Occult Retinal Detachment After Mild Traumatic Brain Injury

Bedgood, Alysia; Rand, Scott E.; Major, James C.

doi:10.1097/jsm.0000000000000114

Cited by 4 publications

(3 citation statements)

References 8 publications

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“…This is exemplified by the accumulating number of reported cases of patients who presented with visual and oculomotor disturbance following minor head injury and SRC that were found to be caused by coexisting traumatic cranial neuropathy, 14,15 demyelinating disease, 13 paraneoplastic syndrome, 39 and retinal detachment. 4 Accordingly, the authors suggest that these vestibulo-ocular tests only be used to supplement a full neurological examination and only be performed by clinicians who are trained to recognize the full spectrum of neuroophthalmological conditions that can accompany traumatic brain injury.…”

Section: Discussionmentioning

confidence: 99%

Clinical predictors of vestibulo-ocular dysfunction in pediatric sports-related concussion

Ellis

Cordingley²,

Vis³

et al. 2017

PED

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OBJECTIVE There were 2 objectives of this study. The first objective was to identify clinical variables associated with vestibulo-ocular dysfunction (VOD) detected at initial consultation among pediatric patients with acute sports-related concussion (SRC) and postconcussion syndrome (PCS). The second objective was to reexamine the prevalence of VOD in this clinical cohort and evaluate the effect of VOD on length of recovery and the development of PCS. METHODS A retrospective review was conducted for all patients with acute SRC and PCS who were evaluated at a pediatric multidisciplinary concussion program from September 2013 to May 2015. Acute SRS was defined as presenting < 30 days postinjury, and PCS was defined according to the International Classification of Diseases, 10th Revision criteria and included being symptomatic 30 days or longer postinjury. The initial assessment included clinical history and physical examination performed by 1 neurosurgeon. Patients were assessed for VOD, defined as the presence of more than 1 subjective vestibular and oculomotor complaint (dizziness, diplopia, blurred vision, etc.) and more than 1 objective physical examination finding (abnormal near point of convergence, smooth pursuits, saccades, or vestibulo-ocular reflex testing). Poisson regression analysis was used to identify factors that increased the risk of VOD at initial presentation and the development of PCS. RESULTS Three hundred ninety-nine children, including 306 patients with acute SRC and 93 with PCS, were included. Of these patients, 30.1% of those with acute SRC (65.0% male, mean age 13.9 years) and 43.0% of those with PCS (41.9% male, mean age 15.4 years) met the criteria for VOD at initial consultation. Independent predictors of VOD at initial consultation included female sex, preinjury history of depression, posttraumatic amnesia, and presence of dizziness, blurred vision, or difficulty focusing at the time of injury. Independent predictors of PCS among patients with acute SRC included the presence of VOD at initial consultation, preinjury history of depression, and posttraumatic amnesia at the time of injury. CONCLUSIONS This study identified important potential risk factors for the development of VOD following pediatric SRC. These results provide confirmatory evidence that VOD at initial consultation is associated with prolonged recovery and is an independent predictor for the development of PCS. Future studies examining clinical prediction rules in pediatric concussion should include VOD. Additional research is needed to elucidate the natural history of VOD following SRC and establish evidence-based indications for targeted vestibular rehabilitation.

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Section: Discussionmentioning

confidence: 99%

Clinical predictors of vestibulo-ocular dysfunction in pediatric sports-related concussion

Ellis

Cordingley²,

Vis³

et al. 2017

PED

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“…It is particularly important to assess for retinal tears and retinal detachment when evaluating head trauma because these are emergencies that require prompt intervention (Amos, 1999;Ibrar et al, 2021). Symptoms may be overlooked and attributed to the concussed state (Bedgood et al, 2015). The retina, an extension of the central nervous system (CNS), converts light signals into nerve impulses (Behar-Cohen et al, 2020).…”

Section: Flashing Lights After Tbimentioning

confidence: 99%

Traumatic brain injury: Mechanisms, manifestations, and visual sequelae

et al. 2023

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Traumatic brain injury (TBI) results when external physical forces impact the head with sufficient intensity to cause damage to the brain. TBI can be mild, moderate, or severe and may have long-term consequences including visual difficulties, cognitive deficits, headache, pain, sleep disturbances, and post-traumatic epilepsy. Disruption of the normal functioning of the brain leads to a cascade of effects with molecular and anatomical changes, persistent neuronal hyperexcitation, neuroinflammation, and neuronal loss. Destructive processes that occur at the cellular and molecular level lead to inflammation, oxidative stress, calcium dysregulation, and apoptosis. Vascular damage, ischemia and loss of blood brain barrier integrity contribute to destruction of brain tissue. This review focuses on the cellular damage incited during TBI and the frequently life-altering lasting effects of this destruction on vision, cognition, balance, and sleep. The wide range of visual complaints associated with TBI are addressed and repair processes where there is potential for intervention and neuronal preservation are highlighted.

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“…Retinal detachment has a number of causes and could be rhegmatogenous or may due to other causes such as traumatic brain injury, severe myopia, retinal tear, or vascular abnormalities frequently encountered in diabetic retina and hypertension [224][225][226][227]. In rodent models, retinal detachment induced by subretinal injection of 1% hyaluronic acid resulted in a rapid increase in autophagic activity 3 days after insult.…”

Section: Retinal Detachmentmentioning

confidence: 99%

Autophagy in Ocular Pathophysiology

Mitter¹,

Boulton²

2016

Autophagy in Current Trends in Cellular Physiology and Pathology

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Autophagy is an evolutionarily conserved intracellular recycling pathway that is indispensable for cellular quality control. Dysfunctional autophagy has been associated with several neurodegenerative, myodegenerative, infectious, and cancerous disorders. Autophagic processes are not only important for cellular maintenance in the retina but also intimately involved with phagocytosis and the very core of retinal visual process. Additionally, excessively upregulated autophagy may culminate into a cell death modality, which may be detrimental to the non-dividing cells of various eye segments. Major advances have been made in understanding the role and fate of autophagy in different ocular tissue layers. In this chapter, we summarize the current understanding of autophagy in the eye in the context of development, aging, and disease. We also speculate on the putative therapeutic strategies where autophagy may be incorporated to treat oculopathies.

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Occult Retinal Detachment After Mild Traumatic Brain Injury

Cited by 4 publications

References 8 publications

Clinical predictors of vestibulo-ocular dysfunction in pediatric sports-related concussion

Clinical predictors of vestibulo-ocular dysfunction in pediatric sports-related concussion

Traumatic brain injury: Mechanisms, manifestations, and visual sequelae

Autophagy in Ocular Pathophysiology

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