Association between head injury and concussion with retinal vessel caliber

PLoS One. 2018 Jul 11;13(7):e0200441. doi: 10.1371/journal.pone.0200441. eCollection 2018.

Abstract

The adverse long-term consequences following traumatic brain injury are poorly understood, particularly on the cerebral microvasculature. Retinal vessels are a surrogate marker of cerebral vascular changes. We therefore aimed to examine the cross-sectional association between serious head injury or being knocked unconscious, and/or concussion and retinal microvascular signs, specifically, mean retinal arteriolar and venular calibre, in older adults after accounting for potential confounders. This cohort study involved 2,624 adults with mean age of 66.9 (±9.1) years who self-reported head injury and concussion parameters, and had gradable retinal photographs. Face-to-face interviews with trained interviewers allowed participants to report prior serious head injury or being knocked unconscious, and/or a previous diagnosis of concussion by a medical professional. Fundus photographs were taken and retinal vascular calibre measured using computer-assisted techniques and summarized. There were 25.9%, 15.3% and 10.1% who reported a prior serious head injury or being "knocked unconscious", concussion, and both, respectively. Participants in the first group compared to non-injured participants had significantly wider (~2 μm) mean retinal venular calibre (p = 0.02), after adjusting for age, sex, smoking, body mass index, mean arterial blood pressure, type 2 diabetes and fellow vessel calibre. No significant associations were observed in people reporting medically diagnosed concussion or with mean retinal arteriolar calibre. Our exploratory study suggests that head injury is independently associated with wider retinal venular caliber. These findings warrant further investigation in longitudinal cohort studies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cohort Studies
  • Craniocerebral Trauma / diagnostic imaging*
  • Craniocerebral Trauma / epidemiology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Male
  • Microvessels / diagnostic imaging
  • Retinal Vessels / diagnostic imaging*

Grants and funding

The Blue Mountains Eye and Hearing Studies were supported by the Australian National Health and Medical Research Council (Grant Nos. 974159, 991407, 211069, 262120) (PM). The authors also acknowledge financial support from the HEARing CRC, established and supported under the Australian Government's Cooperative Research Centres Program. IDC is funded by an Australian National Health and Medical Research Council Practitioner Fellowship. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.