohort study, the authors analyzed the imaging studies and visual field tests at the baseline and 6-month visits of 162 eyes of 162 participant in the Glaucoma Imaging Longitudinal Study (GILS). They assessed the difference, expressed as the standard error of measurement, of Humphrey field analyzer II (HFA) Swedish Interactive Threshold Algorithm fast, Heidelberg retinal tomograph (HRT) II, and retinal thickness analyzer (RTA) parameters between the two visits and assumed that this difference was due to measurement variability, not pathologic change. A statistically significant change was defined as twice the standard error of measurement.

RESULTS:

In this cohort of treated glaucoma patients, it was found that statistically significant changes were 3.2 dB for mean deviation (MD), 2.2 for pattern standard deviation (PSD), 0.12 for cup shape measure, 0.26 mm for rim area, and 32.8 microm and 31.8 microm for superior and inferior macular thickness, respectively. On the basis of these values, it was estimated that the number of potential progression events detectable in this cohort by the parameters of MD, PSD, cup shape measure, rim area, superior macular thickness, and inferior macular thickness was 7.5, 6.0, 2.3, 5.7, 3.1, and 3.4, respectively.

CONCLUSIONS:

The variability of the measurements of MD, PSD, and rim area, relative to the range of possible values, is less than the variability of cup shape measure or macular thickness measurements. Therefore, the former measurements may be more useful global measurements for assessing progressive glaucoma damage.

Retinal pigment epithelial cell multinucleation in the aging eye - a mechanism to repair damage and maintain homoeostasis

Retinal pigment epithelial (RPE) cells are central to retinal health and homoeostasis. Dysfunction or death of RPE cells underlies many age-related retinal degenerative disorders particularly age-related macular degeneration. During aging RPE cells decline in number, suggesting an age-dependent cell loss. RPE cells are considered to be postmitotic, and how they repair damage during aging remains poorly defined. We show that RPE cells increase in size and become multinucleate during aging in C57BL/6J mice. Multinucleation appeared not to be due to cell fusion, but to incomplete cell division, that is failure of cytokinesis. Interestingly, the phagocytic activity of multinucleate RPE cells was not different from that of mononuclear RPE cells. Furthermore, exposure of RPE cells in vitro to photoreceptor outer segment (POS), particularly oxidized POS, dose-dependently promoted multinucleation and suppressed cell proliferation. Both failure of cytokinesis and suppression of proliferation required contact with POS. Exposure to POS also induced reactive oxygen species and DNA oxidation in RPE cells. We propose that RPE cells have the potential to proliferate in vivo and to repair defects in the monolayer. We further propose that the conventionally accepted 'postmitotic' status of RPE cells is due to a modified form of contact inhibition mediated by POS and that RPE cells are released from this state when contact with POS is lost. This is seen in long-standing rhegmatogenous retinal detachment as overtly proliferating RPE cells (proliferative vitreoretinopathy) and more subtly as multinucleation during normal aging. Age-related oxidative stress may promote failure of cytokinesis and multinucleation in RPE cells.

Development of a Vehicle-Bridge-Soil Dynamic Interaction Model for Scour Damage Modelling

Damage detection in bridges using vibration-based methods is an area of growing research interest. Improved assessment
methodologies combined with state-of-the-art sensor technology are rapidly making these approaches applicable for real-world
structures. Applying these techniques to the detection and monitoring of scour around bridge foundations has remained
challenging; however this area has gained attraction in recent years. Several authors have investigated a range of methods but
there is still significant work required to achieve a rounded and widely applicable methodology to detect and monitor scour.This
paper presents a novel Vehicle-Bridge-Soil Dynamic Interaction (VBSDI) model which can be used to simulate the effect of scour
on an integral bridge. The model outputs dynamic signals which can be analysed to determine modal parameters and the variation
of these parameters with respect to scour can be examined.The key novelty of this model is that it is the first numerical model for
simulating scour that combines a realistic vehicle loadingmodel with a robust foundation soil responsemodel.This paper provides a
description of the model development and explains the mathematical theory underlying themodel. Finally a case study application
of the model using typical bridge, soil, and vehicle properties is provided.

Numerical considerations for the implementation of a comprehensive composite damage model

A comprehensive continuum damage mechanics model [1] had been developed to capture the detailed
behaviour of a composite structure under a crushing load. This paper explores some of the difficulties
encountered in the implementation of this model and their mitigation. The use of reduced integration
element and a strain softening model both negatively affect the accuracy and stability of the
simulation. Damage localisation effects demanded an accurate measure of characteristic length. A
robust algorithm for determining the characteristic length was implemented. Testing showed that this
algorithm produced marked improvements over the use of the default characteristic length provided
by Abaqus. Zero-energy or hourglass modes, in reduced integration elements, led to reduced
resistance to bending. This was compounded by the strain softening model, which led to the formation
of elements with little resistance to deformation that could invert if left unchecked. It was shown,
through benchmark testing, that by deleting elements with excess distortions and controlling the mesh
using inbuilt distortion/hourglass controls, these issues can be alleviated. These techniques
contributed significantly to the viability and usability of the damage model.

Validation of a 3D damage model for predicting the response of composite structures under crushing loads

A 3D intralaminar continuum damage mechanics based material model, combining damage mode interaction and material nonlinearity, was developed to predict the damage response of composite structures undergoing crush loading. This model captures the structural response without the need for calibration of experimentally determined material parameters. When used in the design of energy absorbing composite structures, it can reduce the dependence on physical testing. This paper validates this model against experimental data obtained from the literature and in-house testing. Results show that the model can predict the force response of the crushed composite structures with good accuracy. The simulated energy absorption in each test case was within 12% of the experimental value. Post-crush deformation and the damage morphologies, such as ply splitting, splaying and breakage, were also accurately reproduced. This study establishes the capability of this damage model for predicting the responses of composite structures under crushing loads.

Predicting impact damage, residual strength and crashworthiness of composite structures

The development of the latest generation of wide-body carbon-fibre composite passenger aircraft has heralded a new era in the utilisation of these materials. The premise of superior specific strength and stiffness, corrosion and fatigue resistance, is tempered by high development costs, slow production rates and lengthy and expensive certification programmes. Substantial effort is currently being directed towards the development of new modelling and simulation tools, at all levels of the development cycle, to mitigate these shortcomings. One of the primary challenges is to reduce the extent of physical testing, in the certification process, by adopting a ‘certification by simulation’ approach. In essence, this aspirational objective requires the ability to reliably predict the evolution and progression of damage in composites. The aerospace industry has been at the forefront of developing advanced composites modelling tools. As the automotive industry transitions towards the increased use of composites in mass-produced vehicles, similar challenges in the modelling of composites will need to be addressed, particularly in the reliable prediction of crashworthiness. While thermoset composites have dominated the aerospace industry, thermoplastics composites are likely to emerge as the preferred solution for meeting the high-volume production demands of passenger road vehicles. This keynote presentation will outline recent progress and current challenges in the development of finite-element-based predictive modelling tools for capturing impact damage, residual strength and energy absorption capacity of thermoset and thermoplastic composites for crashworthiness assessments.