Diffusion Tensor Imaging Detects Microstructural Differences of Visual Pathway in Patients With Primary Open-Angle Glaucoma and Ocular Hypertension.
Diffusion Tensor Imaging Detects Microstructural Differences of Visual Pathway in Patients With Primary Open-Angle Glaucoma and Ocular Hypertension.
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弥散张量成像检测原发性开角型青光眼和高眼压患者视觉通路的微观结构差异
DOI：
10.3389/fnhum.2018.00426
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发表时间：
2018
影响因子：
2.9
通讯作者：
Zhang YY
中科院分区：
文献类型：
--
作者：
Song XY;Puyang Z;Chen AH;Zhao J;Li XJ;Chen YY;Tang WJ;Zhang YY
高眼压症（ocular hypertension，OHT）是成人门诊患者的常见病，占全球发病率的约15%.然而，目前的标准方法在鉴别OHT和早期原发性开角型青光眼（POAG）方面仍存在一些实际问题。应用高分辨率扩散张量成像（DTI）技术，我们可以区分开角型青光眼和高眼压症患者视路的轴突结构。在32例POAG患者（15例OHT和14例对照组）中，62.5%的青光眼处于早期。所有受试者均接受标准自动视野检查和光学相干断层扫描（OCT）眼科评估。应用DTI技术测量视束、外侧膝状体和视辐射的各向异性分数（FA）和平均扩散率（MD），并进行体素分析。我们的数据表明，POAG患者双侧OR的FA值在右侧或左侧明显低于OHT患者（左侧OR：0.51 ± 0.04 vs. 0.54 ± 0.03，p <0.05;右侧OR：0.51 ± 0.05 vs. 0.54 ± 0.03，p <0.05）。在右侧LGN中，POAG患者的MD值高于OHT患者（9.81 ± 1.45 vs.8.23 ± 0.62，p <0.05）。然而，所有的DTI参数OHT和对照组之间没有显着差异。POAG患者的DTI参数与形态学和功能测量值呈正相关（p <0.05）。垂直杯盘比（VCDR）与OT同侧FA（p <0.05）、OT同侧MD（p <0.05）、LGN同侧MD（p <0.05）和OT对侧MD（p <0.05）相关。视野平均偏差（MDVF）与OT同侧FA（p <0.05）、OT同侧MD（p <0.05）和LGN同侧FA（p <0.05）相关。我们的研究表明，DTI可以区分POAG和OHT患者的视路，特别是早期POAG，并且DTI参数可以量化POAG的进展。
Ocular hypertension (OHT), the common situation in adult patients in the outpatients, occurs ∼5% worldwide. However, there are still some practical problems in differentiation of OHT with early primary open-angle glaucoma (POAG) using current standard methods. Application of high resolution diffusion tensor imaging (DTI) enables us to the differentiate axonal architecture of visual pathway between POAG and OHT subjects. Among 32 POAG patients recruited (15 OHT and 14 control subjects), 62.5% of glaucoma were in early stage for the current study. All subjects underwent ophthalmological assessments with standard automated perimetry and optical coherence tomography (OCT). DTI was applied to measure fraction anisotropy (FA) and mean diffusivity (MD) of optic tract (OT), lateral geniculate body (LGN) and optic radiation (OR) using voxel-based analysis. Our data demonstrated that FA values of bilateral OR in POAG were significantly lower in the right or left than that of OHT patients (left OR: 0.51 ± 0.04 vs. 0.54 ± 0.03, p < 0.05; right OR: 0.51 ± 0.05 vs. 0.54 ± 0.03, p < 0.05). In right LGN, MD values were higher in POAG patients compared with OHT subjects (9.81 ± 1.45 vs. 8.23 ± 0.62, p < 0.05). However, no significant difference of all of the DTI parameters was observed between OHT and control subjects. DTI parameters in POAG patients were positively correlated with morphological and functional measurements (p < 0.05). Vertical cup to disc ratio (VCDR) was correlated with ipsilateral FA of OT (p < 0.05), ipsilateral MD of OT (p < 0.05), ipsilateral MD of LGN (p < 0.05), and contralateral MD of OT (p < 0.05). Mean deviation of visual field (MDVF) was correlated with ipsilateral FA of OT (p < 0.05), ipsilateral MD of OT (p < 0.05), and ipsilateral FA of LGN (p < 0.05). Our study demonstrated that DTI can differentiate POAG from OHT subjects in optic pathway, particularly in early POAG, and DTI parameters can quantify the progression of POAG.
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