Human glaucoma and neural degeneration in intracranial optic nerve, lateral geniculate nucleus, and visual cortex

Voxel-Based Morphometry and Diffusion Tensor Imaging of the Optic Pathway in Primary Open-Angle Glaucoma: A Preliminary Study

“…Wallerian degeneration is a well-known process in neurodegenerative diseases. 5 Consequently, glaucomatous optic neuropathy can produce loss not only of retinal ganglion cells and their axons but also of neural cells in the LGN and, to some extent, even of the visual cortex. The present study, by using VBM and voxel-based DTI analysis in patients with POAG, demonstrated several structural changes in the optic pathway.…”

“…All patients fulfilled the diagnostic criteria for POAG of the American Academy of Ophthalmology, which are intraocular pressure Ն21 mm Hg, glaucomatous optic disc and visual field abnormalities, and a nonoccludable anterior chamber angle without characteristics of congenital or secondary glaucoma. 17 In patients, the disease duration from the diagnosis of glaucoma was [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] …”

“…4 Experimental studies in animal models and postmortem studies of human glaucoma provide evidence of the fundamental process of neurodegeneration by demonstrating the death of retinal ganglion cells and the degeneration of the ON, LGN, and visual cortex. [5][6][7] The development of imaging modalities for the early detection of these changes in vivo could be very important for more accurate evaluation of the disease severity and assessment of the therapeutic efficacy of treatment strategies. Conventional MR imaging and magnetization-transfer imaging have been used in the evaluation of POAG and, with the use of region-of-interest methods, have demonstrated ON atrophy and a decrease of the magnetization-transfer ratio suggestive of degeneration in the chiasma and the visual cortex.…”

“…3 These observations suggest that mechanisms independent of intraocular pressure are also implicated in the progression of the disease. 4 Neurodegeneration may play an important role in the pathogenesis and progression of glaucoma, 4,5 and a variety of neuroprotective agents are under investigation for application in glaucoma treatment. The fundamental common process observed in neurodegenerative disorders is death of a specific neuron population followed by antegrade or retrograde transsynaptic spread of degeneration (wallerian degeneration) from abnormal to normal neurons.…”

Assessment of Lateral Geniculate Nucleus Atrophy with 3T MR Imaging and Correlation with Clinical Stage of Glaucoma

“…6,7 Gupta et al 6 reported the first clinicopathologic case of human glaucoma, demonstrating degenerative changes in the brain involving the intracranial optic nerves, LGN, and visual cortex in 2006. Three years later in vivo MR imaging evidence of LGN degeneration in human glaucoma was found, which was consistent with ex vivo primate and human neuropathologic studies.…”