Modifications in macular perfusion and neuronal loss after acute traumatic brain injury.
Author
Hepschke, Jenny LLaws, Elinor
Bin Saliman, Noor H
Juncu, Stefana
Courtie, Ella
Belli, Antonio
Blanch, Richard J
Publication date
2023-04-03
Metadata
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Purpose: Traumatic brain injury (TBI) causes structural damage and functional impairment in the visual system, often with retinal ganglion cell (RGC) degeneration occurring without visual symptoms. RGC degeneration is associated with reduced retinal blood-flow, however, it is not known whether reductions in perfusion precede or are secondary to neurodegeneration. Methods: We conducted a prospective observational single-center case series. Patients were included if they were admitted to the hospital after acute TBI and underwent ophthalmic clinical examination, including optical coherence tomography (OCT) and OCT angiography (OCTA) acutely and at follow-up. Ganglion cell layer thickness (GCL) thickness, vascular density in the superficial vascular plexus (SVP), and intermediate capillary plexus (ICP) were quantified. Results: Twenty-one patients aged 20 to 65 years (mean = 38 years) including 16 men and 5 women were examined less than 14 days after moderate to severe TBI, and again after 2 to 6 months. Macular structure and perfusion were normal at baseline in all patients. Visual function was abnormal at baseline in three patients and subsequent neurodegeneration and loss of perfusion corresponded to baseline visual function abnormalities. Nine patients (43%) had reduced macular GCL thickness at follow up. Perfusion in the SVP strongly associated with local GCL thickness. The strongest association of the SVP metrics was the sum of vessel density (P < 0.0001). Conclusions: In cases of reduced visual function after TBI, macular perfusion remained normal until reductions in GCL thickness occurred, indicating that perfusion changes were secondary to local GCL loss.Citation
Hepschke JL, Laws E, Bin Saliman NH, Juncu S, Courtie E, Belli A, Blanch RJ. Modifications in Macular Perfusion and Neuronal Loss After Acute Traumatic Brain Injury. Invest Ophthalmol Vis Sci. 2023 Apr 3;64(4):35. doi: 10.1167/iovs.64.4.35Type
ArticleAdditional Links
http://www.iovs.org/PMID
37115535ae974a485f413a2113503eed53cd6c53
10.1167/iovs.64.4.35