Brain imaging in glaucoma from clinical studies to clinical practice

Area of Science:

• Neuroscience
• Ophthalmology
• Radiology

Background:

• Glaucoma is increasingly recognized for its central nervous system (CNS) manifestations.
• Conventional neuroimaging has limitations in detecting subtle CNS changes associated with glaucoma.

Purpose of the Study:

• To explore the utility of advanced Magnetic Resonance Imaging (MRI) techniques in visualizing CNS alterations in glaucoma.
• To assess the potential of MRI for diagnosing and monitoring glaucoma-related neurodegeneration.

Main Methods:

• Utilized advanced MRI techniques, including diffusion tensor imaging, functional imaging (BOLD-ASL), and magnetic resonance spectroscopy.
• Investigated in vivo, noninvasive detection of alterations along the entire visual pathway in early and late-stage glaucoma.
• Employed conventional neuroimaging for anatomical description and differential diagnosis.

Main Results:

• Advanced MRI techniques successfully identified in vivo, noninvasive alterations in the visual pathway in glaucoma patients.
• These techniques allow for the investigation of white matter tract integrity and cortical gray matter changes.
• Conventional MRI remains crucial for anatomical assessment and ruling out other pathologies.

Conclusions:

• Advanced MRI offers novel insights into CNS manifestations of glaucoma, complementing conventional imaging.
• Future MR quantification of CNS damage is vital for prognostic stratification and evaluating neuroprotective therapies in glaucoma.