A systematic review of optical coherence tomography findings in adults with mild traumatic brain injury

Hannah S. Lyons; Matilde Sassani; Yousef Hyder; James L. Mitchell; Mark Thaller; Susan Mollan; Alexandra J. Sinclair; Richard J. Blanch; Alexandra Sinclair; Aliza Finch; Adam Hampshire; Alice Sitch; Ali Mazaheri; Andrew Bagshaw; Andy Palmer; Asha Strom; Alice Waitt; Andreas Yiangou; Ahmed Abdel-Hay; Alexander Bennett; Amy Clark; Angus Hunter; Barry Seemungal; Caroline Witton; Caroline Dooley; Deborah Bird; Davinia Fernandez-Espejo; Dave Smith; Dan Ford; Daniel Sherwood; Donna Holding; Duncan Wilson; Edward Palmer; John Golding; Hamid Dehghani; Hyojin Park; Hannah Lyons; Hazel Smith; Helen Brunger; Henrietta Ellis; Iman Idrees; Ian Varley; Jessica Hubbard; Jun Cao; Jon Deeks; James Mitchell; Jan Novak; Jamie Pringle; John Terry; Jack Rogers; Tim Read; Jessikah Fildes; Karen Mullinger; Lisa Hill; Marco Aurisicchio; Mark Thaller; Martin Wilson; Mark Pearce; Matilde Sassani; Matthew Brookes; Mohammad Mahmud; Ray Rayhan; Ned Jenkinson; Niki Karavitaki; Nick Capewell; Olivia Grech; Ole Jensen; Pete Hellyer; Philip Woodgate; Sebastian Coleman; Raymond Reynolds; Richard J. Blanch; Katie Morris; Ryan Ottridge; Rachel Upthegrove; Ronan Dardis; Ruwan Wanni Arachchige; Sarah Berhane; Sam Lucas; Sophie Prosser; Shayan Sharifi; Shreshth Dharm-Datta; Susan Mollan; Toby Ellmers; Tara Ghafari; Tony Goldstone; Waheeda Hawa; Yidian Gao

doi:10.1038/s41433-023-02845-w

A systematic review of optical coherence tomography findings in adults with mild traumatic brain injury

Hannah S. Lyons, Matilde Sassani, Yousef Hyder, James L. Mitchell, Mark Thaller, Susan Mollan, Alexandra J. Sinclair, Richard J. Blanch^*, Alexandra Sinclair, Aliza Finch, Adam Hampshire, Alice Sitch, Ali Mazaheri, Andrew Bagshaw, Andy Palmer, Asha Strom, Alice Waitt, Andreas Yiangou, Ahmed Abdel-Hay, Alexander BennettAmy Clark, Angus Hunter, Barry Seemungal, Caroline Witton, Caroline Dooley, Deborah Bird, Davinia Fernandez-Espejo, Dave Smith, Dan Ford, Daniel Sherwood, Donna Holding, Duncan Wilson, Edward Palmer, John Golding, Hamid Dehghani, Hyojin Park, Hannah Lyons, Hazel Smith, Helen Brunger, Henrietta Ellis, Iman Idrees, Ian Varley, Jessica Hubbard, Jun Cao, Jon Deeks, James Mitchell, Jan Novak, Jamie Pringle, John Terry, Jack Rogers, Tim Read, Jessikah Fildes, Karen Mullinger, Lisa Hill, Marco Aurisicchio, Mark Thaller, Martin Wilson, Mark Pearce, Matilde Sassani, Matthew Brookes, Mohammad Mahmud, Ray Rayhan, Ned Jenkinson, Niki Karavitaki, Nick Capewell, Olivia Grech, Ole Jensen, Pete Hellyer, Philip Woodgate, Sebastian Coleman, Raymond Reynolds, Richard J. Blanch^*, Katie Morris, Ryan Ottridge, Rachel Upthegrove, Ronan Dardis, Ruwan Wanni Arachchige, Sarah Berhane, Sam Lucas, Sophie Prosser, Shayan Sharifi, Shreshth Dharm-Datta, Susan Mollan, Toby Ellmers, Tara Ghafari, Tony Goldstone, Waheeda Hawa, Yidian Gao

^*Corresponding author for this work

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Abstract

Mild traumatic brain injury (mTBI) is common with many patients suffering disabling long-term sequelae, with visual symptoms frequently reported. There are no objective biomarkers of mTBI that are routinely used in clinical practice. Optical coherence tomography (OCT) has been used in mTBI research, as it enables visualisation of the neuroretina, allowing measurement of the retinal nerve fibre layer and ganglion cell layer. This systematic review aims to appraise the available literature and assess whether there are significant changes within the retinal nerve fibre layer and ganglion cell layer in subjects after mTBI. A systematic review was carried out in accordance with PRISMA guidelines and registered with PROSPERO (Number: CRD42022360498). Four databases were searched for relevant literature published from inception until 1 September 2022. Abstracts and full texts were screened by three independent reviewers. Initial screening of databases yielded 341 publications, of these, three fulfilled all the criteria for inclusion. All three studies showed thinning of the retinal nerve fibre layer, whereas there were no significant changes in the ganglion cell layer. This systematic review demonstrated that thinning of the retinal nerve fibre layer (but not of the ganglion cell layer) is associated with mTBI. It provides preliminary evidence for the use of the retinal nerve fibre layer as a potential biomarker of damage to the visual system in mTBI. Further prospective longitudinal studies ensuring uniform diagnosis and accurate phenotyping of mTBI are needed to understand the effects on the visual system and potential of OCT as a prognostic biomarker.

Original language	English
Pages (from-to)	1077-1083
Number of pages	7
Journal	Eye (Basingstoke)
Volume	38
Issue number	6
Early online date	18 Jan 2024
DOIs	https://doi.org/10.1038/s41433-023-02845-w
Publication status	Published - Apr 2024

Bibliographical note

Copyright © Crown 2024. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

Funding

This work was funded by the Ministry of Defence, UK, through the mTBI Predict Consortium.

Funders	Funder number
Ministry of Defence

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10.1038/s41433-023-02845-wLicence: CC BY 4.0

HS Lyons et al_mBTI Predict Consortium_Systematic review of optical coherence tomography in adults w mild traumatic brain injury
Copyright © Crown 2024. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/
Final published version, 2.3 MBLicence: CC BY 4.0

Cite this

Lyons, H. S., Sassani, M., Hyder, Y., Mitchell, J. L., Thaller, M., Mollan, S., Sinclair, A. J., Blanch, R. J., Sinclair, A., Finch, A., Hampshire, A., Sitch, A., Mazaheri, A., Bagshaw, A., Palmer, A., Strom, A., Waitt, A., Yiangou, A., Abdel-Hay, A., ... Gao, Y. (2024). A systematic review of optical coherence tomography findings in adults with mild traumatic brain injury. Eye (Basingstoke), 38(6), 1077-1083. https://doi.org/10.1038/s41433-023-02845-w

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title = "A systematic review of optical coherence tomography findings in adults with mild traumatic brain injury",

abstract = "Mild traumatic brain injury (mTBI) is common with many patients suffering disabling long-term sequelae, with visual symptoms frequently reported. There are no objective biomarkers of mTBI that are routinely used in clinical practice. Optical coherence tomography (OCT) has been used in mTBI research, as it enables visualisation of the neuroretina, allowing measurement of the retinal nerve fibre layer and ganglion cell layer. This systematic review aims to appraise the available literature and assess whether there are significant changes within the retinal nerve fibre layer and ganglion cell layer in subjects after mTBI. A systematic review was carried out in accordance with PRISMA guidelines and registered with PROSPERO (Number: CRD42022360498). Four databases were searched for relevant literature published from inception until 1 September 2022. Abstracts and full texts were screened by three independent reviewers. Initial screening of databases yielded 341 publications, of these, three fulfilled all the criteria for inclusion. All three studies showed thinning of the retinal nerve fibre layer, whereas there were no significant changes in the ganglion cell layer. This systematic review demonstrated that thinning of the retinal nerve fibre layer (but not of the ganglion cell layer) is associated with mTBI. It provides preliminary evidence for the use of the retinal nerve fibre layer as a potential biomarker of damage to the visual system in mTBI. Further prospective longitudinal studies ensuring uniform diagnosis and accurate phenotyping of mTBI are needed to understand the effects on the visual system and potential of OCT as a prognostic biomarker.",

author = "Lyons, {Hannah S.} and Matilde Sassani and Yousef Hyder and Mitchell, {James L.} and Mark Thaller and Susan Mollan and Sinclair, {Alexandra J.} and Blanch, {Richard J.} and Alexandra Sinclair and Aliza Finch and Adam Hampshire and Alice Sitch and Ali Mazaheri and Andrew Bagshaw and Andy Palmer and Asha Strom and Alice Waitt and Andreas Yiangou and Ahmed Abdel-Hay and Alexander Bennett and Amy Clark and Angus Hunter and Barry Seemungal and Caroline Witton and Caroline Dooley and Deborah Bird and Davinia Fernandez-Espejo and Dave Smith and Dan Ford and Daniel Sherwood and Donna Holding and Duncan Wilson and Edward Palmer and John Golding and Hamid Dehghani and Hyojin Park and Hannah Lyons and Hazel Smith and Helen Brunger and Henrietta Ellis and Iman Idrees and Ian Varley and Jessica Hubbard and Jun Cao and Jon Deeks and James Mitchell and Jan Novak and Jamie Pringle and John Terry and Jack Rogers and Tim Read and Jessikah Fildes and Karen Mullinger and Lisa Hill and Marco Aurisicchio and Mark Thaller and Martin Wilson and Mark Pearce and Matilde Sassani and Matthew Brookes and Mohammad Mahmud and Ray Rayhan and Ned Jenkinson and Niki Karavitaki and Nick Capewell and Olivia Grech and Ole Jensen and Pete Hellyer and Philip Woodgate and Sebastian Coleman and Raymond Reynolds and Blanch, {Richard J.} and Katie Morris and Ryan Ottridge and Rachel Upthegrove and Ronan Dardis and Arachchige, {Ruwan Wanni} and Sarah Berhane and Sam Lucas and Sophie Prosser and Shayan Sharifi and Shreshth Dharm-Datta and Susan Mollan and Toby Ellmers and Tara Ghafari and Tony Goldstone and Waheeda Hawa and Yidian Gao",

note = "Copyright {\textcopyright} Crown 2024. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article{\textquoteright}s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article{\textquoteright}s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/",

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doi = "10.1038/s41433-023-02845-w",

language = "English",

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Lyons, HS, Sassani, M, Hyder, Y, Mitchell, JL, Thaller, M, Mollan, S, Sinclair, AJ, Blanch, RJ, Sinclair, A, Finch, A, Hampshire, A, Sitch, A, Mazaheri, A, Bagshaw, A, Palmer, A, Strom, A, Waitt, A, Yiangou, A, Abdel-Hay, A, Bennett, A, Clark, A, Hunter, A, Seemungal, B, Witton, C, Dooley, C, Bird, D, Fernandez-Espejo, D, Smith, D, Ford, D, Sherwood, D, Holding, D, Wilson, D, Palmer, E, Golding, J, Dehghani, H, Park, H, Lyons, H, Smith, H, Brunger, H, Ellis, H, Idrees, I, Varley, I, Hubbard, J, Cao, J, Deeks, J, Mitchell, J, Novak, J, Pringle, J, Terry, J, Rogers, J, Read, T, Fildes, J, Mullinger, K, Hill, L, Aurisicchio, M, Thaller, M, Wilson, M, Pearce, M, Sassani, M, Brookes, M, Mahmud, M, Rayhan, R, Jenkinson, N, Karavitaki, N, Capewell, N, Grech, O, Jensen, O, Hellyer, P, Woodgate, P, Coleman, S, Reynolds, R, Blanch, RJ, Morris, K, Ottridge, R, Upthegrove, R, Dardis, R, Arachchige, RW, Berhane, S, Lucas, S, Prosser, S, Sharifi, S, Dharm-Datta, S, Mollan, S, Ellmers, T, Ghafari, T, Goldstone, T, Hawa, W & Gao, Y 2024, 'A systematic review of optical coherence tomography findings in adults with mild traumatic brain injury', Eye (Basingstoke), vol. 38, no. 6, pp. 1077-1083. https://doi.org/10.1038/s41433-023-02845-w

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T1 - A systematic review of optical coherence tomography findings in adults with mild traumatic brain injury

AU - Lyons, Hannah S.

AU - Sassani, Matilde

AU - Hyder, Yousef

AU - Mitchell, James L.

AU - Thaller, Mark

AU - Mollan, Susan

AU - Sinclair, Alexandra J.

AU - Blanch, Richard J.

AU - Sinclair, Alexandra

AU - Finch, Aliza

AU - Hampshire, Adam

AU - Sitch, Alice

AU - Mazaheri, Ali

AU - Bagshaw, Andrew

AU - Palmer, Andy

AU - Strom, Asha

AU - Waitt, Alice

AU - Yiangou, Andreas

AU - Abdel-Hay, Ahmed

AU - Bennett, Alexander

AU - Clark, Amy

AU - Hunter, Angus

AU - Seemungal, Barry

AU - Witton, Caroline

AU - Dooley, Caroline

AU - Bird, Deborah

AU - Fernandez-Espejo, Davinia

AU - Smith, Dave

AU - Ford, Dan

AU - Sherwood, Daniel

AU - Holding, Donna

AU - Wilson, Duncan

AU - Palmer, Edward

AU - Golding, John

AU - Dehghani, Hamid

AU - Park, Hyojin

AU - Lyons, Hannah

AU - Smith, Hazel

AU - Brunger, Helen

AU - Ellis, Henrietta

AU - Idrees, Iman

AU - Varley, Ian

AU - Hubbard, Jessica

AU - Cao, Jun

AU - Deeks, Jon

AU - Mitchell, James

AU - Novak, Jan

AU - Pringle, Jamie

AU - Terry, John

AU - Rogers, Jack

AU - Read, Tim

AU - Fildes, Jessikah

AU - Mullinger, Karen

AU - Hill, Lisa

AU - Aurisicchio, Marco

AU - Thaller, Mark

AU - Wilson, Martin

AU - Pearce, Mark

AU - Sassani, Matilde

AU - Brookes, Matthew

AU - Mahmud, Mohammad

AU - Rayhan, Ray

AU - Jenkinson, Ned

AU - Karavitaki, Niki

AU - Capewell, Nick

AU - Grech, Olivia

AU - Jensen, Ole

AU - Hellyer, Pete

AU - Woodgate, Philip

AU - Coleman, Sebastian

AU - Reynolds, Raymond

AU - Blanch, Richard J.

AU - Morris, Katie

AU - Ottridge, Ryan

AU - Upthegrove, Rachel

AU - Dardis, Ronan

AU - Arachchige, Ruwan Wanni

AU - Berhane, Sarah

AU - Lucas, Sam

AU - Prosser, Sophie

AU - Sharifi, Shayan

AU - Dharm-Datta, Shreshth

AU - Mollan, Susan

AU - Ellmers, Toby

AU - Ghafari, Tara

AU - Goldstone, Tony

AU - Hawa, Waheeda

AU - Gao, Yidian

N1 - Copyright © Crown 2024. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

PY - 2024/4

Y1 - 2024/4

N2 - Mild traumatic brain injury (mTBI) is common with many patients suffering disabling long-term sequelae, with visual symptoms frequently reported. There are no objective biomarkers of mTBI that are routinely used in clinical practice. Optical coherence tomography (OCT) has been used in mTBI research, as it enables visualisation of the neuroretina, allowing measurement of the retinal nerve fibre layer and ganglion cell layer. This systematic review aims to appraise the available literature and assess whether there are significant changes within the retinal nerve fibre layer and ganglion cell layer in subjects after mTBI. A systematic review was carried out in accordance with PRISMA guidelines and registered with PROSPERO (Number: CRD42022360498). Four databases were searched for relevant literature published from inception until 1 September 2022. Abstracts and full texts were screened by three independent reviewers. Initial screening of databases yielded 341 publications, of these, three fulfilled all the criteria for inclusion. All three studies showed thinning of the retinal nerve fibre layer, whereas there were no significant changes in the ganglion cell layer. This systematic review demonstrated that thinning of the retinal nerve fibre layer (but not of the ganglion cell layer) is associated with mTBI. It provides preliminary evidence for the use of the retinal nerve fibre layer as a potential biomarker of damage to the visual system in mTBI. Further prospective longitudinal studies ensuring uniform diagnosis and accurate phenotyping of mTBI are needed to understand the effects on the visual system and potential of OCT as a prognostic biomarker.

AB - Mild traumatic brain injury (mTBI) is common with many patients suffering disabling long-term sequelae, with visual symptoms frequently reported. There are no objective biomarkers of mTBI that are routinely used in clinical practice. Optical coherence tomography (OCT) has been used in mTBI research, as it enables visualisation of the neuroretina, allowing measurement of the retinal nerve fibre layer and ganglion cell layer. This systematic review aims to appraise the available literature and assess whether there are significant changes within the retinal nerve fibre layer and ganglion cell layer in subjects after mTBI. A systematic review was carried out in accordance with PRISMA guidelines and registered with PROSPERO (Number: CRD42022360498). Four databases were searched for relevant literature published from inception until 1 September 2022. Abstracts and full texts were screened by three independent reviewers. Initial screening of databases yielded 341 publications, of these, three fulfilled all the criteria for inclusion. All three studies showed thinning of the retinal nerve fibre layer, whereas there were no significant changes in the ganglion cell layer. This systematic review demonstrated that thinning of the retinal nerve fibre layer (but not of the ganglion cell layer) is associated with mTBI. It provides preliminary evidence for the use of the retinal nerve fibre layer as a potential biomarker of damage to the visual system in mTBI. Further prospective longitudinal studies ensuring uniform diagnosis and accurate phenotyping of mTBI are needed to understand the effects on the visual system and potential of OCT as a prognostic biomarker.

UR - https://www.nature.com/articles/s41433-023-02845-w

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U2 - 10.1038/s41433-023-02845-w

DO - 10.1038/s41433-023-02845-w

M3 - Review article

C2 - 38238577

AN - SCOPUS:85182446598

SN - 0950-222X

VL - 38

SP - 1077

EP - 1083

JO - Eye (Basingstoke)

JF - Eye (Basingstoke)

IS - 6

ER -

A systematic review of optical coherence tomography findings in adults with mild traumatic brain injury

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