Department of Radiology, Bezmialem Vakif University, 34093, Istanbul, Turkey.
Department of Ophthalmology, Bezmialem Vakif University, Istanbul, Turkey.
Clin Neuroradiol. 2019 Dec;29(4):615-621. doi: 10.1007/s00062-018-0728-7. Epub 2018 Oct 5.
The aim of the study was to investigate any metabolic changes on magnetic resonance spectroscopy (MRS) throughout the visual pathway of the brain in patients with glaucoma and a control group and correlate the results with clinical findings.
A total of 87 patients were enrolled in the study, 30 healthy controls, 25 glaucoma, 16 suspected glaucoma (GS) and 16 ocular hypertension (OHT) patients. A single voxel MRS on TE 30 ms was performed by placing the volume of interest (VOI) on the corpus geniculatum laterale (CGL) and primary visual cortex (VC). Peak values of metabolites, such as N‑acetyl aspartate (NAA), creatine (Cr), choline (Cho) and Myo-inositol (Ins) were investigated on MRS. The MRS results were correlated with age, intraocular pressure (IOP), retinal nerve fiber length (RNFL), mean deviation (MD) and cup disk ratio (CD).
The NAA values obtained from the CGL in glaucoma and GS cases were lower than the healthy control group. The Cho values at CGL in glaucoma were lower than GS and controls. There was a negative correlation between NAA values of the VC and CD in glaucoma cases. Additionally, there was a negative correlation between age and RNFL in both glaucoma and GS cases.
The use of MRS can reveal neurodegeneration in CGL and VC in patients with glaucoma. Depiction of metabolic changes throughout the visual pathways via MRS will guide the treatment planning and follow-up in glaucoma and GS cases.
本研究旨在探讨青光眼患者和对照组大脑视觉通路的磁共振波谱(MRS)上是否存在代谢变化,并将结果与临床发现相关联。
共纳入 87 名患者,其中 30 名健康对照者,25 名青光眼患者,16 名疑似青光眼(GS)患者和 16 名高眼压(OHT)患者。通过在外侧膝状体(CGL)和初级视皮层(VC)上放置感兴趣区(VOI),进行 TE 30ms 的单体素 MRS。研究了代谢物的峰值值,如 N-乙酰天冬氨酸(NAA)、肌酸(Cr)、胆碱(Cho)和肌醇(Ins)。将 MRS 结果与年龄、眼内压(IOP)、视网膜神经纤维长度(RNFL)、平均偏差(MD)和杯盘比(CD)相关联。
青光眼和 GS 病例的 CGL 获得的 NAA 值低于健康对照组。青光眼的 CGL 的 Cho 值低于 GS 和对照组。青光眼病例的 VC 的 NAA 值与 CD 之间存在负相关。此外,青光眼和 GS 病例的年龄与 RNFL 之间存在负相关。
MRS 的使用可以揭示青光眼患者 CGL 和 VC 中的神经退行性变。通过 MRS 描绘整个视觉通路的代谢变化将指导青光眼和 GS 病例的治疗计划和随访。