Investigating possible retinal biomarkers of head trauma in Olympic boxers using optical coherence tomography

The medical question

Can a scan of the retina show the effects of repeated head blows in boxers?

The Fight Medicine Research Institute uses this evidence to frame questions about whether retinal imaging could serve as a measure of the effects of head impacts while a fighter is still competing. The study’s small sample, its lack of data on head blows or concussion, and its use of different scanners for boxers and controls determine which questions it can inform.

Summary

Retinal scans of 16 UK Olympic boxers taken 18 months apart showed changes in the thickness of retinal layers, and at the second scan the boxers’ measurements were lower than those of 20 sedentary controls.

What the work reports

• The authors analysed anonymized data from two mandatory eye screenings, 18 months apart, of 16 UK Olympic boxers. Optical coherence tomography (OCT), a non-invasive scan of the retina, measured the thickness of the macula (the central area of the retina) and of the retinal nerve fiber layer; 20 sedentary healthy adults with no history of concussion were scanned for comparison at the time of the boxers’ second screening.
• Between the two screenings the boxers’ macula became significantly thicker in six of eight sectors of the right eye and seven of eight of the left, while some quadrants of the retinal nerve fiber layer became thicker and others thinner. At the second screening the boxers’ macula and nerve fiber layer measurements were lower than the controls’, significantly so in some sectors and quadrants.
• The authors describe the change over 18 months as unexpected in healthy elite athletes and note that thickening is the opposite of the thinning reported in neurodegenerative conditions. They conclude that OCT may prove useful as a candidate retinal biomarker of change after mild traumatic brain injury or repeated head blows, and they describe the study as a first step.

Limits to keep in mind

• The boxers’ data were anonymized, so the authors had no record of each boxer’s head blows or concussions and estimated exposure from a median of 22 bouts in the 18 months.
• Boxers and controls were scanned on different OCT systems, which the authors say could have affected the comparison, and the controls were older and included more women.
• The authors state that they cannot rule out measurement variability as the reason for the changes between the boxers’ two scans.
• They also recognize a lack of precise visual, behavioral and concussive measures, so the study cannot show whether the retinal changes relate to brain injury.

Source issues recorded

• The abstract says the macula thickened significantly in 75% of right eye sectors and 50% of left eye sectors. The results and discussion count six of eight right eye sectors and seven of eight left eye sectors. This record uses the counts from the results.
• The article states that it is published and licensed by Dove Medical Press Limited. The Crossref record lists the publisher as Informa UK Limited.

Publication status and notices

Published in Eye and Brain, a peer-reviewed journal. Original research article in Eye and Brain.

Form of this work: Version of record. The version of record is the final article as issued by its publisher.

No correction or retraction notice was found in Crossref or Europe PMC when this record was checked.

Fight Medicine Research Institute contribution

Fight Medicine Research Institute selected and catalogued this study, prepared an original research summary, verified its bibliographic details, and maintains the associated citation record.

PDF files

Article details

Relationship

External research catalogued by the Fight Medicine Research Institute. The original authors, journal and DOI are unchanged.

Published online

December 2018

Repository date

14 December 2018 (Europe PMC first-publication date)

Date used here

14 December 2018 (Europe PMC first-publication date)

Rights

CC BY-NC 3.0. Open access under a Creative Commons Attribution-NonCommercial licence (CC BY-NC 3.0), as recorded by Europe PMC and the licence link in the source record. The licence does not cover commercial reuse. The summary on this page is Fight Medicine Research Institute’s own wording. No text or figure from the article is reproduced here. Licence terms.

Source check

12 November 2026, against PubMed Central full text, Crossref and Europe PMC. Checked under the direction of Casey C. Sears, Founder. An LLM was utilized as a research tool with direct human oversight.

Appraisal

The check covered bibliographic details, links, licence and notices. It is not a formal critical appraisal of the full paper.

Clinical review

None. This record is a research summary, not clinical education.

Funding and conflicts

The authors report no conflicts of interest in this work. The article contains no funding statement.

Catalog

FH-061, added 12 November 2026

Cite the original work

These files cite the work by its own authors, journal and DOI. Fight Medicine Research Institute appears only in a note, as curator of this catalog page.

Charmaine Childs, Lynne A Barker, Alex MD Gage, Mike Loosemore. Investigating possible retinal biomarkers of head trauma in Olympic boxers using optical coherence tomography. Eye and Brain. 2018;10:101-110. https://doi.org/10.2147/EB.S183042

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Related on this website

• Research program: Chronic traumatic encephalopathy (CTE)
• Research priority: Repetitive head impacts and CTE
• Fighter Health: Eye injuries