a Ocular Trauma Division , Staff Scientist US Army Institute of Surgical Research, Joint Base San Antonio, USA.
b Ocular Trauma Division , Engineer US Army Institute of Surgical Research, Joint Base San Antonio, USA.
Curr Eye Res. 2019 Jul;44(7):770-780. doi: 10.1080/02713683.2019.1567791.
: Blast-related brain and ocular injuries can lead to acute and chronic visual dysfunction. The chronic visual consequences of blast exposure and its progression remain unclear. The goal of this study is to analyze ocular functional response to four levels of blast exposure and identify a threshold of blast exposure leading to acute and chronic visual dysfunction. : Anesthetized adult male Long-Evans rats received a single-blast exposure at a peak overpressure of 78, 117, 164 or 213 kPa, delivered by a compressed air-driven shock tube. Clinical eye examination, intraocular pressure (IOP), flash electroretinography (fERG) and spectral-domain optical coherence tomography (SD-OCT) images were assessed prior to, and at multiple time points post exposure. : No abnormal fERG were observed for the two lowest-level blast groups (78 kPa or 117 kPa). For the 164 kPa group, the a- and b-wave amplitudes of the fERG were decreased at 3 days postexposure ( = 0.009 for a-wave, = 0.010 for b-wave), but recovered to baseline levels by 7 days post-exposure. The IOP was unchanged for the 117 kPa and 164 kPa groups. The 78 kPa group demonstrated a small transient increase during week one ( = 0.046). For the highest blast group (213 kPa), the IOP was significantly elevated immediately post-exposure ( = 0.0001), but recovered by 24 hr. A bimodal depression in the fERG a- and b-wave amplitudes was observed for this group: the amplitudes were depressed at day 3 post-exposure ( = 0.007 for a-wave, = 0.012 for b-wave), and recovered by day 7 post-exposure. However, the fERG amplitudes were once again depressed at week 8 post-exposure, suggesting a chronic retinal dysfunction. All retinae appeared normal in SD-OCT images. : Our study demonstrates that a single-blast exposure may result in acute and chronic fERG deficit, and traumatic IOP elevation. Noninvasive functional tests may hold promise for identifying individuals with a risk for developing chronic visual deficits, and indicating a time window for early clinical diagnosis, rehabilitation, and treatment.
爆炸相关的脑和眼部损伤可导致急性和慢性视力障碍。爆炸暴露及其进展的慢性视觉后果尚不清楚。本研究的目的是分析眼部对四级爆炸暴露的功能反应,并确定导致急性和慢性视力障碍的爆炸暴露阈值。
在一项研究中,成年雄性 Long-Evans 大鼠在一个峰值超压为 78、117、164 或 213 kPa 的单次爆炸暴露下接受治疗,由压缩空气驱动的激波管产生。在暴露前和暴露后多个时间点评估临床眼部检查、眼内压(IOP)、闪光视网膜电图(fERG)和光谱域光学相干断层扫描(SD-OCT)图像。
对于两个最低水平的爆炸组(78 kPa 或 117 kPa),没有观察到异常的 fERG。对于 164 kPa 组,fERG 的 a 波和 b 波振幅在暴露后 3 天降低(a 波为 0.009,b 波为 0.010),但在暴露后 7 天恢复到基线水平。117 kPa 和 164 kPa 组的 IOP 不变。78 kPa 组在第一周内显示出短暂的轻度升高( = 0.046)。对于最高的爆炸组(213 kPa),IOP 在暴露后立即显著升高( = 0.0001),但在 24 小时内恢复。该组观察到 fERG a 波和 b 波振幅的双峰抑郁:振幅在暴露后 3 天降低(a 波为 0.007,b 波为 0.012),并在暴露后 7 天恢复。然而,fERG 振幅在暴露后 8 周再次降低,表明存在慢性视网膜功能障碍。在 SD-OCT 图像中,所有视网膜均正常。
我们的研究表明,单次爆炸暴露可能导致急性和慢性 fERG 缺陷和创伤性 IOP 升高。非侵入性功能测试可能有助于识别发生慢性视力缺陷风险的个体,并为早期临床诊断、康复和治疗提供时间窗口。