Automated Perimetry and Visual Dysfunction in Blast-Related Traumatic Brain Injury

Lemke, Sonne; Cockerham, Glenn C.; Glynn-Milley, Catherine; Lin, Richard; Cockerham, Kimberly P.

doi:10.1016/j.ophtha.2015.10.003

Cited by 23 publications

(32 citation statements)

References 35 publications

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“…SITA tests often are used to identify and follow patients with field loss from diseases other than glaucoma, [31][32][33] and therefore one could consider the lack of inclusion of patients with such diseases as a weakness. This certainly was the case also when the early clinical studies of the SITA Standard and SITA Fast tests were published.…”

Section: Discussionmentioning

confidence: 99%

“…[23][24][25] Despite these test time reductions, SITA test programs identified at least as much glaucomatous field loss 22,[26][27][28] as the algorithms that they replaced, and the SITA testing strategies enjoyed broad acceptance. [29][30][31][32][33] Over the last 15 years, results from large randomized glaucoma trials have changed our sense of what constitutes optimal glaucoma management. It has become clear that many or perhaps even most glaucomatous eyes progress, even in patients where measured intraocular pressures always are within statistically normal limits, and that rates of progression vary tremendously among eyes.…”

mentioning

confidence: 99%

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A New SITA Perimetric Threshold Testing Algorithm: Construction and a Multicenter Clinical Study

Heijl

Patella

Chong

et al. 2019

American Journal of Ophthalmology

100

121

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To describe a new time-saving threshold visual field-testing strategy-Swedish Interactive Thresholding Algorithm (SITA) Faster, which is intended to replace SITA Fast-and to report on a clinical evaluation of this new strategy. DESIGN: Description and validity analysis for modifications applied to SITA Fast. METHODS: Five centers tested 1 eye of each of 126 glaucoma and glaucoma suspect patients with SITA Faster, SITA Fast, and SITA Standard at each of 2 visits. Outcomes included test time, mean deviation, and the visual field index (VFI), significant test points in probability maps, and intertest threshold variability. RESULTS: Mean (standard deviation) test times were 171.9 (45.3) seconds for SITA Faster, 247.0 (56.7) for SITA Fast, and 369.5 (64.5) for SITA Standard (P < .001). SITA Faster test times averaged 30.4 % shorter than SITA Fast and 53.5 % shorter than SITA Standard. Mean deviation was similar among all 3 tests.VFI did not differ between SITA Fast and SITA Faster tests, mean difference 0%, but VFI values were 1.2% lower with SITA Standard compared to both SITA Fast (P [ .007) and SITA Faster (P [ .002). A similar trend was seen with a slightly higher number of significant test points with SITA Standard than with SITA Fast and SITA Faster. All 3 tests had similar test-retest variability over the entire range of threshold values. CONCLUSIONS: SITA Faster saved considerable test time. SITA Faster and SITA Fast gave almost identical results. There were small differences between SITA Faster and SITA Standard, of the same character as previously shown for SITA Fast vs SITA Standard. (Am J

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

A New SITA Perimetric Threshold Testing Algorithm: Construction and a Multicenter Clinical Study

Heijl

Patella

Chong

et al. 2019

American Journal of Ophthalmology

100

121

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“…We have characterized many of the physical features of our blast protocol (including a pressure/time profile, overpressure, positive phase and duration) [83], which will help the comparison of these studies to other models of blast-mediated and non-blast mediated TBI. It should be noted that the visual and cognitive dysfunction we have previously reported using our model [11,12,13,84] is bilateral, suggesting a lack of effect from blunt impacts, and these same dysfunctions are frequently observed in Soldiers and Veterans exposed to blast injury [37,38,42,43,85,86]. This study also only focused on a single brain region, whereas past studies have focused globally on the brain or brain-connected fluids [23].…”

Section: Discussionmentioning

confidence: 75%

“…We have utilized novel proteomics-based qualitative approaches to identify candidates for serum-based biomarkers of TBI. We focused our study on the thalamus, as it is a major sensory relay station in the brain, and previous findings of both auditory and visual difficulties have been observed in humans following blast-mediated TBI [37,38,39,40,41,42,43,44]. Thus, the thalamus may be a site particularly prone to damage and appropriate for developing biomarkers.…”

Section: Discussionmentioning

confidence: 99%

Identification of chronic brain protein changes and protein targets of serum auto-antibodies after blast-mediated traumatic brain injury

Harper

Rudd²,

Meyer

et al. 2020

Heliyon

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In addition to needing acute emergency management, blast-mediated traumatic brain injury (TBI) is also a chronic disorder with delayed-onset symptoms that manifest and progress over time. While the immediate consequences of acute blast injuries are readily apparent, chronic sequelae are harder to recognize. Indeed, the identification of individuals with mild-TBI or TBI-induced symptoms is greatly impaired in large part due to the lack of objective and robust biomarkers. The purpose of this study was to address these need by identifying candidates for serumbased biomarkers of blast TBI, and also to identify unique or differentially regulated protein expression in the thalamus in C57BL/6J mice exposed to blast using high throughput qualitative screens of protein expression. To identify thalamic proteins differentially or uniquely associated with blast exposure, we utilized an antibody-based affinity-capture strategy (referred to as "proteomics-based analysis of depletomes"; PAD) to deplete thalamic lysates from blast-treated mice of endogenous thalamic proteins also found in control mice. Analysis of this "depletome" detected 75 unique proteins, many with associations to the myelin sheath. To identify blastassociated proteins eliciting production of circulating autoantibodies, serum antibodies of blast-treated mice were immobilized, and their immunogens subsequently identified by proteomic analysis of proteins specifically captured following incubation with thalamic lysates (a variant of a strategy referred to as "proteomics-based expression library screening"; PELS). This analysis identified 46 blast-associated immunogenic proteins, including 6 shared in common with the PAD analysis (ALDOA, PHKB, HBA-A1, DPYSL2, SYN1, and CKB). These proteins and their autoantibodies are appropriate for further consideration as biomarkers of blast-mediated TBI.

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“…7 High rates of visual field deficits were demonstrated on reliable automated perimetry testing in veterans with blastrelated TBI of various severities. 8 An increasing number of veterans from recent military conflicts abroad have been diagnosed with mTBI and visual pathway trauma, especially ITON. Data on the epidemiology and natural history of visual pathway trauma in the military are currently being collected from The Defense and Veterans Eye Injury and Vision Registry, a registry for traumatic optic neuropathy that collects longitudinal clinical data on active duty service members and veterans with traumatic visual dysfunction.…”

mentioning

confidence: 99%

Indirect Traumatic Optic Neuropathy in Mild Chronic Traumatic Brain Injury

Chan

Hills

Bakall

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To analyze the clinical presentation and optical coherence tomography (OCT) findings in indirect traumatic optic neuropathy (ITON) in veterans with chronic mild traumatic brain injury (mTBI). METHODS. This retrospective study is the first to describe the OCT pattern of subclinical to mild ITON in veterans with chronic mTBI. The thicknesses of the macular ganglion cell layer (mGCL), peripapillary retinal nerve fiber layer (pRNFL), and subfoveal choroidal layer were analyzed in young veterans who had mTBI of >6 months' duration and either blunt head injury or improvised explosive device (IED) concussions. RESULTS. Three major OCT findings were demonstrated: (1) temporal pRNFL thinning was associated with subclinical TON in the eyes of chronic mTBI patients compared with controls; within mTBI subjects, nasal mGCL thinning at the 3-mm modified Early Treatment Diabetic Retinopathy Study circle diameter distance from the fovea correlated with the corresponding temporal retinal nerve fiber layer thinning; (2) inner (1 mm) superior thinning was greater than that of the temporal mGCL in blunt head injury and could potentially distinguish it from IED concussive head trauma; and (3) subfoveal choroidal thinning was significantly worse in eyes of mTBI patients compared with those of controls. CONCLUSIONS. These OCT findings may contribute to the understanding of the spectrum of visual injuries resulting from head trauma.

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Automated Perimetry and Visual Dysfunction in Blast-Related Traumatic Brain Injury

Cited by 23 publications

References 35 publications

A New SITA Perimetric Threshold Testing Algorithm: Construction and a Multicenter Clinical Study

A New SITA Perimetric Threshold Testing Algorithm: Construction and a Multicenter Clinical Study

Identification of chronic brain protein changes and protein targets of serum auto-antibodies after blast-mediated traumatic brain injury

Indirect Traumatic Optic Neuropathy in Mild Chronic Traumatic Brain Injury

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