Department of Defense/Veterans Affairs Vision Center of Excellence, Bethesda, Maryland.
University of Maryland, Baltimore County, Maryland.
Optom Vis Sci. 2021 Aug 1;98(8):891-900. doi: 10.1097/OPX.0000000000001757.
This study reports the prevalence and relative risk of photophobia in patients with traumatic brain injury (TBI).
This study aimed to conduct a systematic review and meta-analysis to determine the prevalence and relative risk of photophobia in patients with TBI.
Three databases were used for literature search: PubMed, EMBASE, and Cochrane Library.
Publications reporting the prevalence of photophobia after TBI in patients of any age were included. A series of meta-regression analyses based on a generalized linear mixed model was performed to identify potential sources of heterogeneity in the prevalence estimates.
Seventy-five eligible publications were identified. The prevalence of photophobia was 30.46% (95% confidence interval [CI], 20.05 to 40.88%) at 1 week after the injury. Prevalence decreased to 19.34% (95% CI, 10.40 to 28.27%) between 1 week and 1 month after TBI and to 13.51% (95% CI, 5.77 to 21.24%) between 1 and 3 months after the injury. The rapid decrease in the prevalence of photophobia in the first 3 months after a TBI injury was significant (P < .001). Three months post-TBI, the prevalence of photophobia leveled off to a near plateau with nonsignificant variability, increasing between 3 and 6 months (17.68%; 95% CI, 9.05 to 26.32%) and decreasing between 6 and 12 months since TBI (14.85%; 95% CI, 6.80 to 22.90%). Subgroup analysis of 14 publications that contained control data showed that the estimated risk ratio for photophobia was significantly higher in the TBI than in the control group during the entire 12 months after TBI.
This study demonstrates that photophobia is a frequent complaint after TBI, which largely resolves for many individuals within 3 months after the injury. For some patients, however, photophobia can last up to 12 months and possibly longer. Developing an objective quantitative methodology for measuring photophobia, validating a dedicated photophobia questionnaire, and having a specific photophobia International Classification of Diseases, Tenth Revision code would greatly improve data gathering and analysis.
本研究报告了创伤性脑损伤（TBI）患者畏光的患病率和相对风险。
本研究旨在进行系统回顾和荟萃分析，以确定 TBI 患者畏光的患病率和相对风险。
使用三个数据库进行文献检索：PubMed、EMBASE 和 Cochrane 图书馆。
纳入了报告任何年龄 TBI 后畏光患病率的出版物。基于广义线性混合模型进行了一系列荟萃回归分析，以确定患病率估计值中潜在的异质性来源。
确定了 75 篇符合条件的出版物。受伤后 1 周时畏光的患病率为 30.46%（95%置信区间[CI]，20.05%至 40.88%）。1 周至 1 个月后，患病率下降至 19.34%（95%CI，10.40%至 28.27%），1 至 3 个月后下降至 13.51%（95%CI，5.77%至 21.24%）。TBI 后 3 个月内畏光患病率的快速下降具有统计学意义（P<0.001）。TBI 后 3 个月，畏光患病率趋于平稳，无显著变化，3 至 6 个月（17.68%；95%CI，9.05%至 26.32%）增加，6 至 12 个月（14.85%；95%CI，6.80%至 22.90%）减少。包含对照数据的 14 项出版物的亚组分析表明，TBI 组的畏光估计风险比在 TBI 后 12 个月内显著高于对照组。
本研究表明，畏光是 TBI 后的常见主诉，大多数患者在受伤后 3 个月内基本缓解。然而，对于一些患者，畏光可能持续长达 12 个月甚至更长时间。开发一种用于测量畏光的客观定量方法、验证专门的畏光问卷以及制定特定的畏光国际疾病分类第十版代码将极大地改善数据收集和分析。
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