September 23, 2019
2 min read
This article is more than 5 years old. Information may no longer be current.
OCT may indicate neurological changes in patients with frequent head trauma
The use of OCT could determine retinal biomarkers of neuropathological change after neurological trauma, according to findings published in Eye and Brain.
Charmaine Childs , PhD, MPhil, B Nurs, and colleagues investigated retinal structures in Olympic boxers who were exposed to frequent head blows.
“Studies have shown thinning of the [retinal nerve fiber layer] in multiple sclerosis, a degenerative brain condition causing white matter atrophy. Similarly, RNFL and total macular volumes are thinner in Alzheimer’s disease and in Parkinson’s disease when comparisons are made with normal ranges, the changes correlating with disease severity,” Childs, a professor of clinical science at the Faculty of Health and Wellbeing at Sheffield Hallam University in England, and colleagues wrote. “Alterations to the retinal vasculature have also been reported after mild traumatic brain injury.”
The researchers measured data from two eye screenings of the boxers for macular and RNFL thickness over time. The data was compared with a control group of 20 sedentary, healthy adults (mean age 30.5 years, eight men) without a history of concussion.
Childs and colleagues examined 16 boxers (mean age 24.5 years, 12 men) in the cohort.
In a period of 18 months, significant macular thickening was identified in 75% of right eye sectors and 50% of left eye sectors, the researchers wrote. When examining RNFL, the left eye quadrant thickened compared with thickening and thinning of the right eye quadrant.
In the boxer cohort, there were thinner macular sectors and RNFL quadrants compared with the control group, Childs and colleagues wrote. – by Earl Holland Jr.
Disclosure: The authors report no relevant financial disclosures.
Perspective
Back to Top
Brad Sutton, OD, FAAO
It is known that OCT measurements of the macular ganglion cell complex (GCC) and the retinal nerve fiber layer (RNFL) can be impacted by neurodegenerative conditions. These include multiple sclerosis, Alzheimer’s disease, and Parkinson’s disease. Might OCT also be able to identify changes due to repeated traumatic brain injuries? Perhaps.
While the results of this study comparing English Olympic boxers to matched controls are intriguing, there are several things worth noting about the findings. The research looked at a total of 16 boxers and 20 controls. This is certainly a small number of patients from which to draw generalized conclusions. The fact that GCC and RNFL measurements were thinner on average in the boxers seems to imply that repeated, traumatic brain injuries may indeed manifest retinal changes. However, the boxers had an original set of measurements taken, which were then repeated 18 months later. On average, the RNFL and GCC measurements were actually thicker 18 months later when compared to those same values at the original visit. This is difficult to understand. If repeated head trauma leads to neurological damage with retinal manifestations, then 18 months of additional repeated trauma via matches and sparring should lead to more GCC and RNFL thinning instead of thickening as was seen on average. Additionally, most sector measurements were thicker, but some sectors were actually thinner. Overall, while this preliminary research is interesting, the jury is still out, and further work is needed.
Brad Sutton, OD, FAAO
Clinical professor, Indiana University School of Optometry
Service chief, Indianapolis Eye Care Center
Disclosures: Sutton reports no relevant financial disclosures.
Published by: