Macular, Choroidal, and Peripapillary Perfusion Changes in Mild and Moderate Traumatic Brain Injury Using Optical
Grant A Justin1,2,3, Lauren Winslow1,2, Anita Kundu1,2
1Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA.
Journal of Vitreoretinal Diseases
|November 14, 2024
Summary
Optical coherence tomography (OCT) and OCT angiography (OCTA) revealed reduced macular perfusion in patients with traumatic brain injury (TBI). The choroidal vascularity index may help identify subtle TBI effects, suggesting OCT and OCTA as potential noninvasive screening tools.
Area of Science:
- Ophthalmology
- Neurology
- Medical Imaging
Background:
- Traumatic brain injury (TBI) can lead to subtle neurological and physiological changes.
- Assessing microvascular alterations in the retina and choroid may offer insights into TBI's impact.
Purpose of the Study:
- To compare retinal and choroidal microvasculature in mild to moderate TBI patients versus controls using OCT and OCTA.
- To investigate the utility of OCT and OCTA parameters in detecting TBI-related changes.
Main Methods:
- Recruited patients with TBI and matched controls.
- Utilized optical coherence tomography (OCT) and OCT angiography (OCTA) to assess parameters like choroidal vascularity index and foveal avascular zone (FAZ) metrics.
- Analyzed macular vessel density, perfusion density, and peripapillary capillary perfusion.
Main Results:
- Patients with TBI showed reduced FAZ circularity and macular OCTA vessel density/perfusion density.
- TBI associated with PTSD exhibited significantly reduced macular OCTA parameters.
- Choroidal vascularity index increased with TBI severity but decreased with multiple TBIs.
Conclusions:
- Mild to moderate TBI is associated with reduced macular perfusion.
- Choroidal vascularity index can differentiate subtle effects of TBI severity and repetition.
- OCT and OCTA show promise as noninvasive screening tools for TBI-induced microvascular changes.
