Structural Analysis of Glaucoma Brain and its Association With Ocular Parameters

Abstract

Precis: Glaucoma patients presented a decreased occipital pole surface area in both hemispheres. Moreover, these parameters are independently correlated with functional and structural ocular parameters. Purpose: The purpose of this study was to evaluate structural brain abnormalities in glaucoma patients using 3-Tesla magnetic resonance imaging and assess their correlation with associated structural and functional ocular findings. Patients and Methods: This cross-sectional prospective study included 30 glaucoma patients and 18 healthy volunteers. All participants underwent standard automated perimetry, spectral-domain optical coherence tomography, and 3.0-Tesla magnetic resonance imaging. Results: There was a significant difference between the surface area of the occipital pole in the left hemisphere of glaucoma patients (mean: 1253.9±149.3 mm2) and that of control subjects (mean: 1341.9±129.8 mm2), P=0.043. There was also a significant difference between the surface area of the occipital pole in the right hemisphere of glaucoma patients (mean: 1910.5±309.4 mm2) and that of control subjects (mean: 2089.1±164.2 mm2), P=0.029. There was no significant difference between the lingual, calcarine, superior frontal, and inferior frontal gyri of glaucoma patients and those of the control subjects (P>0.05 for all comparisons). The surface area of the occipital pole in the left hemisphere was significantly correlated with perimetry mean deviation values, visual acuity, age, and retinal nerve fiber layer thickness (P=0.001, <0.001, 0.010, and 0.006, respectively). The surface area of the occipital pole in the right hemisphere was significantly correlated with perimetry mean deviation values, visual field indices, visual acuity, age, and retinal nerve fiber layer thickness (P<0.001, 0.007, <0.001, 0.046, and <0.001, respectively). Conclusion: Glaucoma patients presented a decreased occipital pole surface area in both hemispheres that independently correlated with functional and structural ocular parameters.

Brain Functional Network Analysis of Patients with Primary Angle-Closure Glaucoma

“…Notably, reduced visual stimulation in the visual cortices may lead to a loss of projections from these areas in glaucoma, an effect that leads to impairments in the primary and secondary visual cortices [ 44 ]. As similar with previous researches, these impairments include structural damage and functional impairment in the calcarine area, cuneus [ [ 45 , 46 ]], and occipital lobe [ [ 45 , 47 ]]. Similarly, the DC is decreased in the superior/inferior occipital and lingual gyri.…”

Altered coupling of cerebral blood flow and functional connectivity strength in visual and higher order cognitive cortices in primary open angle glaucoma

“…Experimental evidence supports the notion that POAG is a widespread neurodegenerative condition associated with the central nervous system (CNS). [3][4][5][6] In addition, close links between POAG and Alzheimer's disease (AD) have been observed. 7 Studies have established deposition of amyloid b (Ab) and tau in the retina and vitreous of glaucoma patients, consistent with the pattern found in the cerebral spinal fluid of patients with AD.…”

“…Widespread damage to gray matter, anatomic connectivity and functional connectivity can go beyond the visual system in patients with POAG, including into the visual, working memory, attention and executive networks. [4][5][6][20][21][22][23] In addition, altered cerebral vascular autoregulation and vasoreactivity have been discovered in POAG patients. [24][25][26][27][28][29] To date, studies on cerebral blood perfusion in POAG have been mainly limited to the visual cortex, but the relationships between abnormal neurovascular activity and corresponding cerebral blood perfusion changes have not been elucidated.…”

Application of advanced magnetic resonance imaging in glaucoma: a narrative review

“…In the occipital lobe, MRI volume studies pay special attention to the visual and visual-related cortex. Recent reports using the volumetric MRI technique have observed a decrease in occipital surface area or visual cortex volume in both hemispheres of glaucoma patients (14).…”

“…Magnetic resonance imaging (MRI) has been widely used as a non-invasive imaging tool to evaluate intracranial structures. Traditional MRI is a highly sensitive diagnostic imaging method for evaluating internal structure, with special emphasis on soft tissue (14); however, such technology is usually not quantitative, direct comparability between scans is poor, and critical information for study of glaucoma is not captured in the brain examination results (15).…”