Wang Ling, Fan Ke, Zhang Yanqiu, Chen Yanzi, Tian Qin, Shi Dapeng
Department of Radiology, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Henan Key Laboratory for Medical Imaging of Neurological Disease, Zhengzhou, Henan, 450003, China.
Department of Ophthalmology, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, 450003, China.
Eur J Radiol. 2017 Aug;93:24-29. doi: 10.1016/j.ejrad.2017.05.025. Epub 2017 May 22.
To quantitatively analyze the optic nerve alterations in chronic Leber's hereditary optic neuropathy (LHON) using reduced field-of-view diffusion tensor imaging (rFOV-DTI) and evaluate the correlation of diffusion parameters with visual functional and peripapillary retinal nerve fiber layer (RNFL) thickness.
Twenty-five patients (50 affected optic nerves) with chronic LHON and 28 healthy controls (56 normal optic nerves) were enrolled. The rFOV-DTI was performed in the bilateral optic nerves for all the subjects. The fractional anisotropy (FA), mean diffusivity (MD), principal eigenvalue (λ//), and orthogonal eigenvalue (λ⊥) were calculated for quantitative analysis. Visual field (VF) and visual acuity (VA) were measured in all subjects. The peripapillary RNFL thickness was assessed using optical coherence tomography (OCT). The correlation of DTI diffusion parameters with visual function and peripapillary RNFL thickness was evaluated.
Compared with optic nerves in the control group, the mean FA was significant decreased (P<0.005), and the mean MD, λ//and λ⊥ significant increased (P<0.005). The average and temporal peripapillary RNFL thickness were significantly thinned in LHON patients. There was a significant correlation between optic nerve FA and VA, mean deviation of visual field (MD) (P<0.005). Also, optic nerve FA correlated significantly with average RNFL thickness (P<0.05) but not with MD, λ//and λ⊥ (P>0.05). However, none of the DTI parameters correlated with age and disease duration (P>0.05).
Our study has demonstrated that rFOV-DTI could provide information of optic nerve damage in chronic LHON, and can serve as technique for detecting and evaluating pathological changes in the optic nerve in LHON.
使用缩小视野扩散张量成像(rFOV-DTI)对慢性Leber遗传性视神经病变(LHON)的视神经改变进行定量分析,并评估扩散参数与视觉功能及视乳头周围视网膜神经纤维层(RNFL)厚度的相关性。
纳入25例慢性LHON患者(50条患侧视神经)和28例健康对照者(56条正常视神经)。对所有受试者双侧视神经进行rFOV-DTI检查。计算各向异性分数(FA)、平均扩散率(MD)、主本征值(λ//)和垂直本征值(λ⊥)用于定量分析。对所有受试者进行视野(VF)和视力(VA)测量。使用光学相干断层扫描(OCT)评估视乳头周围RNFL厚度。评估DTI扩散参数与视觉功能及视乳头周围RNFL厚度的相关性。
与对照组视神经相比,患侧视神经平均FA显著降低(P<0.005),平均MD、λ//和λ⊥显著升高(P<0.005)。LHON患者视乳头周围RNFL平均厚度和颞侧厚度显著变薄。视神经FA与VA、视野平均偏差(MD)显著相关(P<0.005)。此外,视神经FA与RNFL平均厚度显著相关(P<0.05),但与MD、λ//和λ⊥无显著相关性(P>0.05)。然而,DTI参数均与年龄和病程无相关性(P>0.05)。
我们的研究表明,rFOV-DTI能够提供慢性LHON视神经损伤信息,可作为检测和评估LHON视神经病理改变的技术。