Blast mild traumatic brain injury is associated with increased myopia and chronic convergence insufficiency.
Blast mild traumatic brain injury is associated with increased myopia and chronic convergence insufficiency.
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爆炸性轻度创伤性脑损伤与近视增加和慢性会聚功能不全有关。
DOI：
10.1016/j.visres.2021.04.004
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发表时间：
2021-09
期刊：
影响因子：
1.8
通讯作者：
McGlinchey RE
中科院分区：
文献类型：
--
作者：
Fortenbaugh FC;Gustafson JA;Fonda JR;Fortier CB;Milberg WP;McGlinchey RE
虽然慢性视觉症状主诉在有轻度创伤性脑损伤 (mTBI) 病史的退伍军人中很常见，但研究仍在进行中，以确定与 mTBI 最密切相关的视觉缺陷模式，特别是与爆炸相关的 mTBI 对视觉功能的影响。尚未得到充分探讨的一个领域是急变 mTBI 对屈光不正的潜在影响。虽然平民头部受伤后近视转变已被记录，但尚未在军事 mTBI 参与者中探讨创伤后近视转变。本研究调查了爆炸性 mTBI 对一系列视觉功能指标的影响，包括距离敏锐度和屈光不正，研究对象为 31 名 9/11 后退伍军人，他们接受了有关军事和 TBI 历史的详细临床访谈。 17 名参与者有与急变相关的 mTBI 病史（急变 mTBI+ 组），而 14 名参与者没有（急变 mTBI− 组）。结果显示，相对于原始 mTBI− 组，原始 mTBI+ 组会聚不足和近视的频率有所增加。线性回归分析进一步表明，距离敏锐度和屈光不正的缺陷与服兵役期间突发性 mTBI 的数量有关，但与非突发性 mTBI 的数量或终生非突发性 TBI 的数量无关，并且不能用 PTSD 来解释。这些结果与 mTBI 对皮层下视觉结构造成的长期损害一致，这些视觉结构支持聚散运动和在不同距离清晰地看到物体所需的调节功能。
While chronic visual symptom complaints are common among Veterans with a history of mild traumatic brain injury (mTBI), research is still ongoing to characterize the pattern of visual deficits that is most strongly associated with mTBI and specifically, the impact of blast-related mTBI on visual functioning. One area that has not been well explored is the potential impact of blast mTBI on refractive error. While myopic shifts have been documented following head injuries in civilian populations, posttraumatic myopic shifts have not been explored in participants with military mTBI. This study investigated the impact of blast mTBIs on a range of visual function measures including distance acuity and refractive error, in a well-characterized cohort of thirty-one Post-9/11 veterans for whom detailed clinical interviews regarding military and TBI history were available. Seventeen participants had a history of blast-related mTBI (blast mTBI+ group) while 14 did not (blast mTBI− group). Results show an increased frequency of convergence insufficiency and myopia in the blast mTBI+ group relative to the blast mTBI− group. Linear regression analyses further show that deficits in distance acuity and refractive error are associated with the number of blast mTBIs during military service but not the number of non-blast mTBIs or the number of lifetime non-blast TBIs and cannot be accounted for by PTSD. These results are consistent with long-lasting damage following blast mTBI to subcortical visual structures that support both vergence movements and the accommodative functions needed to see clearly objects at varying distances.
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