Retinal nerve fibre changes in sports-related repetitive traumatic brain injury

Julian C. Kelman*, Christopher Hodge, Peter Stanwell, Nina Mustafic, Clare L. Fraser

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)


Importance: There is limited literature on the use of optical coherence tomography in the assessment of retinal nerve fibre layer (RNFL) thickness in sports-related repetitive mild traumatic brain injury. Background: To evaluate RNFL thickness in professional rugby league players. RNFL thinning may serve as a proxy for wider white matter degeneration. Design: Cross-sectional observational study. Participants: Thirteen retired Australian professional rugby league players were recruited. Methods: Participants underwent binocular optical coherence tomography to measure RNFL thickness. Each participant underwent a complete ophthalmic assessment to exclude concurrent disease. Main Outcome Measures: RNFL thickness of each eye were compared with a normative database. Results: Participants had played professional Rugby League for 18 years on average and reported sustaining 15 sports-related concussions throughout their career. The RNFL in participants was four micrometres thinner than that of matched normative data. Cohort average RNFL thickness was reduced in 12 out of 14 optical coherence testing parameters. These findings were statistically significant in the left inferonasal [P =.013] and left nasal [P =.006] sectors. There was no statistically significant relationship between RNFL thickness and other visual measures. Conclusions and Relevance: This study is the first to demonstrate RNFL thinning in a cohort of retired Australian professional Rugby League players. RNFL changes have been shown to correlate with cerebral white matter loss and neurodegeneration. Optical coherence tomography may serve as a safe and economical means of screening for repetitive traumatic brain injury related neurodegeneration in contact sport athletes.

Original languageEnglish
Pages (from-to)204-211
Number of pages8
JournalClinical and Experimental Ophthalmology
Issue number2
Early online date6 Nov 2019
Publication statusPublished - Mar 2020
Externally publishedYes


  • concussive trauma
  • imaging system
  • neuro-imaging
  • neuro-ophthalmic disease
  • retinal degeneration


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