目的：评估轻度创伤性脑损伤(mTBI)对眼动参数的长期影响。

方法：前瞻性研究。收集2021-02/08于我院就诊的mTBI后6～12mo的患者46例，根据脑损伤视觉调查问卷(BIVSS)评分分为mTBI有症状组(BIVSS总分≥32分，n=24)和mTBI无症状组(BIVSS总分<32分，n=22)。另选取无mTBI史的健康志愿者作为对照组(n=23)。所有受试者均进行眼动参数检查，评估双眼视功能。

结果：三组受试者单眼调节幅度、单眼调节灵敏度、近距水平眼位绝对值、近距水平融像范围-负融像恢复点、扫视均有差异(P<0.05)，但集合近点、远距水平眼位绝对值、近距水平融像范围-负融像模糊点、正融像模糊点、正融像恢复点均无差异(P>0.05)。三组受试者调节异常率、集合异常率、扫视异常率均有差异(P<0.01)，其中mTBI有症状组调节异常率显著高于mTBI无症状组和对照组(均P<0.0167)； mTBI有症状组和mTBI无症状组集合异常率显著高于对照组(均P<0.0167)； mTBI有症状组扫视异常率显著高于mTBI无症状组和对照组(均P<0.0167)。

结论：mTBI有症状患者的调节、集合和扫视功能均降低，mTBI无症状患者部分视功能也受到影响，提示mTBI对部分患者的眼动参数存在长期影响，应对mTBI患者进行全面的眼动检查。

METHODS: Prospective study. A total of 46 patients from 6 to 12mo after mTBI who visited Tianjin Eye Hospital from February to August 2021 were collected. According to the score of the Brain Injury Vision Sympton Survey(BIVSS)Questionnaire, they were divided into the symptomatic group of mTBI(BIVSS total score ≥32, n=24)and the asymptomatic group of mTBI(BIVSS total score <32, n=22). In addition, healthy people without mTBI were selected as the control group(n=23). All of the subjects accepted test of oculomotor parameters to evaluate binocular vision.

RESULTS: Monocular accommodation amplitude, monocular accommodation facility, the absolute value of phoria at near, BI recovery point of fusional range at near and saccades were different among the three groups(P<0.05); There were no significant differences in near point of convergence, the absolute value of distance phoria, BI blur, BO blur and recovery of fusional range at near among the three groups(P>0.05). The incidence of accommodative abnormality, convergence abnormality, and saccadic dysfunction were different among the three groups(P<0.01). The incidence of accommodative abnormality in the symptomatic group was significantly higher than that in the asymptomatic and control groups(all P<0.0167); the incidence of convergence dysfunction in the symptomatic and the asymptomatic groups were higher than that in the control group(all P<0.0167); the incidence of saccadic dysfunction in the symptomatic group was significantly higher than that in the asymptomatic and control groups(all P<0.0167).

CONCLUSION: Accommodation, convergence, and saccades functions in the mTBI symptomatic group were lower, and some of the binocular vision in the asymptomatic group was also affected. It is suggested that mTBI has a long-term impact on oculomotor parameters, and comprehensive oculomotor assessment is necessary for mTBI patients.