Detection of visuomotor dysfunction in mild traumatic brain injury using binocular retinal polarization scanning

ABSTRACT

Objective

The head and intraocular trauma tool (HITT) is a portable, binocular retinal polarization scanner (RPS) that detects ocular fixation with high precision to assess visuomotor function. We conducted a pilot evaluation of a prototype binocular RPS device to evaluate alterations in fixation stability, binocularity (convergence), and saccadic latency after mild traumatic brain injury (mTBI).

Methods

Two groups were studied prospectively: (1) single observation study of mTBI patients in a hospital ER (n = 7) and age-matched controls (n = 43); (2) high-school athletes preseason (n = 28), after sports-related mTBI (n = 3), and at season end (n = 5). Subjects were asked to fixate on an internal target and track randomly presented peripheral and central targets as fixation was assessed using binocular RPS.

Results

There were clinically and statistically significant alterations in the hospital ER group after mTBI, including a decrease in fixation stability (54.6% in patents vs 90.2% in controls, p = 0.014) and binocularity (28.7% in patients vs 86.6% in controls; p = 0.004). Similar trends, not statistically significant, were observed in saccadic latency in the hospital ER group as well as in the injured high school athletes.

Conclusion

The HITT device shows promise as an objective, noninvasive method for assessment of the impact of mTBI on visuomotor function. Additional studies with larger patient populations are required to evaluate efficacy for clinical use.

KEYWORDS:

• Mild traumatic brain injury
• retinal polarization scanning
• concussion
• sideline test
• retinal birefringence

Disclosure statement

Justin Shaka is an employee of Rebion, and holds equity. Lee Goldstein is a paid consultant of Rebion and holds equity. David Hunter is an advisor of Rebion and Luminopia and holds equity in both. Rebion is the developer of the HITT device.

Additional information

Funding

The work was supported by  Rebion; the Pennsylvania Department of Health; and Award Number 4P50FD004895-03 from the Food and Drug Administration. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the FDA.