Visual Dysfunctions at Different Stages after Blast and Non-blast Mild Traumatic Brain Injury
Visual Dysfunctions at Different Stages after Blast and Non-blast Mild Traumatic Brain Injury
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DOI：
10.1097/opx.0000000000000825
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发表时间：
2017-01-01
影响因子：
1.4
通讯作者：
Riggs, Daniel W.
中科院分区：
文献类型：
--
作者：
Capo-Aponte, Jose E.;Jorgensen-Wagers, Kendra L.;Riggs, Daniel W.
目的.评估非Y冲击波或冲击波诱导的轻度创伤性脑损伤（mTBI）后不同阶段战士视觉功能障碍和相关症状的患病率。对500名美国军事人员的电子健康记录进行了全面回顾性审查，这些人员被诊断为在Landstuhl地区医疗中心接受眼部护理的部署相关mTBI。为了进行分析，将数据按损伤机制分组，并根据损伤与首次眼部检查之间的天数将每组进一步分为三个亚组。数据显示，高频率的视觉症状和视觉功能障碍。然而，除了眼痛和复视外，视觉症状和视觉功能障碍的患病率在损伤机制和损伤后阶段之间没有显著差异。在视觉症状中，双眼功能障碍较常见，包括近垂直隐斜增加、近点负性融合性聚散度中断减少、近点会聚度后退、立体视锐度下降和正性相对斜视减少。亚组（爆炸与非爆炸）之间的视觉后遗症方面缺乏差异表明，针对平民非爆炸事件造成的mTBI视觉后遗症的评估和管理的研究与主要由爆炸事件造成战斗损伤的军事人员有关。
Purpose. To assess the prevalence of visual dysfunctions and associated symptoms in war fighters at different stages after nonYblast- or blast-induced mild traumatic brain injury (mTBI).Methods. A comprehensive retrospective review of the electronic health records of 500 U.S. military personnel with a diagnosis of deployment-related mTBI who received eye care at the Landstuhl Regional Medical Center. For analysis, the data were grouped by mechanism of injury, and each group was further divided in three subgroups based on the number of days between injury and initial eye examination.Results. The data showed a high frequency of visual symptoms and visual dysfunctions. However, the prevalence of visual symptoms and visual dysfunctions did not differ significantly between mechanism of injury and postinjury stage, except for eye pain and diplopia. Among visual symptoms, binocular dysfunctions were more common, including higher near vertical phoria, reduced negative fusional vergence break at near, receded near point of convergence, decreased stereoacuity, and reduced positive relative accommodation.Conclusions. The lack of difference in terms of visual sequelae between subgroups (blast vs. nonblast) suggests that research addressing the assessment and management of mTBI visual sequelae resulting from civilian nonblast events is relevant to military personnel where combat injury results primarily from a blast event.