Primary Visual Pathway Changes in Individuals With Chronic Mild Traumatic Brain Injury

Area of Science:

• Neuroscience
• Ophthalmology
• Medical Diagnostics

Background:

• Individuals with mild traumatic brain injury (TBI) frequently experience vision problems despite normal visual acuity and fundus examinations.
• There is a critical need for effective diagnostic methods to identify visual dysfunction in patients with mild TBI.

Purpose of the Study:

• To evaluate the effectiveness of a comprehensive battery of assessments and machine-learning approaches in diagnosing visual dysfunction in patients with mild TBI.

Main Methods:

• A prospective, observational, case-control study involved 28 mild TBI patients and 28 matched controls.
• Assessments included oculomotor function, optical coherence tomography, contrast sensitivity, visual evoked potentials, visual field testing, and MRI.
• Machine learning algorithms were employed to analyze data from the primary visual pathway.

Main Results:

• Mild TBI patients exhibited significantly reduced prism convergence breakpoints and recovery points.
• Decreased contrast sensitivity and increased visual evoked potential binocular summation index were observed in the mild TBI group.
• Machine learning detected subtle visual pathway differences, including in the optic radiations and occipital lobe, irrespective of reported symptoms.

Conclusions:

• The visual system is demonstrably affected in individuals with mild TBI, even when vision problems are not self-reported.
• A combination of detailed visual assessments and machine learning shows promise for accurately diagnosing visual dysfunction post-mild TBI.