David V Walsh1, José E Capó-Aponte1, Kendra Jorgensen-Wagers2, Leonard A Temme1, Gregory Goodrich3, Josue Sosa1, Daniel W Riggs1. 1. Visual Sciences Branch, Sensory Research Division, U.S. Army Aeromedical Research Laboratory, 6901 Farrel Road, Fort Rucker, AL 36362. 2. Traumatic Brain Injury Clinic, Landstuhl Regional Medical Center, Germany, APO AE 09180. 3. Psychology Service & Western Blind Rehabilitation Center, Veteran Affairs Palo Alto Health Care System, 795 Willow Road Building. T-365, Menlo Park, CA 94025.
Abstract
OBJECTIVES: Traumatic brain injury (TBI) is the leading injury coming out of the past decades' two major military conflicts, with mild TBI (mTBI) being the most commonly diagnosed form. The aim of this study was to assess the frequency and types of visual field (VF) defects seen at different testing stages following nonblast and blast-induced mTBI. METHODS: A comprehensive retrospective review was performed on 500 electronic health records for military personnel sustaining an mTBI during deployment, of which 166 patients were tested with both confrontation VF and 30-2 Humphrey Matrix Frequency Doubling Technology (FDT) perimetry. RESULTS: Scatter defects (48%) were the most predominantly found deficits in both blast and nonblast mTBI injury mechanisms and over postinjury test time frames. Confrontation VF was shown to be a poor qualitative predictor of VF defect. A profound decrease in VF sensitivity was noted in comparison to previously reported FDT normative data. Finally, a significant trend of decreasing VF defects was seen over time, indicating the potential usage of FDT as a visual biomarker for monitoring mTBI recovery. CONCLUSIONS: The findings of this study highlight the importance of performing threshold perimeter testing in those who have suffered an mTBI or concussion-like event. Reprint &
OBJECTIVES:Traumatic brain injury (TBI) is the leading injury coming out of the past decades' two major military conflicts, with mild TBI (mTBI) being the most commonly diagnosed form. The aim of this study was to assess the frequency and types of visual field (VF) defects seen at different testing stages following nonblast and blast-induced mTBI. METHODS: A comprehensive retrospective review was performed on 500 electronic health records for military personnel sustaining an mTBI during deployment, of which 166 patients were tested with both confrontation VF and 30-2 Humphrey Matrix Frequency Doubling Technology (FDT) perimetry. RESULTS: Scatter defects (48%) were the most predominantly found deficits in both blast and nonblast mTBI injury mechanisms and over postinjury test time frames. Confrontation VF was shown to be a poor qualitative predictor of VF defect. A profound decrease in VF sensitivity was noted in comparison to previously reported FDT normative data. Finally, a significant trend of decreasing VF defects was seen over time, indicating the potential usage of FDT as a visual biomarker for monitoring mTBI recovery. CONCLUSIONS: The findings of this study highlight the importance of performing threshold perimeter testing in those who have suffered an mTBI or concussion-like event. Reprint &
Authors: Francesca C Fortenbaugh; Jennifer A Gustafson; Jennifer R Fonda; Catherine B Fortier; William P Milberg; Regina E McGlinchey Journal: Vision Res Date: 2021-05-14 Impact factor: 1.984