RNFL thinning may provide method for detecting TBIs
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BOSTON – Retinal nerve fiber layer degradation showed potential as an objective method to detect and monitor patients with a history of traumatic brain injury, according to data presented at the American Academy of Optometry annual meeting.
“Traumatic brain injury [TBI] can lead to a wide range of acute and chronic symptoms and makes it a major cause of disability and death worldwide,” Elizabeth Stern-Green, a student at the Ohio State University College of Optometry, said during an academy-sponsored press conference. “The numbers are on the rise. Globally, there are about 10 million annual cases, 2.5 million of which are in the United States.”
Stern-Green said there are currently no objective methods to detect or monitor patients with TBI.
She and colleagues designed their study to look at the retina as a potential biomarker for TBI, because the long axons of retinal neurons are “likely subject to the same shearing forces caused by TBI as neurons in the brain,” she said.
The study comprised 10 adult patients with a history of at least two mild or moderate TBIs (average 3.3 over a range of 1 to 18 years), eight patients of whom were women. The researchers also included an age- and sex-matched cohort of participants with no TBI history.
Stern-Green and colleagues found no differences in minimal foveal thickness or macular phase retardation between the groups. There were also no differences in OCT-measured global, temporal, temporal-superior, nasal-superior, nasal and temporal-interior RNFL thicknesses between the groups.
However, nasal-inferior RNFL thickness was significantly lower (97.1 vs. 118 microns; P = .04) among the patients compared with controls. Similarly, scanning laser polarimetry-measured inferior (56.6 vs. 60.7; P = .02) and temporal-superior-nasal-inferior-temporal average (62.9 vs. 68.5; P = .03) were lower among patients compared with controls.
“We detected some RNFL loss in young, mostly female subjects with a history of multiple TBIs. This is important because our results agree with past reports in the literature of RNFL thinning in male collision-sport athletes and veterans and supports the eye’s potential as a site to objectively detect structural changes to neural tissue after TBI,” Stern-Green concluded.
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Stern-Green E, et al. Retinal nerve fiber layer degradation in subjects with a history of multiple traumatic brain injuries. Presented at: American Academy of Optometry annual meeting; Nov. 2-6; Boston.
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