Karthik Naveen, Patel Sejal D, Justin Grant A, Stinnett Sandra S, Chiu Stephanie J, Tagg Nathan T, Agrawal Rupesh, Grewal Dilraj S, Fekrat Sharon
iMIND Study Group, Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA.
Walter Reed National Military Medical Center, Bethesda, MD, USA.
J Vitreoretin Dis. 2025 Sep 3:24741264251367104. doi: 10.1177/24741264251367104.
To assess retinal layer thickness and volume by optical coherence tomography (OCT) in patients with prior traumatic brain injury (TBI). Adults (≥18 years) with prior TBI were prospectively recruited. 512 × 128-mm macular cube scans were obtained using Zeiss Cirrus HD-5000 OCT. The previously validated Duke Reading Center's DRCVisualizer semiautomatically segmented (manually corrected) the ganglion cell-inner plexiform (GC-IPL), inner nuclear (INL), outer plexiform (OPL), outer nuclear (ONL), photoreceptors (PR), and retinal pigment epithelium (RPE) layers. Mean thickness and volume were obtained within 3- and 6-mm ETDRS perifoveal rings. Individuals were age- and sex-matched (±5 years) with controls. Thirty-eight patients with TBI (66 eyes; mean ± SD age 45 ± 19 years) and 37 controls (66 eyes; age 44 ± 18 years) were enrolled. Time from TBI to imaging was a mean ± SD 136 ± 89 weeks. TBI was categorized by severity (mild without loss of consciousness [LOC] [n = 25], mild with LOC [n = 35], moderate [n = 6]) and injury mechanism (nonpenetrating contact [n = 54], acceleration-deceleration [n = 12]). Mean GC-IPL was significantly decreased and mean OPL thickness and volume were significantly increased in male TBI patients versus controls. Eyes with moderate TBI had significantly increased mean neurosensory retina, INL, OPL, and RPE thickness and volume versus other TBI severity groups. Eyes with nonpenetrating contact TBI had significantly increased mean neurosensory retina and ONL thickness and volume versus eyes with acceleration-deceleration TBI. All eyes showed a significant correlation for decreasing mean GC-IPL thickness and volume with time from TBI to imaging. TBI may impact thickness and volume of the retinal layers, and changes may be progressive over time.
通过光学相干断层扫描（OCT）评估既往有创伤性脑损伤（TBI）患者的视网膜层厚度和体积。前瞻性招募既往有TBI的成年人（≥18岁）。使用蔡司Cirrus HD - 5000 OCT获得512×128 - mm的黄斑立方体扫描图像。先前经过验证的杜克阅读中心的DRCVisualizer对神经节细胞 - 内丛状层（GC - IPL）、内核层（INL）、外丛状层（OPL）、外核层（ONL）、光感受器层（PR）和视网膜色素上皮层（RPE）进行半自动分割（手动校正）。在3毫米和6毫米的早期糖尿病性视网膜病变研究协会（ETDRS）中心凹周围环内获得平均厚度和体积。个体在年龄和性别上与对照组匹配（±5岁）。纳入了38例TBI患者（66只眼；平均±标准差年龄45±19岁）和37名对照组（66只眼；年龄44±18岁）。从TBI到成像的时间平均±标准差为136±89周。TBI按严重程度（无昏迷的轻度 [n = 25]、有昏迷的轻度 [n = 35]、中度 [n = 6]）和损伤机制（非穿透性接触 [n = 54]、加速 - 减速 [n = 12]）进行分类。与对照组相比，男性TBI患者的平均GC - IPL显著降低，平均OPL厚度和体积显著增加。与其他TBI严重程度组相比，中度TBI患者的眼睛平均神经感觉视网膜、INL、OPL和RPE厚度及体积显著增加。与加速 - 减速性TBI的眼睛相比，非穿透性接触性TBI的眼睛平均神经感觉视网膜和ONL厚度及体积显著增加。所有眼睛均显示平均GC - IPL厚度和体积随从TBI到成像的时间减少存在显著相关性。TBI可能会影响视网膜层的厚度和体积，且这些变化可能会随时间进展。
