Anterior visual pathway assessment by magnetic resonance imaging in normal-pressure glaucoma

作者：Zhang, Ya Q.; Li, Jing; Xu, Liang^*; Zhang, Li; Wang, Zhen C.; Yang, Hua; Chen, Chang X.; Wu, Xi S.; Jonas, Jost B.

来源：Acta Ophthalmologica, 2012, 90(4): E295-E302.

DOI：10.1111/j.1755-3768.2011.02346.x

• glaucoma
• glaucomatous optic nerve damage
• glaucomatous optic neuropathy
• lateral geniculate nucleus
• normal-pressure glaucoma
• optic chiasm

Purpose: To analyze the axonal architecture of the optic nerve in patients with normal-pressure glaucoma and determine whether these parameters correlate with the disease severity.
Methods: Using magnetic resonance (MRI) imaging (1.5-Tesla unit) and diffusion tensor (DT) MRI, we measured the optic nerve diameter, optic chiasm height and lateral geniculate nucleus (LGN) volume in patients with normal-pressure glaucoma and an age-matched control group. The retinal nerve fibre layer thickness (RNFL) was determined by optical coherence tomography (OCT).
Results: The study included 30 patients with normal-pressure glaucoma and 30 age-matched control subjects. Optic nerve diameter (p < 0.001), optic chiasm height (p < 0.001) and LGN volume (p = 0.02) were significantly smaller in the glaucoma group than in the control group and were significantly correlated with RNFL thickness and perimetric loss. In the control group, the parameters significantly (p < 0.05) decreased with age. The DT-MRI-derived fractional anisotropy for the optic nerve was significantly lower (p < 0.001), and the DT-MRI-derived mean diffusivity (p < 0.001), radial diffusivity (lambda(perpendicular to); p < 0.001) and axial diffusivity (lambda(parallel to); p = 0.009) for the optic nerve were significantly higher in the glaucoma group and significantly correlated with RNFL thickness and mean perimetric defect.
Conclusions: Patients with normal-pressure glaucoma show an age-adjusted reduced optic nerve diameter, optic chiasm height and LGN volume as measured by MRI, correlating with a reduced RNFL thickness and increased perimetric loss. MRI may be applied to examine the optic nerve in patients with glaucoma with opaque optic media.

• 出版日期2012-6
• 单位北京市眼科研究所; 首都医科大学