Abstract
Purpose :
Vision deficits and oculomotor dysfunction have been previously reported in association with concussions or mild traumatic brain injuries. We aim to identify the visual manifestations of post-concussion syndrome using a retrospective, observational clinical study.
Methods :
A retrospective chart review study was performed. All patients referred to a neuro-ophthalmology clinic over two years with a post-concussion syndrome diagnosis were included. Patients with abnormal CT or MRI neuroimaging suggestive of moderate or severe traumatic brain injury were excluded. All ocular signs and symptoms, visual field, and OCT imaging of the RNFL and GCL were evaluated. The Circle test assessed stereoacuity. Analysis of the data was performed to determine the prevalence of the studied elements.
Results :
Fifty-two patients were eligible for the study. The mean age was 49.65 ± 14.08 years and were predominantly female (69.2%), not Hispanic or Latino (75.6%), and White or Caucasian (79.5%). 50.0% of the patients had multiple office visits. The most common modes of injury were motor vehicle accidents and falls, and 50.0% had multiple concussions, including 13.6% having three or more. 76.3% of the subjects had pre-existing migraines, and 26.9% were taking prescribed opioid medications. Headaches (92.3%) and light sensitivity (91.3%) were the most significant symptoms, and 36.5% of the total subjects had convergence insufficiency or reading difficulties. Severe or moderate loss of stereopsis was found in 72.2% of patients, who tended to be older than those with mild or no stereopsis loss (52.69 ± 13.87 years vs. 40.00 ± 13.15 years; p = 0.0148). Visual field testing was unreliable in 42.6% of subjects, while OCT imaging of the RNFL and GCL was normal (95.9% and 88.2%, respectively). The average RNFL thickness was found to be 97.37 ± 10.78 µm.
Conclusions :
Headaches and light sensitivity are the most prevalent symptoms in post-concussion syndrome, while the loss of stereopsis and convergence insufficiency are the most common ocular signs.
This is a 2021 ARVO Annual Meeting abstract.