Document Type
Article
Publication Date
7-8-2024
Abstract
PURPOSE: To investigate the contributions of the microstructural and metabolic brain environment to glaucoma and their association with visual field (VF) loss patterns by using advanced diffusion magnetic resonance imaging (dMRI), proton magnetic resonance spectroscopy (MRS), and clinical ophthalmic measures.
METHODS: Sixty-nine glaucoma and healthy subjects underwent dMRI and/or MRS at 3 Tesla. Ophthalmic data were collected from VF perimetry and optical coherence tomography. dMRI parameters of microstructural integrity in the optic radiation and MRS-derived neurochemical levels in the visual cortex were compared among early glaucoma, advanced glaucoma, and healthy controls. Multivariate regression was used to correlate neuroimaging metrics with 16 archetypal VF loss patterns. We also ranked neuroimaging, ophthalmic, and demographic attributes in terms of their information gain to determine their importance to glaucoma.
RESULTS: In dMRI, decreasing fractional anisotropy, radial kurtosis, and tortuosity and increasing radial diffusivity correlated with greater overall VF loss bilaterally. Regionally, decreasing intra-axonal space and extra-axonal space diffusivities correlated with greater VF loss in the superior-altitudinal area of the right eye and the inferior-altitudinal area of the left eye. In MRS, both early and advanced glaucoma patients had lower gamma-aminobutyric acid (GABA), glutamate, and choline levels than healthy controls. GABA appeared to associate more with superonasal VF loss, and glutamate and choline more with inferior VF loss. Choline ranked third for importance to early glaucoma, whereas radial kurtosis and GABA ranked fourth and fifth for advanced glaucoma.
CONCLUSIONS: Our findings highlight the importance of non-invasive neuroimaging biomarkers and analytical modeling for unveiling glaucomatous neurodegeneration and how they reflect complementary VF loss patterns.
Recommended Citation
Pang, Yueyin; Bang, Ji Won; Kasi, Anisha; Li, Jeremy; Parra, Carlos; Fieremans, Els; Wollstein, Gadi; Schuman, Joel S.; Wang, Mengyu; and Chan, Kevin C, "Contributions of Brain Microstructures and Metabolism to Visual Field Loss Patterns in Glaucoma Using Archetypal and Information Gain Analyses" (2024). Wills Eye Hospital Papers. Paper 225.
https://jdc.jefferson.edu/willsfp/225
Creative Commons License
This work is licensed under a Creative Commons Attribution-No Derivative Works 4.0 License.
PubMed ID
38975942
Language
English
Comments
This article is the author's final published version in Investigative Ophthalmology & Visual Science, Volume 65, Issue 15, July 2024.
The published version is available at https://doi.org/10.1167/iovs.65.8.15.
Copyright © 2024 The Authors