Diffusion Tensor Imaging Detects Rarefaction of Optic Radiation in Glaucoma Patients

Abstract

Diffusion tensor imaging (DTI) can depict rarefaction of the optical fibres. Hence, we applied DTI to assess pathological changes of the optic radiation in glaucoma patients. Fifty glaucoma patients and 50 healthy age-matched controls were examined by a 3T high-field magnetic resonance scanner. Fiber tracts were volume rendered using a semiquantitative approach to assess rarefaction and results were correlated with the extent of optic nerve atrophy and reduced spatial-temporal contrast sensitivity of the retina using established ophthalmological examinations. Twenty-two glaucoma patients (44%) showed significant rarefaction of the optic radiation: the volume was reduced to 67 ± 16% compared with controls. Hereby, the glaucomatous optic nerve atrophy stage correlated with the presence of DTI-derived rarefied optic radiation (Kendall tau-b 0.272, P = .016). Aside, cerebral microangiopathy affecting the optic radiation was significantly higher among glaucoma patients compared to controls (10 patients compared with 2 patients, P < .05). In patients with glaucomatous optic nerve atrophy, there is anterograde and-most likely because of microangiopathic lesions within the optic radiation-retrograde transneuronal rarefaction of the optic radiation that can be assessed in vivo using DTI with good correlation to established ophthalmological examinations.