Traumatic brain injury (TBI) causes structural and functional damage to the central nervous system including the visual pathway. Defects in the afferent visual pathways affect visual function and in severe cases cause complete visual loss. Visual dysfunction is detectable by structural and functional ophthalmic examinations that are routine in the eye clinic, including examination of the pupillary light reflex and optical coherence tomography (OCT). Assessment of pupillary light reflex is a non-invasive assessment combining afferent and efferent visual function. While a assessment using a flashlight is relatively insensitive, automated pupillometry has 95% specificity and 78.1% sensitivity in detecting TBI-related visual and cerebral dysfunction with an area under the curve of 0.69–0.78. OCT may also serve as a noninvasive biomarker of TBI severity, demonstrating changes in the retinal ganglion cell layer and nerve fiber layer throughout the range of TBI severity even in the absence of visual symptoms. This review discusses the impact of TBI on visual structure and function.

中文翻译：

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创伤性脑损伤的传入视觉表现

创伤性脑损伤 (TBI) 会导致包括视觉通路在内的中枢神经系统的结构和功能损伤。传入视觉通路的缺陷会影响视觉功能，在严重的情况下会导致完全的视力丧失。视觉功能障碍可通过眼科诊所常规的结构性和功能性眼科检查检测，包括瞳孔光反射检查和光学相干断层扫描 (OCT)。瞳孔对光反射的评估是一种结合传入和传出视觉功能的非侵入性评估。虽然使用手电筒进行评估相对不敏感，但自动瞳孔测量在检测 TBI 相关的视觉和脑功能障碍方面具有 95% 的特异性和 78.1% 的敏感性，曲线下面积为 0.69-0.78。OCT 还可以作为 TBI 严重程度的非侵入性生物标志物，即使在没有视觉症状的情况下，也可以显示在整个 TBI 严重程度范围内视网膜神经节细胞层和神经纤维层的变化。本综述讨论了 TBI 对视觉结构和功能的影响。