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Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
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Evaluation of Visual Cortex Activity Using Functional Near-Infrared Spectroscopy in Primary Open Angle and Primary

Hage Angku1, Rohit Verma2, Karthikeyan Mahalingam1

  • 1Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.

Journal of Glaucoma
|May 15, 2024
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Summary

Functional near-infrared spectroscopy (fNIRS) revealed reduced visual cortex activity in glaucoma patients. This decreased activity correlates with glaucoma severity, suggesting neurodegeneration in the occipital cortex.

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Area of Science:

  • Neuroscience
  • Ophthalmology
  • Medical Imaging

Background:

  • Glaucoma, a leading cause of irreversible blindness, involves progressive optic nerve damage.
  • Visual cortex dysfunction is increasingly recognized in glaucoma, but its assessment remains challenging.

Purpose of the Study:

  • To evaluate visual cortex activity using functional near-infrared spectroscopy (fNIRS) in patients with primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG).
  • To compare visual cortex activity between glaucoma patients and healthy controls.
  • To investigate the correlation between visual cortex activity and glaucoma severity.

Main Methods:

  • A cross-sectional observational pilot study involving 30 POAG patients, 31 PACG patients, and 30 age-matched healthy controls.
  • fNIRS was employed to measure changes in oxyhemoglobin (OxyHb) concentration in the visual cortex during a visual stimulus.
  • Visual cortex activity was quantified by the maximum amplitude of OxyHb change over 10 seconds.

Main Results:

  • Both POAG and PACG groups exhibited significantly lower visual cortex activity compared to controls in the middle occipital gyri.
  • No significant difference in visual cortex activity was found between POAG and PACG groups.
  • Glaucoma patients showed a negative correlation between visual cortex activity and visual field defect severity (mean deviation) and a positive correlation with retinal nerve fiber layer thickness.

Conclusions:

  • Patients with glaucoma demonstrate reduced visual cortex activity, potentially indicating neuronal degeneration in the occipital cortex.
  • Visual cortex activity is closely correlated with glaucoma disease severity.
  • fNIRS is a promising neuroimaging tool for assessing hemodynamic and neurodegenerative changes in glaucoma.