Real-time assessment of retinal perfusion and blood flow as a surrogate measure for cerebral perfusion in severe traumatic brain injury
Acute severe traumatic brain injury
Patients will have cerebral and retinal perfusion assessed after TBI. Invasive neuromonitoring will assess cerebral oxygenation and intracranial pressure and collect cerebral microdialysis. Ocular imaging techniques, optical coherence tomography and optical coherence tomography angiography, will assess retinal oedema and retinal perfusion, respectively. Non-invasive measures of cerebral perfusion will include transcranial Doppler ultrasound and Near Infra-red Spectroscopy. Biofluids such as blood, CSF, and microdialysate will be collected to assess AQP4 expression. The disability rating scale will assess early functional outcomes.
Patients with acute TBI: 1. Moderate to severe TBI 2. Over 18 years of age 3. Planned invasive neuromonitoring or insertion of invasive neuromonitoring consistent with the study protocol within the prior 24 hours 4. At least one eye with optically clear media to allow retinal imaging Healthy control participants: 1. Over 18 years of age 2. Two eyes 3. Capacity to consent 4. Willing and able to follow the protocol 5. No prior history of moderate to severe TBI 6. No prior history of retinal or optic nerve degenerative disease 7. At least one eye with optically clear media to allow retinal imaging
1. Under 18 years of age 2. Pregnancy