Difüzyon Tensör Görüntülemenin Primer Açık Açılı Glokom Hastalarının Görme Yollarındaki Tanısal Performansı
Abstract
Amaç: Glokomlu hastalarda optik sinir (OS), optik trakt (OT) ve optik radyasyonda (OR) nörodejenerasyonun tespitinde difüzyon tensör görüntülemenin (DTG) tanı performasını değerlendirmek ve DTG parametreleri ile glokom evresi arasında uyumu belirlemek.
Gereç ve Yöntem: Primer açık açılı glokomlu 33 hastanın (17 erkek, 16 kadın, 29-81 yaşında) 65 gözü ve 37 hastalığı bulunmayan gönüllünün 74 gözü çalışmaya dâhil edilmiştir. Tüm çalışmaya katılanlar optik koherens tomografinin de dâhil olduğu tam göz muayenesinden geçirilmiş olup Hodapp-Anderson-Parrish sınıflamasına göre evrelere ayrılmışlardır. 3T cihazla elde edilen görüntülerden otomatik olarak MD ve FA haritaları oluşturularak ortalama difüzivite (MD), fraksiyonel anizotropi (FA), radyal ve aksiyel difüzivite (RD ve AD) ölçümleri yapılmıştır. İstatistik analizi için SPSS kullanılmıştır. p<0.05 istatistiksel olarak anlamlı kabul edilmiştir.
Bulgular: Kontrol grubu ile karşılaştırıldığında glokomlu hastalarda FA (sırasıyla 0,45 ve 0,43) OS ve OT’da düşük bulunmuştur. MD (sırasıyla 1,30 ve 1,44 x10-3 mm2/sn,) ve RD (sırasıyla 0,86 ve 0,83 x10-3 mm2/sn) ise OS ve OT’da yüksek bulunmuştur (p<0,001). DTG parametrelerinde OR’da anlamlı farklılık izlenmedi. DTG parametrelerinin glokom evrelerine göre karşılaştırılmasında OS FA ile OT FA ve MD değerlerinde tüm evreler ile kontrol grubu arasında anlamlı farklılık saptandı (p≤0,005). Ayrıca retina sinir lifi tabakası kalınlığı ile OS (p<0,001, r=0,555) ve OT FA (p=0,001, r=0,416) ile OT MD (p=0,001, r=0,405) arasında anlamlı korelasyon bulundu. OS ‘de FA, MD ve RD ile OT ‘da FA ve MD değerlerine ROC analizi yapılmış olup yüksek duyarlılık ve özgüllük ile eşik değerler belirlenmiştir.
Sonuç: DTG parametreleri olan MD, FA ve RD OS ve OT’daki nörodejenerasyonu saptamada ve hastalığın şiddetini belirlemede klinik muayeneyi tamamlayıcı biyomarker olarak kullanılabilecektir.
Keywords
Aksiyel difüzivite; AD Difüzyon tensör görüntüleme; DTG Fraksiyonel anizotropi; FA glokom ortalama difüzivite; MD radyal difüzivite; RD
Supporting Institution
Kocaeli Üniversitesi Bilimsel Araştırmalar Projesi
Thanks
Katkılarından dolayı Hamiyet Demirkıran'a teşekkürü bir borç biliriz.
References
- Quigley HA, Number of People with Glaucoma Worldwide, Br J Ophtalmol, 1996; 80: 389-393.
- Gupta N, Yücel YH. What changes can we expect in the brain of glaucoma patients? Surv Ophthalmol 2007; 52: 122–6.
- Yücel YH, Zhang Q, Gupta N, Kaufman PL, Weinreb RN, Loss of neurons in magnocellular and parvocellular layers of the LGN in glaucoma. Arch Ophthalmol 2000;118(3):378–384.
- Gupta N, Ang LC, Noel de Tilly L, Bidaisee L, Yücel YH. Human glaucoma and neural degeneration in intracranial optic nerve, lateral geniculate nucleus, and visual cortex. Br J Ophthalmol 2006; 90(6):674–678.
- Roberts TPL, Schwartz ES. Principles and implementation of diffusion-weighted and diffusion tensor imaging. Pediatr Radiol 2007;37(8):739–48.
- Uluğ AM, van Zijl P. Orientation independent diffusion imaging without tensor diagonalization: Anisotropy definitions based on physical attributes of the diffusion ellipsoid. Journal of Magnetic Resonance Imaging 1999; 9: 804-813.
- Garaci FG, V. Cozzolino, C. Nucci, F. Gaudiello, A. Ludovici, T. Lupattelli, R. Floris, G. Simonetti. Advances in neuroimaging of the visual pathways and their use in glaucoma Prog Brain Res 2008; 173:165–177.
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- Omodaka K, Murata T, Sato S, Takahashi M, et al. Correlation of magnetic resonance imaging optic nerve parameters to optical coherence tomography and the visual field in glaucoma. Clin Experiment Ophthalmol. 2013 Sep 30.
- Chen Z, Lin F, Wang J, Li Z, Dai H, Mu K, Ge J, Zhang H. Diffusion tensor magnetic resonance imaging reveals visual pathway damage that correlates with clinical severity in glaucoma. Clin Experiment Ophthalmol. 2013 Jan-Feb;41(1):43-9
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- Boucard CC, Hanekamp S, Curcic-Blake B, Ida M, Yoshida M, Cornelissen FW. Neurodegeneration beyond the primary visual pathways in a population with a high incidence of normal-pressure glaucoma. Ophthalmic Physiol Opt 2016; 36: 344–353. doi: 10.1111/ opo.12297
- Frezzotti P, Giorgio A, Toto F, De Leucio A, De Stefano N. Early Changes of Brain Connectivity in Primary Open Angle Glaucoma. Human Brain Mapping 2016; DOI: 10.1002/hbm.23330
- Tellouck L, Durieux M, Coupe ́ P, et al. Optic radiations microstructural changes in glaucoma and association with severity: a study using 3Tesla-magnetic resonance diffusion tensor imaging. Invest Ophthalmol Vis Sci. 2016; 57:6539–6547. DOI:10.1167/iovs.16-19838
- Garaci FG, Bolacchi F, Cerulli A, Melis M, Spanò A, Cedrone C, Floris R, Simonetti G, Nucci C. Optic nerve and optic radiation neurodegeneration in patients with glaucoma: in vivo analysis with 3-T diffusion-tensor MR imaging. Radiology 2009; 252(2): 496-501
- Chang ST, Xu J, Trinkaus K, Pekmezci M, Arthur SN, Song SK, Barnett EM. Optic nerve diffusion tensor imaging parameters and their correlation with optic disc topography and disease severity in adult glaucoma patients and controls. J Glaucoma. 2013 Apr 29.
- Engelhorn T, Michelson G, Waerntges S, Hempel S, El-Rafei A, Struffert T, Doerfler A. A new approach to assess intracranial white matter abnormalities in glaucoma patients: changes of fractional anisotropy detected by 3T diffusion tensor imaging. Acad Radiol. 2012; 19(4): 485-8.
- Zhang YQ, Li J, Xu L, Zhang L, Wang ZC, Yang H, Chen CX, Wu XS, Jonas JB. Anterior visual pathway assessment by magnetic resonance imaging in normal-pressure glaucoma. Acta Ophthalmol. 2012 Jun;90(4): 295-302.
- Murai H, Suzuki Y, Kiyosawa M, Tokumaru AM, Ishii K, Mochizuki M. Positive correlation between the degree of visual field defect and optic radiation damage in glaucoma patients. Jpn J Ophthalmol. 2013 May;57(3):257-62.
- Dai H, Yin D, Hu C, Morelli JN, Hu S, Yan X, Xu D. Whole-brain voxel-based analysis of diffusion tensor MRI parameters in patients with primary open angle glaucoma and correlation with clinical glaucoma stage. Neuroradiology. 2013 Feb;55(2):233-43.
- Hodapp E, Parrish RK II, Anderson DR. Clinical decisions in glaucoma. St Louis: The CV Mosby Co; 1993. pp. 52–61.
- Quigley HA. Neuronal death in glaucoma. Prog Retin Eye Res. 1999; 18: 39–57
- Yücel YH, Zhang Q, Gupta N, Kaufman PL, Weinreb RN. Loss of neurons in magnocellular and parvocellular layers of the LGN in glaucoma. Arch Ophthalmol. 2000; 118: 378–84.
- Qing G, Zhang S, Wang B, Wang N. Functional MRI signal changes in primary visual cortex corresponding to the central normal visual field of patients with primary open-angle glaucoma. Invest Ophthalmol Vis Sci 2010; 51: 4627–4634.
- Trip SA, Wheeler-Kingshott C, Jones SJ, et al. Optic nerve diffusion tensor imaging in optic neuritis. Neuroimage 2006; 30(2): 498– 505.
Abstract
References
- Quigley HA, Number of People with Glaucoma Worldwide, Br J Ophtalmol, 1996; 80: 389-393.
- Gupta N, Yücel YH. What changes can we expect in the brain of glaucoma patients? Surv Ophthalmol 2007; 52: 122–6.
- Yücel YH, Zhang Q, Gupta N, Kaufman PL, Weinreb RN, Loss of neurons in magnocellular and parvocellular layers of the LGN in glaucoma. Arch Ophthalmol 2000;118(3):378–384.
- Gupta N, Ang LC, Noel de Tilly L, Bidaisee L, Yücel YH. Human glaucoma and neural degeneration in intracranial optic nerve, lateral geniculate nucleus, and visual cortex. Br J Ophthalmol 2006; 90(6):674–678.
- Roberts TPL, Schwartz ES. Principles and implementation of diffusion-weighted and diffusion tensor imaging. Pediatr Radiol 2007;37(8):739–48.
- Uluğ AM, van Zijl P. Orientation independent diffusion imaging without tensor diagonalization: Anisotropy definitions based on physical attributes of the diffusion ellipsoid. Journal of Magnetic Resonance Imaging 1999; 9: 804-813.
- Garaci FG, V. Cozzolino, C. Nucci, F. Gaudiello, A. Ludovici, T. Lupattelli, R. Floris, G. Simonetti. Advances in neuroimaging of the visual pathways and their use in glaucoma Prog Brain Res 2008; 173:165–177.
- Huang J, Friedland RP, Auchus AP. Diffusion tensor imaging of normal appearing white matter in mild cognitive impairment and early Alzheimer disease: preliminary evidence of axonal degeneration in the temporal lobe. Am J Neuroradiol 2007; 28(10):1943–8.
- Chen T, Lin C, Chen Y, Liu H, Hua M, Huang Y, et al. Diffusion tensor changes in patients with amnesic mild cognitive impairment and various dementias. Psychiatry Res: Neuroimaging 2009; 173(1):15–21.
- Omodaka K, Murata T, Sato S, Takahashi M, et al. Correlation of magnetic resonance imaging optic nerve parameters to optical coherence tomography and the visual field in glaucoma. Clin Experiment Ophthalmol. 2013 Sep 30.
- Chen Z, Lin F, Wang J, Li Z, Dai H, Mu K, Ge J, Zhang H. Diffusion tensor magnetic resonance imaging reveals visual pathway damage that correlates with clinical severity in glaucoma. Clin Experiment Ophthalmol. 2013 Jan-Feb;41(1):43-9
- Wang MY, Wu K, Xu JM, Dai J, Qin W, Liu J, Tian J, Shi D. Quantitative 3-T diffusion tensor imaging in detecting optic nerve degeneration in patients with glaucoma: association with retinal nerve fiber layer thickness and clinical severity. Neuroradiology. 2013 Mar; 55(4): 493-8.
- Nucci C, Mancino R, Martucci A, Bolacchi F, Manenti G, Cedrone C, Culasso F, Floris R, Cerulli L, Garaci FG. 3-T Diffusion tensor imaging of the optic nerve in subjects with glaucoma: correlation with GDx-VCC, HRT-III and Stratus optical coherence tomography findings. Br J Ophthalmol. 2012 Jul; 96(7): 976-80.
- Boucard CC, Hanekamp S, Curcic-Blake B, Ida M, Yoshida M, Cornelissen FW. Neurodegeneration beyond the primary visual pathways in a population with a high incidence of normal-pressure glaucoma. Ophthalmic Physiol Opt 2016; 36: 344–353. doi: 10.1111/ opo.12297
- Frezzotti P, Giorgio A, Toto F, De Leucio A, De Stefano N. Early Changes of Brain Connectivity in Primary Open Angle Glaucoma. Human Brain Mapping 2016; DOI: 10.1002/hbm.23330
- Tellouck L, Durieux M, Coupe ́ P, et al. Optic radiations microstructural changes in glaucoma and association with severity: a study using 3Tesla-magnetic resonance diffusion tensor imaging. Invest Ophthalmol Vis Sci. 2016; 57:6539–6547. DOI:10.1167/iovs.16-19838
- Garaci FG, Bolacchi F, Cerulli A, Melis M, Spanò A, Cedrone C, Floris R, Simonetti G, Nucci C. Optic nerve and optic radiation neurodegeneration in patients with glaucoma: in vivo analysis with 3-T diffusion-tensor MR imaging. Radiology 2009; 252(2): 496-501
- Chang ST, Xu J, Trinkaus K, Pekmezci M, Arthur SN, Song SK, Barnett EM. Optic nerve diffusion tensor imaging parameters and their correlation with optic disc topography and disease severity in adult glaucoma patients and controls. J Glaucoma. 2013 Apr 29.
- Engelhorn T, Michelson G, Waerntges S, Hempel S, El-Rafei A, Struffert T, Doerfler A. A new approach to assess intracranial white matter abnormalities in glaucoma patients: changes of fractional anisotropy detected by 3T diffusion tensor imaging. Acad Radiol. 2012; 19(4): 485-8.
- Zhang YQ, Li J, Xu L, Zhang L, Wang ZC, Yang H, Chen CX, Wu XS, Jonas JB. Anterior visual pathway assessment by magnetic resonance imaging in normal-pressure glaucoma. Acta Ophthalmol. 2012 Jun;90(4): 295-302.
- Murai H, Suzuki Y, Kiyosawa M, Tokumaru AM, Ishii K, Mochizuki M. Positive correlation between the degree of visual field defect and optic radiation damage in glaucoma patients. Jpn J Ophthalmol. 2013 May;57(3):257-62.
- Dai H, Yin D, Hu C, Morelli JN, Hu S, Yan X, Xu D. Whole-brain voxel-based analysis of diffusion tensor MRI parameters in patients with primary open angle glaucoma and correlation with clinical glaucoma stage. Neuroradiology. 2013 Feb;55(2):233-43.
- Hodapp E, Parrish RK II, Anderson DR. Clinical decisions in glaucoma. St Louis: The CV Mosby Co; 1993. pp. 52–61.
- Quigley HA. Neuronal death in glaucoma. Prog Retin Eye Res. 1999; 18: 39–57
- Yücel YH, Zhang Q, Gupta N, Kaufman PL, Weinreb RN. Loss of neurons in magnocellular and parvocellular layers of the LGN in glaucoma. Arch Ophthalmol. 2000; 118: 378–84.
- Qing G, Zhang S, Wang B, Wang N. Functional MRI signal changes in primary visual cortex corresponding to the central normal visual field of patients with primary open-angle glaucoma. Invest Ophthalmol Vis Sci 2010; 51: 4627–4634.
- Trip SA, Wheeler-Kingshott C, Jones SJ, et al. Optic nerve diffusion tensor imaging in optic neuritis. Neuroimage 2006; 30(2): 498– 505.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Articles |
| Authors | |
| Publication Date | June 29, 2021 |
| Submission Date | February 1, 2021 |
| Published in Issue | Year 2021 Volume: 11 Issue: 2 |
The published articles in SMJ are licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.