Retinal eye-tracking as a prognostic tool for traumatic brain injury and concussion

摘要 本计画的目标是进一步发展追踪扫描雷射检眼镜 （TSLO），Retitrack设备，使广泛使用的技术，高分辨率的眼睛- 跟踪头部损伤，如轻度创伤性脑损伤（mTBI）/脑震荡。第一阶段 格兰特使50名最近被诊断患有 在急性恢复期和清除时都有脑震荡。考虑到年龄和 自受伤后的时间，注视眼动指标能够预测个体的长期 回收率（AUC=0.81; 95%CI：0.68-0.93; p<0.001）。退休轨道带来了前所未有的水平 通过使用基于图像的视网膜方法， 运动测量，灵敏度为0.25弧分（~1微米）。目前，该系统是 标准眼科仪器中使用的最准确、最快速、最实用的眼动跟踪系统。 研究表明，瞳孔眼动跟踪技术已经验证了使用 眼球运动作为脑震荡的生物标志物，但目前可用的眼球跟踪仪缺乏 预测mTBI恢复的能力、可重复性和灵敏度。Retitrack设备可以 精确测量注视眼球运动（FEM），量化视网膜扫视， 前所未有的水平，并可能成为mTBI预后的新兴生物标志物。此外，委员会认为， 它可以作为多种其他神经系统疾病的严重程度的指标 紊乱Retitrack设备作为一种脑震荡的预测工具将是完美的适合运动 医疗诊所和更衣室，用于脑震荡后恢复监测，确保安全 恢复活动和减轻脑震荡的长期后果， 有效的治疗。进一步优化固定任务，建设创新型 使用人工智能算法自动量化视网膜微扫视的软件 这将导致预测脑震荡的恢复和/或恶化的改进。

Abstract The goal of our project is to further develop the tracking scanning laser ophthalmoscope (TSLO), the Retitrack device, to enable widespread use of the technology for high-resolution eye- tracking for head injuries, such as mild traumatic brain injury (mTBI)/concussions. Phase I of this grant enabled the collection of data from 50 patients who had recently been diagnosed with a concussion both during their acute recovery period and upon clearance. Accounting for age and time since injury, fixational eye motion metrics were able to predict individuals with prolonged recovery (AUC=0.81; 95% CI: 0.68-0.93; p<0.001). The Retitrack brings an unprecedented level of accuracy of eye tracking to the clinic by using an image-based retinal approach resulting in motion measurements with a sensitivity of 0.25 arcmin (~1 micron). Currently, this system is the most accurate, fast and functional eye-tracking system used in a standard ophthalmic instrument. Research has suggested that pupil eye-tracking technologies have validated the idea of using eye movements as a biomarker of concussion, but the current eye-trackers available lack the capacity, repeatability, and sensitivity to predict recovery in mTBI. The Retitrack device can accurately measure fixational eye movements (FEMs), quantify retinal saccades at an unprecedented level, and can become an emerging biomarker of mTBI prognosis. Furthermore, it can serve as an indicator of severity in the symptomatology of multiple other neurological disorders. The Retitrack device as a concussive prognostic tool would be the perfect fit for Sport Medicine Clinics and the locker room for post-concussion recovery monitoring ensuring a safe return to activity and mitigating long-term consequences of concussion by guiding the most effective therapies. Further optimization of fixational tasks and the construction of innovative software that uses Artificial Intelligence algorithms to automatically quantify retinal microsaccades which will lead to the improvement of predicting the recovery and/or worsening of concussion.