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

摘要 本课题的目标是进一步开发跟踪扫描激光检眼镜 RetiTrack设备(TSLO)，使这项技术能够广泛应用于高分辨率眼睛- 跟踪头部损伤，如轻度创伤性脑损伤(MTBI)/脑震荡。这个项目的第一阶段 格兰特使收集数据成为可能，这些患者最近被诊断出患有 在急性恢复期和清除时都有脑震荡。考虑到年龄和 自受伤以来的时间，凝视性眼动测量能够预测个人的延长 回收率(AUC=0.81；95%CI：0.68-0.93；p&lt；0.001)。RetiTrack带来了前所未有的水平 通过使用基于图像的视网膜方法将眼睛跟踪的准确性应用于临床，从而导致 运动测量，灵敏度为0.25角分(~1微米)。目前，该系统是 标准眼科仪器中使用的最准确、快速和功能强大的眼球跟踪系统。 研究表明，瞳孔眼球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器缺乏 容量、重复性和灵敏度，以预测mTBI的恢复情况。RetiTrack设备可以 准确测量凝视性眼球运动(FEMS)，量化视网膜眼跳 史无前例的水平，可成为判断mTBI预后的新兴生物标志物。此外， 它可以作为多种其他神经系统症状学严重程度的指标 精神错乱。RetiTrack设备作为一种脑震荡预测工具将是运动的完美选择 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，并通过引导最多的 有效的治疗方法。进一步优化视听任务构建创新视听平台 使用人工智能算法自动量化视网膜微眼跳的软件 这将有助于提高对脑震荡恢复和/或恶化的预测。

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.