Truong James Q, Ciuffreda Kenneth J, Han M H Esther, Suchoff Irwin B
Department of Biological and Vision Sciences, SUNY College of Optometry , New York, NY , USA.
Brain Inj. 2014;28(10):1283-7. doi: 10.3109/02699052.2014.915989. Epub 2014 Jun 19.
To determine whether photosensitivity (PS) changes over time and, if so, what factors may be related to the change; furthermore, to determine whether tint density changes over time, all in mild traumatic brain injury (mTBI).
A retrospective analysis of 62 patient records (aged 18-40 years) with mTBI and PS was conducted. All charts were obtained from the SUNY/College of Optometry clinics from 2004-2011.
Fifty per cent demonstrated reduced PS over time, with most occurring after year 1 post-injury (40%). Promotion of PS reduction appears to be associated with the lack of spectacle tint usage (p = 0.01) and the use of contact lenses (p = 0.03). Inhibition of PS reduction appears to be associated with tinted lenses (p = 0.06), hyperacusis (p = 0.03), dry eye (p = 0.04), migraines (p = 0.03) and loss of consciousness at the time of injury (p = 0.05). Concerning tint density changes over time, 71% (p = 0.002) maintained the same degree over time, while 27% (p = 0.002) reduced and 2% waxed and waned.
Neural adaptation to PS appears to be a long-term process. Tint usage may act to inhibit this adaptive process, while the use of contact lenses may act to promote it. These findings may provide guidance in the clinical management of photosensitivity in the mTBI population.
确定轻度创伤性脑损伤(mTBI)患者的光敏性(PS)是否随时间变化,若有变化,哪些因素可能与之相关;此外,确定色彩密度是否随时间变化。
对62例患有mTBI且有PS的患者记录(年龄18 - 40岁)进行回顾性分析。所有病历均来自纽约州立大学验光学院诊所2004年至2011年期间的病例。
50%的患者PS随时间降低,多数发生在受伤后第1年之后(40%)。PS降低似乎与未使用有色眼镜(p = 0.01)和使用隐形眼镜(p = 0.03)有关。PS降低的抑制因素似乎与有色镜片(p = 0.06)、听觉过敏(p = 0.03)、干眼(p = 0.04)、偏头痛(p = 0.03)以及受伤时意识丧失(p = 0.05)有关。关于色彩密度随时间的变化,71%(p = 0.002)随时间保持相同程度,27%(p = 0.002)降低,2%有波动。
神经对PS的适应似乎是一个长期过程。使用有色眼镜可能会抑制这一适应过程,而使用隐形眼镜可能会促进这一过程。这些发现可为mTBI人群光敏性的临床管理提供指导。