Assessing Visual Photosensitivity in Subjects With and Without Traumatic Brain Injury Using the Ocular Photosensitivity Analyzer

Visual photosensitivity is an incapacitating symptom of traumatic brain injury (TBI). We assessed photosensitivity in healthy and TBI subjects with and without light filtering lenses by using the validated Ocular Photosensitivity Analyzer (OPA) (PMID:30460148) and Visual Light Sensitivity Questionnaire-8 (VLSQ-8) (PMID:28845363).

311 Assessing Visual Photosensitivity in Subjects with and without Traumatic Brain Injury Using the Ocular Photosensitivity Analyzer Byron Lam 1, Mariela Aguilar 2, Alex Gonzalez 2, Heather Durkee 2, Shivam Patel 2, David Arias 2, Cornelis Rowaan 2, Rhiya Mittal 2, Paula Sepulveda-Beltran 2, Gemayaret Alvarez 3, Barry Hurwitz 4, Elizabeth Felix 5, Jean-Marie Parel 2, Anat Galor 1 Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 2 Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 3 Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, 4 Department of Psychology, University of Miami, 5 Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, 1 Introduction: Visual photosensitivity is an incapacitating symptom of traumatic brain injury (TBI). We assessed photosensitivity in healthy and TBI subjects with and without light filtering lenses by using the validated Ocular Photosensitivity Analyzer (OPA) (PMID:30460148) and Visual Light Sensitivity Questionnaire-8 (VLSQ-8) (PMID:28845363). Methods: 46 healthy subjects (age 32.5±13.4 years, 26 females) and 46 TBI subjects (age 42.0±15.0 years, 11 females) were administered VLSQ-8 before OPA testing. The OPA automated audio instructed the subject to press a button when light stimulus is “uncomfortable”. The visual photosensitivity thresholds (VPT) is calculated from the mean of ten response reversals. A lower VPT and a higher VLSQ-8 score indicate more photosensitivity. Each subject completed two, five-trial study visits, one month apart (V1 and V2). The five trials were performed with no lens (NL), followed by plano lens (PL), blue-light blocking lens (BL), FL-41 (FL), and gray filtering lens (GL) glasses. Results: Test-retest reproducibility for all trials between visits showed good reliability (ICC=0.79-0.92). NL and PL lenses produced comparable VPT values within healthy and TBI subjects. FL and GL lenses improved light tolerance in healthy and TBI subjects significantly, more than the NL, PL, and BL light filtering lenses (p< 0.05). The VPT of healthy and TBI subjects at V1 were 2.5±0.8 and 1.7±0.9 log lux, respectively (p< 0.01). The VLSQ-8 scores of healthy and TBI subjects at V1 were 11.5±3.4 and 21.1±8.3, respectively, (< 0.01). The VPT scores were negatively correlated with the VLSQ-8 scores (r=-0.61, p< 0.01). Conclusions: The OPA and VLSQ-8 are reliable tool for quantifying visual photosensitivity in TBI with TBI subjects having lower VPT and higher VLSQ-8 scores compared to healthy subjects. FL and GL lenses increased VPT and improved photosensitivity in healthy and TBI subjects. FL lenses are preferred to GL lenses given potential dark adaptation with long-term use of GL lenses. References: None provided. Keywords: Trauma, Higher visual functions, Diagnostic tests (ERG, VER, OCT, HRT, mfERG, etc)yEyelid & adnexal disease Financial Disclosures: Byron Lam: Visual Light Sensitivity Questionnaire-8 (VLSQ-8) is copyrighted by the investigator's employer University of Miami; royalty for commercial use; Mariela Aguilar; Alex Gonzalez; Heather Durkee; Shivam Patel; David Arias; Cornelis Rowaan; Rhiya Mittal; Paula Sepulveda-Beltran; Gemayaret Alvarez; Barry Hurwitz; Elizabeth Felix; JeanMarie Parel; Anat Galor Grant Support: Department of Defense Vision Research Program W81XWH-20-1-0820/VR190009, Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Clinical Sciences R&D (CSRD) I01 CX002015, Biomedical Laboratory R&D (BLRD) Service I01 BX004893, Rehabilitation R&D (RRD) I21 RX003883, Department of Defense Gulf War Illness Research Program (GWIRP) W81XWH-20-1-0579, National Eye Institute U01 EY034686, R01EY026174, R61EY032468 (Dr. Galor); Florida Lions Eye Bank and the Beauty of Sight Foundation, Donations from: Drs. Harry W. Flynn Jr, Karl R. Olsen, Martha E. Hildebrandt, Raksha Urs, Aaron Furtado, NIH Center Grant P30EY14801, NIH NEI – LRP (Dr. Aguilar and Dr. Durkee), Research to Prevent Blindness – Unrestricted Grant to BPEI (GR004596), Henri and Flore Lesieur Foundation (Dr. Parel) Contact Information: Byron Lam, [e-mail] 468 | North American Neuro-Ophthalmology Society