Retinal imaging: a first report of the retinal microvasculature in acute mild traumatic brain injury

摘要

Mild traumatic brain injury (mTBI) accounts for 90% of all brain trauma. As only 15% of mTBI patients will have an identifiable intracranial lesion on brain computed tomography [1], injury is often considered as 'insignificant' when compared with the devastating and highly visible sequelae that follows severe TBI. Nevertheless, the lingering postconcussive symptoms (PCS) reported by patients after TBI are now well recognized and particularly so in returning Operation Iraqi and Operation Enduring Freedom veterans [2]. However, how can the risk of PCS be assessed in the absence of a diagnostic test? Of relevance here, and in the context of a potential candidate clinical 'biomarker', is the relationship alreadydescribed between retinal microvascular signs (e.g. reti-nopathy, retinal venular widening, increased arteriolar and venular tortuosity) and brain damage because of cerebral ischaemia after stroke [3] and cardiovascular disease [4]. To our knowledge, no study has explored the potential utility of retinal microvascular signs using retinal photography after mTBI. Here, we describe the results of a 'first of kind' pilot clinical investigation.