Quality of Life Worse for Veterans with Vision Loss Caused by Traumatic Brain Injury than for Comparable Civilians

Many young veterans of the Iraq and Afghanistan wars suffer traumatic brain injury (TBI) from exposure to combat explosions. A recent study of TBI’s effect on visual function and quality of life in such veterans found that most had severe vision problems and poorer quality of life than comparable civilian patients.

The researchers assessed visual function and occult eye injuries in 42 young veterans with blast-related TBI, then evaluated them using two standard quality of life tests, the National Eye Institute Visual Function Questionnaire (VFQ-25) and Neuro-Ophthalmic Supplement (NOS). The veterans’ VFQ-25 and NOS scores were compared with accepted norms for patients with similar visual disorders. On the VFQ-25, overall scores were significantly lower for veterans than the reference patient groups with glaucoma, multiple sclerosis and diabetic eye disease. On the NOS the veterans’ scores were significantly lower than norms for patients with MS and disease-free adults and were similar to norms for comparable neuro-ophthalmic patients.

The eyes and related tissues are less protected than the head during explosions and are vulnerable to blast forces. A comprehensive eye exam and neuro-ophthalmic evaluation detect occult injuries that may include: structural damage that can lead to glaucoma, retinal and choroidal damage, optic nerve injury, double vision, visual field changes and other disorders.

Future studies will correlate visual function with specific life challenges and determine how these change over time.

Read the release here ^[1].

Genes Linked to Response to Treatment in Macular Degeneration

According to a genome-wide association study, specific genes may impact a patient’s response to ranibizumab. The researchers found that patients with a combination of three genes related to wound repair had a gain of 24 letters of visual acuity whereas those without any of the three actually lost 7.6 letters during ranibizumab treatment.

The researchers looked at the pharmacogenetics of response in three ranibizumab studies — FOCUS, MARINA, and ANCHOR — as well as their extension phase results in the HORIZON study. More than than 600,000 single nucleotide polymorphisms were examined in the 352 patients with long-term outcome results who were genetically tested.

Genome-wide associations were seen with visual acuity at baseline in the treated eyes of patients as well as with type of choroidal neovascularization and its presence in the untreated eye, but most notably with visual acuity change over 12 months.

This information may help with patient selection in the future but it is still far from being ready for clinical use.

This was presented at the AAO-PAAO meeting: Ehrlich JS et al. AAO 2009; Abstract PA004.

Read the article here ^[2].