Illinois Eye Institute (DL, CM, LVM, RJS, YP), Illinois College of Optometry, Chicago, Illinois; and Departments of Neurology, Ophthalmology, Population Health (SLG, LJB), New York University, New York, New York.
J Neuroophthalmol. 2018 Sep;38(3):285-291. doi: 10.1097/WNO.0000000000000572.
Vision-based measures have been shown to be useful markers in multiple sclerosis (MS), Alzheimer and Parkinson disease. Therefore, these testing paradigms may have applications to populations explaining repetitive head trauma that has been associated with long-term neurodegenerative sequelae. We investigated retinal structure and visual function in professional collision sport athletes compared to age- and race-matched control participants.
In this cross-sectional study, participants underwent spectral-domain optical coherence tomography (OCT) measurements of peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell complex (GCC = ganglion cell + inner plexiform layers) thickness. High-contrast visual acuity (100% level), low-contrast letter acuity (LCLA) (1.25% and 2.5% levels), and King-Devick Test of rapid number naming performance were administered. Vision-specific quality of life (QOL) measures were assessed.
Among 46 collision sport athletes (boxing, n = 14; football, n = 29; ice hockey, n = 3) and 104 control participants, average RNFL thickness was a significant predictor of athlete vs control status with athletes demonstrating 4.8-μm of thinning compared to controls (P = 0.01, generalized estimating equation [GEE] models accounting for age and within-subject, intereye correlations). Athlete vs control status was not a predictor of RNFL thickness for the subgroup of football players in this cohort (P = 0.60). Binocular (P = 0.001) and monocular (P = 0.02) LCLA at 2.5% contrast and vision-specific QOL (P = 0.04) were significant predictors of athlete vs control status (GEE models accounting for age and within-subject, intereye correlations). Rapid number naming performance times were not significantly different between the control and athlete groups.
This study showed that retinal axonal and neuronal loss is present among collision sport athletes, with most notable differences seen in boxers. These findings are accompanied by reductions in visual function and QOL, similar to patterns observed in multiple sclerosis, Alzheimer and Parkinson diseases. Vision-based changes associated with head trauma exposure that have the potential to be detected in vivo represent a unique opportunity for further study to determine if these changes in collision sport athletes are predictive of future neurodegeneration.
基于视觉的测量方法已被证明在多发性硬化症（MS）、阿尔茨海默病和帕金森病中是有用的标志物。因此，这些测试范式可能适用于解释与长期神经退行性后果相关的重复性头部创伤的人群。我们研究了职业碰撞运动运动员与年龄和种族匹配的对照组参与者的视网膜结构和视觉功能。
在这项横断面研究中，参与者接受了周边视网膜神经纤维层（RNFL）和黄斑神经节细胞复合体（GCC=神经节细胞+内丛状层）厚度的光谱域光学相干断层扫描（OCT）测量。进行了高对比度视力（100%水平）、低对比度字母视力（LCLA，1.25%和 2.5%水平）和 King-Devick 快速数字命名测试。评估了特定于视觉的生活质量（QOL）测量。
在 46 名碰撞运动运动员（拳击手，n=14；足球运动员，n=29；曲棍球运动员，n=3）和 104 名对照组参与者中，平均 RNFL 厚度是区分运动员和对照组的显著预测指标，与对照组相比，运动员的 RNFL 厚度变薄了 4.8μm（P=0.01，广义估计方程[GEE]模型考虑了年龄和个体内、双眼间相关性）。在该队列的足球运动员亚组中，运动员与对照组的状态与 RNFL 厚度无关（P=0.60）。双眼（P=0.001）和单眼（P=0.02）在 2.5%对比度下的 LCLA 和特定于视觉的 QOL（P=0.04）是区分运动员和对照组的显著预测指标（考虑年龄和个体内、双眼间相关性的 GEE 模型）。对照组和运动员组的快速数字命名测试时间没有显著差异。
这项研究表明，在职业碰撞运动运动员中存在视网膜轴突和神经元丢失，在拳击手中最为明显。这些发现伴随着视觉功能和 QOL 的降低，与多发性硬化症、阿尔茨海默病和帕金森病观察到的模式相似。与头部创伤暴露相关的基于视觉的变化有可能在体内被检测到，这为进一步研究提供了一个独特的机会，以确定这些在职业碰撞运动运动员中的变化是否可以预测未来的神经退行性变。
