Intrinsically photosensitive retinal ganglion cell-driven pupil responses in patients with traumatic brain injury

• Published in: Vision research (Oxford) Vol. 188; pp. 174 - 183
• Main Authors: Mostafa, Jakaria, Porter, Jason, Queener, Hope M., Ostrin, Lisa A.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.11.2021
• Subjects: Brain Injuries, Traumatic; Humans; Intrinsically photosensitivity retinal ganglion cells; Light; Photic Stimulation; Pupil; Pupillography; Reflex, Pupillary; Retinal Ganglion Cells; Rod Opsins; Traumatic brain injury; Pupillography; Intrinsically photosensitivity retinal ganglion cells; Traumatic brain injury
• ISSN: 0042-6989; 1878-5646; 1878-5646
• DOI: 10.1016/j.visres.2021.07.007

[Display omitted] •TBI patients did not demonstrate selective damage of ipRGCs.•TBI patients had a smaller baseline pupil and decreased constriction amplitude.•Pupil constriction to 2 min of 0.1 Hz red stimuli attenuated in all participants.•Pupil constriction to 2 min of 0.1 Hz blue stimuli potentiated in all participants. Previous findings regarding intrinsically photosensitive retinal ganglion cell (ipRGC) function after traumatic brain injury (TBI) are conflicting. We examined ipRGC-driven pupil responses in civilian TBI and control participants using two pupillography protocols that assessed transient and adaptive properties: (1) a one second (s) long wavelength “red” stimulus (651 nm, 133 cd/m2) and 10 increasing intensities of 1 s short wavelength ”blue” stimuli (456 nm, 0.167 to 167 cd/m2) with a 60 s interstimulus interval, and (2) two minutes of 0.1 Hz red stimuli (33 cd/m2), followed by two minutes of 0.1 Hz blue stimuli (16 cd/m2). For Protocol 1, constriction amplitude and the 6 s post illumination pupil response (PIPR) were calculated. For Protocol 2, amplitudes and peak velocities of pupil constriction and redilation were calculated. For Protocol 1, constriction amplitude and the 6 s PIPR were not significantly different between TBI patients and control subjects for red or blue stimuli. For Protocol 2, pupil constriction amplitude attenuated over time for red stimuli and potentiated over time for blue stimuli across all subjects. Constriction and redilation velocities were similar between groups. Pupil constriction amplitude was significantly less in TBI patients compared to control subjects for red and blue stimuli, which can be attributed to age-related differences in baseline pupil size. While TBI, in addition to age, may have contributed to decreased baseline pupil diameter and constriction amplitude, responses to blue stimulation suggest no selective damage to ipRGCs.