Clinical Research Papers:
Longitudinal relationship between traumatic brain injury and the risk of incident optic neuropathy: A 10-year follow-up nationally representative Taiwan survey
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Ying-Jen Chen1,2, Chang-Min Liang1, Ming-Cheng Tai1, Yun-Hsiang Chang1, Tzu-Yu Lin3, Chi-Hsiang Chung4,5, Fu-Huang Lin4,5, Chang-Huei Tsao5,6 and Wu-Chien Chien4,5
1Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C
2Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, R.O.C
3Department of Ophthalmology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan, R.O.C
4School of Public Health, National Defense Medical Center, Taipei, Taiwan, R.O.C
5Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C
6Department of Microbiology and Immunology, National Defense Medical Center, Taipei, Taiwan, R.O.C
Wu-Chien Chien, email: [email protected]
Keywords: traumatic brain injury, optic neuropathy, national health insurance research database
Received: April 07, 2017 Accepted: August 28, 2017 Published: September 18, 2017
Accumulating evidences had shown that traumatic brain injury was associated with visual impairment or vision loss. However, there were a limited number of empirical studies regarding the longitudinal relationship between traumatic brain injury and incident optic neuropathy. We studied a cohort from the Taiwanese National Health Insurance data comprising 553918 participants with traumatic brain injury and optic neuropathy-free in the case group and 1107836 individuals without traumatic brain injury in the control group from 1st January 2000. After the index date until the end of 2010, Cox proportional hazards analysis was used to compare the risk of incident optic neuropathy. During the follow-up period, case group was more likely to develop incident optic neuropathy (0.24%) than the control group (0.11%). Multivariate Cox regression analysis demonstrated that the case group had a 3-fold increased risk of optic neuropathy (HR = 3.017, 95% CI = 2.767–3.289, p < 0.001). After stratification by demographic information, traumatic brain injury remained a significant factor for incident optic neuropathy. Our study provided evidence of the increased risk of incident optic neuropathy after traumatic brain injury during a 10-year follow-up period. Patients with traumatic brain injury required periodic and thorough eye examinations for incident optic neuropathy to prevent potentially irreversible vision loss.
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