Advanced Morphological and Functional Magnetic Resonance Techniques in Glaucoma.

Rodolfo Mastropasqua,Peter A Mattei,Leonardo Mastropasqua,Luca Agnifili,Riccardo Navarra,Giorgio Marchini,Vincenzo Fasanella,Massimo Caulo

doi:10.1155/2015/160454

Rodolfo Mastropasqua, Peter A Mattei + Show 6 more

Open Access

https://doi.org/10.1155/2015/160454

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Abstract

Glaucoma is a multifactorial disease that is the leading cause of irreversible blindness. Recent data documented that glaucoma is not limited to the retinal ganglion cells but that it also extends to the posterior visual pathway. The diagnosis is based on the presence of signs of glaucomatous optic neuropathy and consistent functional visual field alterations. Unfortunately these functional alterations often become evident when a significant amount of the nerve fibers that compose the optic nerve has been irreversibly lost. Advanced morphological and functional magnetic resonance (MR) techniques (morphometry, diffusion tensor imaging, arterial spin labeling, and functional connectivity) may provide a means for observing modifications induced by this fiber loss, within the optic nerve and the visual cortex, in an earlier stage. The aim of this systematic review was to determine if the use of these advanced MR techniques could offer the possibility of diagnosing glaucoma at an earlier stage than that currently possible.

Highlights

Glaucoma is the leading cause of irreversible blindness worldwide
Glaucoma mainly causes the selective death of retinal ganglion cells (RGC), whose dendrites comprise the optic nerve, which in turn provides the majority of the input of the primary visual cortex
A reduction of the number of viable RGC should result in a reduction in the number of dendrites found in the optic nerve, resulting in a decrease in the sensory input of the primary motor cortex, which should decrease the number of functional connections with secondary visual cortex areas

Summary

Introduction

Glaucoma is the leading cause of irreversible blindness worldwide. The definition of glaucoma was mainly based on the presence of a typical optic neuropathy along with elevated intraocular pressure (IOP). A reduction of the number of viable RGC should result in a reduction in the number of dendrites found in the optic nerve, resulting in a decrease in the sensory input of the primary motor cortex, which should decrease the number of functional connections with secondary visual cortex areas. Given that these anatomical structures increase in size with increasing complexity of function, it can be hypothesized that smaller modifications may be more evident in the posterior visual pathway.

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Conflict of Interests