Phal Pramit M, Steward Christopher, Nichols Andrew D, Kokkinos Chris, Desmond Patricia M, Danesh-Meyer Helen, Sufaro Yuval Z, Kaye Andrew H, Moffat Bradford A
Epworth Medical Imaging Epworth Hospital, Richmond, Victoria, Australia 2Department of Radiology, The University of Melbourne, Parkville, Victoria, Australia.
Department of Radiology, The University of Melbourne, Parkville, Victoria, Australia 3Department of Radiology, Royal Melbourne Hospital, Parkville, Victoria, Australia.
Invest Ophthalmol Vis Sci. 2016 Jul 1;57(8):3884-90. doi: 10.1167/iovs.15-18734.
The purpose of this study was to investigate correlations between retinal fiber thickness measured by optical coherence tomography (OCT) and anterograde functional and structural differences in the optic pathway of patients with compression of the optic chiasm. Our hypothesis was that loss of visual acuity caused by chronic compressive pathologies may lead to an irreversible decline in vision because of permanent neurodegeneration of the optic radiations and visual cortex.
Quantitative OCT, functional magnetic resonance imaging (MRI) and diffusion tensor MRI measurements were made in 17 patients being surgically treated for chiasmal compression.
In our study we found that surgically irreversible visual field defects and reduced retinal nerve fiber layer thickness were significantly associated with lower fractional diffusion anisotropy and higher diffusivities in optic radiations and less functional MRI activation in the visual cortex.
Damage to the retinal nerve fiber layer is associated with downstream structural and functional degradation of the optic pathway. This may be related to trans-synaptic degeneration and the fact that these factors are important potential imaging biomarkers for predicting visual recovery after surgical decompression.
本研究旨在探讨通过光学相干断层扫描（OCT）测量的视网膜纤维厚度与视交叉受压患者视路中顺行性功能和结构差异之间的相关性。我们的假设是，慢性压迫性病变导致的视力丧失可能由于视辐射和视皮层的永久性神经退行性变而导致视力不可逆转的下降。
对17例接受视交叉压迫手术治疗的患者进行了定量OCT、功能磁共振成像（MRI）和扩散张量MRI测量。
在我们的研究中，我们发现手术不可逆的视野缺损和视网膜神经纤维层厚度降低与视辐射中较低的分数扩散各向异性和较高的扩散率以及视皮层中较少的功能MRI激活显著相关。
视网膜神经纤维层损伤与视路下游的结构和功能退化有关。这可能与跨突触变性有关，并且这些因素是预测手术减压后视力恢复的重要潜在影像学生物标志物。
