Visual Structure and Function in Collision Sport Athletes

Leong, Danielle; Morettin, Christina; Messner, Leonard V.; Steinmetz, Robert J.; Pang, Yi; Galetta, Steven; Balcer, Laura J.

doi:10.1097/wno.0000000000000572

Cited by 19 publications

(27 citation statements)

References 18 publications

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“…The literature has shown that decreased RNFL thickness correlates with visual outcomes, particularly reduced low contrast letter acuity . In this study, there were no significant visual outcomes observed and RNFL thinning was not shown to correlate with reduced visual acuity.…”

Section: Discussioncontrasting

confidence: 70%

“…The literature has shown that decreased RNFL thickness correlates with visual outcomes, particularly reduced low contrast letter acuity. 26,43 In this study, there were no significant visual outcomes observed and RNFL thinning was not shown to correlate with reduced visual acuity. The findings of normal cognition and mood within this study cohort underlines the need to perform similar studies in those exhibiting clinical features.…”

Section: Discussioncontrasting

confidence: 51%

“…Comparing the degree of RNFL thinning observed in this study with the literature is difficult, as the only other study to perform OCT imaging on non-combat contact athletes failed to find statistically significant thinning in a cohort of American Football players. 26 This may be due to differences in protective gear worn by players, with American Football players typically wearing hard helmets and padded guards, the result of which would be more significant rTBI exposure in Rugby League players. Comparison with studies in Alzheimer disease, a neuropathologically similar condition to CTE, shows similar results.…”

Section: Discussionmentioning

confidence: 99%

“…The diffuse nature and complexity of this network render it susceptible to traumatic brain injury . Recent studies have demonstrated significant RNFL thinning in collision sport athletes and Olympic boxers, however, the former study by Leong et al failed to demonstrate statistically significant RNFL thinning in subgroup analysis of American Football players. Furthermore, studies have reported that RNFL thinning in individuals without a neurodegenerative disease is associated with reduced visual acuity and worse cognitive function .…”

Section: Introductionmentioning

confidence: 99%

“…[20][21][22][23][24][25] Recent studies have demonstrated significant RNFL thinning in collision sport athletes 26 and Olympic boxers, 27 however, the former study by Leong et al failed to demonstrate statistically significant RNFL thinning in subgroup analysis of American Football players. Furthermore, studies have reported that RNFL thinning in individuals without a neurodegenerative disease is associated with reduced visual acuity 26 and worse cognitive function. 28 RNFL thinning has also been shown to predict a greater likelihood of future cognitive decline 28 and dementia.…”

Section: Introductionmentioning

confidence: 99%

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Retinal nerve fibre changes in sports‐related repetitive traumatic brain injury

Kelman

Hodge

Stanwell

et al. 2019

Clinical Exper Ophthalmology

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Importance There is limited literature on the use of optical coherence tomography in the assessment of retinal nerve fibre layer (RNFL) thickness in sports‐related repetitive mild traumatic brain injury. Background To evaluate RNFL thickness in professional rugby league players. RNFL thinning may serve as a proxy for wider white matter degeneration. Design Cross‐sectional observational study. Participants Thirteen retired Australian professional rugby league players were recruited. Methods Participants underwent binocular optical coherence tomography to measure RNFL thickness. Each participant underwent a complete ophthalmic assessment to exclude concurrent disease. Main Outcome Measures RNFL thickness of each eye were compared with a normative database. Results Participants had played professional Rugby League for 18 years on average and reported sustaining 15 sports‐related concussions throughout their career. The RNFL in participants was four micrometres thinner than that of matched normative data. Cohort average RNFL thickness was reduced in 12 out of 14 optical coherence testing parameters. These findings were statistically significant in the left inferonasal [P = .013] and left nasal [P = .006] sectors. There was no statistically significant relationship between RNFL thickness and other visual measures. Conclusions and Relevance This study is the first to demonstrate RNFL thinning in a cohort of retired Australian professional Rugby League players. RNFL changes have been shown to correlate with cerebral white matter loss and neurodegeneration. Optical coherence tomography may serve as a safe and economical means of screening for repetitive traumatic brain injury related neurodegeneration in contact sport athletes.

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Section: Discussioncontrasting

confidence: 70%

Section: Discussioncontrasting

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Retinal nerve fibre changes in sports‐related repetitive traumatic brain injury

Kelman

Hodge

Stanwell

et al. 2019

Clinical Exper Ophthalmology

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Association of Optical Coherence Tomography With Longitudinal Neurodegeneration in Veterans With Chronic Mild Traumatic Brain Injury

et al. 2020

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Key Points Question Do veterans with a history of mild traumatic brain injury show greater neurodegeneration over time compared with control veterans with no history of head injury? Findings In this longitudinal cohort study of 139 veterans with and without a history of mild traumatic brain injury, mild traumatic brain injury was associated with significantly greater thinning of the retinal nerve fiber layer over time. Meaning These findings suggest that structural neural loss in the visual system, as evidenced by thinning of the retinal nerve fiber layer, may be a useful biomarker of neurodegeneration following chronic mild traumatic brain injury.

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Association between retinal thickness and disease characteristics in adult epilepsy: A cross‐sectional OCT evaluation

Delazer,

Bao,

Lauseker

et al. 2023

Epilepsia Open

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ObjectiveThinning of the peripapillary retinal nerve fiber layer (p‐RNFL), as measured by optical coherence tomography (OCT), was recently introduced as a promising marker for cerebral neuronal loss in people with epilepsy (PwE). However, its clinical implication remains to be elucidated. We thus aimed to (1) systematically characterize the extent of the retinal neuroaxonal loss in a broad spectrum of unselected PwE and (2) to evaluate the main clinical determinants.MethodsIn this prospective study, a spectral‐domain OCT evaluation was performed on 98 well‐characterized PwE and 85 healthy controls (18‐55 years of age). All inner retinal layers and the total macula volume were assessed. Group comparisons and linear regression analyses with stepwise backwards selection were performed to identify relevant clinical and demographic modulators of the retinal neuroaxonal integrity.ResultsPwE (age: 33.7±10.6 years; 58.2% female) revealed a significant neuroaxonal loss across all assessed retinal layers (global pRNFL, p=0.001, Δ=4.24μm; macular RNFL, p<0.001, Δ=0.05mm3; ganglion cell inner plexiform layer, GCIP, p<0.001, Δ=0.11mm3; inner nuclear layer, INL, p=0.03, Δ=0.02mm3) as well as significantly reduced total macula volumes (TMV, p<0.001, Δ=0.18mm3) compared to healthy controls (age: 31.2±9.0 years; 57.6% female). The extent of retinal neuroaxonal loss was associated with the occurrence and frequency of tonic‐clonic seizures and the number of anti‐seizure medications, and was most pronounced in male patients.SignificancePwE presented an extensive retinal neuroaxonal loss, affecting not only the peripapillary but also macular structures. The non‐invasive and economic measurement via OCT bears the potential to establish as a practical tool to inform patient management, as the extent of the retinal neuroaxonal loss reflects aspects of disease severity and sex‐specific vulnerability.

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Visual Structure and Function in Collision Sport Athletes

Cited by 19 publications

References 18 publications

Retinal nerve fibre changes in sports‐related repetitive traumatic brain injury

Retinal nerve fibre changes in sports‐related repetitive traumatic brain injury

Association of Optical Coherence Tomography With Longitudinal Neurodegeneration in Veterans With Chronic Mild Traumatic Brain Injury

Association between retinal thickness and disease characteristics in adult epilepsy: A cross‐sectional OCT evaluation

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