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M. Labetoulle, G. Nasser, I. De Monchy, G. Gendron, N. Pogorzalek, D. Ducreux, F. Benoudiba; Diffusion Tensor Magnetic Resonance Imaging and Fiber Tracking of Trigeminal Nerves in Relapsing Herpetic Keratouveitis. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2890.
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© ARVO (1962-2015); The Authors (2016-present)
To assess the efficacy of diffusion tensor magnetic resonance imaging (DTMRI) for the analysis of trigeminal fibres (TGFs) in relapsing herpetic kerato-uveitis.
The TGFs of 12 patients (average age: 57+/-16 years), addressed for relapsing unilateral kerato-uveitis related to Herpes simplex virus (HSV) or varicella-zoster virus (VZV), were tested using DTMRI. The diagnosis of HSV- or VZV-related disease was based on PCR or specific antibodies production within the aqueous humor, or on medical history (zoster). At the time of DTMRI, the kerato-uveitis was in a quiescent period (no recent increase of inflammation). Data were retrospectively assessed by a blinded examiner to compare the affected-side with the non-affected one, and with data from 21 sex- and age-matched normal subjects.
The DTRMI processing showed a significant difference in the mean anisotropic fraction (AF) of trigeminal fibres from the affected eye, compared to the controlateral side (0.40 versus 0.47, p = 0.003). In contrast, there was no significant asymmetry in control subjects (0.39 versus 0.43, p =0,09).
DTMRI is a powerful technique for the analysis of neuronal networks in patients. Our results suggest that multiple HSV or VZV reactivation episodes induce persistent trigeminal fibres injuries (as shown by reduction of mean AF), that probably reflects a significant decrease in the amount of nerve endings.
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