June 2023
Volume 64, Issue 9
Open Access
ARVO Imaging in the Eye Conference Abstract  |   June 2023
Visual cortex perfusion alters with visual field function in glaucoma
Author Affiliations & Notes
  • Laura Massi
    Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York, United States
    Department of Electrical, Electronic, and Information Engineering “Guglielmo Marconi” - DEI, Universita degli Studi di Bologna, Bologna, Emilia-Romagna, Italy
  • Ji Won Bang
    Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York, United States
  • Carlos Parra
    Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York, United States
  • Anna M. Chen
    Department of Radiology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York, United States
  • Jeannie M. Au
    Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York, United States
  • Gadi Wollstein
    Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York, United States
    Department of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, New York, United States
  • Joel S. Schuman
    Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York, United States
    Department of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, New York, United States
  • Kevin Chan
    Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York, United States
    Department of Radiology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York, United States
  • Footnotes
    Commercial Relationships   Laura Massi, None; Ji Won Bang, None; Carlos Parra, None; Anna Chen, None; Jeannie Au, None; Gadi Wollstein, None; Joel Schuman, Zeiss (P); Kevin Chan, None
  • Footnotes
    Support  This work was supported in part by the National Institutes of Health R01-EY028125, R01-EY013178, and P41-EB017183 (Bethesda, Maryland), BrightFocus Foundation G2016030, G2019103, and G2021001F (Clarksburg, Maryland), and an unrestricted grant from Research to Prevent Blindness to NYU Langone Health Department of Ophthalmology (New York, New York).
Investigative Ophthalmology & Visual Science June 2023, Vol.64, PP009. doi:
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    • Get Citation

      Laura Massi, Ji Won Bang, Carlos Parra, Anna M. Chen, Jeannie M. Au, Gadi Wollstein, Joel S. Schuman, Kevin Chan; Visual cortex perfusion alters with visual field function in glaucoma. Invest. Ophthalmol. Vis. Sci. 2023;64(9):PP009.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Glaucoma has been thought of as an ocular manifestation with widespread alterations in the brain. Recent studies have reported decreased ocular blood flow in glaucoma patients. However, little is known about whether cerebral blood flow (CBF) changes with glaucoma severity. In this study, we used magnetic resonance imaging (MRI) to examine whether CBF differs between different stages of the disease, and how CBF changes with the inner retina, optic nerve, and visual field impairments.

Methods : 18 early glaucoma (age=66.1 ± 8.5 years, mean ± S.D), 23 advanced glaucoma (age=66.5 ± 7.6 years, mean ± S.D), and 21 healthy subjects (age=63.9 ± 7.7 years, mean ± S.D) underwent resting pseudo-continuous arterial spin labelling (pCASL) MRI at 3 Tesla. Basal CBF was extracted from pCASL in the Brodmann areas corresponding to the primary (BA17), secondary (BA18) and tertiary (BA19) visual cortices (Fig 1a). ANCOVA and post-hoc Bonferroni tests were applied to evaluate CBF between the 3 subject groups in the 3 brain regions while regressing out the age effect. In addition, we used Humphrey visual field perimetry and spectral-domain optical coherence tomography to correlate CBF values linearly with VF-MD, macular ganglion cell-inner plexiform layer (mGCIPL) thickness, circumpapillary retinal nerve fiber layer (cpRNFL) thickness, and optic nerve head cup-to-disc ratio (c/d) averaged between the left and right eyes.

Results : Advanced glaucoma showed significantly lower CBF than early glaucoma in BA17, BA18, and BA19 by about 25.4% (p=0.007), 24.5% (p=0.009), and 20.4% (p=0.034), respectively. No apparent CBF differences were observed between early glaucoma and healthy subjects. CBF values of BA17 and BA18, but not BA19, were significantly correlated with VF-MD (BA17: p=0.017, BA18: p=0.039, BA19: p=0.06) (Fig 2a). CBF was, however, not correlated with mGCIPL, cpRNFL or c/d (p>0.05)(Fig 2b, 2c, 2d).

Conclusions : Our results suggest that all the three visual cortical areas are susceptible to perfusion changes in more advanced severity stages of glaucoma. Moreover, the tight coupling between CBF and visual field function, but not with ocular structure suggests the local contributions of visual cortex perfusion changes to visual loss in glaucoma.

This abstract was presented at the 2023 ARVO Imaging in the Eye Conference, held in New Orleans, LA, April 21-22, 2023.

 

 

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