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Georg Michelson, Simone Waerntges, Tobias Engelhorn, Ahmed El-Rafei, Joachim Hornegger, Arnd Dörfler; DTI Measures of the Optic Radiation and Visual Field in Glaucomatous and Non-Glaucomatous Optic Nerve Atrophy. Invest. Ophthalmol. Vis. Sci. 2012;53(14):731.
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In glaucomatous optic nerve atrophy (glOA) damage of retinal ganglion cells may continue to the linked optic radiations (OR). In non-glaucomatous optic nerve atrophy (non-glOA, e.g. of congenital, ischemic, traumatic, hereditary, toxic, and/or infectious origin) the optic radiation is supposed to be affected directly. This study investigated differences between glOA and non-glOA in relation to impairment of the optic radiations.
The available data of 42 patients with healthy optic nerve head and no ophthalmological signs of an affected visual pathway, 134 glOA patients, and 35 non-glOA patients (mean age 54.1±15.9 years, 64.4±12.4 years, and 49.1±15.2 years, respectively) were evaluated. The participants underwent the diffusion tensor imaging (DTI) to measure the axonal integrity, i.e. fractional anisotropy (FA) and mean diffusivity (MD), and demyelination, i.e. radial diffusivity (RD), in the semi-automatically outlined optic radiations. The results were correlated with the retinal nerve fiber layer thickness (RNFL) acquired by the Spectralis optical coherence tomography and with the mean defect provided by standard automatic perimetry.
Age correlated significantly with the DTI parameters in all groups. If corrected for age only in the glOA patient group the mean defect correlated with FA (r=-0.312; p=0.004) and RD (r=0.224; p=0.043). In contrast, only in the non-glOA group the RNFL correlated with MD (r=-0.570; p=0.027) and RD (r=-0.595; p=0.019). The control group did not show any correlations of DTI parameters with the mean defect or RNFL.
In non-glaucomatous optic nerve atrophy a correlation was found between visual field and axonal integrity/ demyelination of the optic radiations, and the reduction of the RNFL was associated with an impairment of the axonal integrity/ demyelination of the optic radiation. The damage of the optic nerve was significantly associated with loss of RNFL and ageing.
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