Morphometric Analysis of the Optic Nerve Using MRI in Normal vs. Glaucoma Patients
DOI:
https://doi.org/10.63682/jns.v13i1.9299Keywords:
Glaucoma, Optic Nerve, MRI, Optic Nerve Diameter, Optic Nerve Cross-Sectional Area, Primary Open-Angle GlaucomaAbstract
Background: Glaucoma, a leading cause of irreversible blindness, is characterized by progressive optic nerve damage, primarily affecting retinal ganglion cells and axons.
Objective: To assess and compare MRI-derived optic nerve measurements in POAG patients and healthy controls, and to evaluate the diagnostic accuracy and reliability of these measurements.
Methods: A total of 85 participants (45 POAG patients and 40 healthy controls) were included in this prospective observational study. MRI scans were performed using a 3T MRI scanner with high-resolution T2-weighted fat-suppressed sequences. Optic nerve measurements were taken at three posterior levels (3 mm, 6 mm, and 9 mm).
Results: The POAG group exhibited significantly smaller OND (mean 2.38 ± 0.22 mm) and ON-CSA (mean 4.51 ± 0.81 mm²) compared to the control group (OND: 2.62 ± 0.24 mm, ON-CSA: 5.39 ± 0.90 mm²), with p-values < 0.001 for both. The SASW was significantly wider in the POAG group (2.55 ± 0.28 mm) compared to controls (2.27 ± 0.27 mm, p = 0.003). The diagnostic accuracy of OND and ON-CSA was high, with AUC values of 0.83 and 0.81, respectively. The combination of OND and ON-CSA yielded an AUC of 0.88, indicating excellent diagnostic potential. Intra-rater and inter-rater reliability were excellent, with ICC values above 0.90.
Conclusion: MRI-based morphometric analysis reveals significant reductions in optic nerve diameter and cross-sectional area in POAG patients, with a concomitant widening of the subarachnoid space. These findings support the use of MRI-derived metrics, particularly OND and ON-CSA, as reliable biomarkers for detecting glaucoma
Downloads
References
Rolando, Maurizio, Angelo Macri, Michele Altieri, and Michele Iester. "Morphometric analysis of the optic disc surface: the level of smoothness as a diagnostic parameter for glaucoma." International Ophthalmology 20, no. 1 (1996): 15-20.
Gracitelli, C.P., Duque-Chica, G.L., Sanches, L.G., Moura, A.L., Nagy, B.V., Teixeira, S.H., Amaro Jr, E., Ventura, D.F. and Paranhos Jr, A., 2020. Structural analysis of glaucoma brain and its association with ocular parameters. Journal of Glaucoma, 29(5), pp.393-400.
Zikou, A.K., Kitsos, G., Tzarouchi, L.C., Astrakas, L., Alexiou, G.A. and Argyropoulou, M.I., 2012. Voxel-based morphometry and diffusion tensor imaging of the optic pathway in primary open-angle glaucoma: a preliminary study. American Journal of Neuroradiology, 33(1), pp.128-134.
Mastropasqua, Rodolfo, Luca Agnifili, Peter A. Mattei, Massimo Caulo, Vincenzo Fasanella, Riccardo Navarra, Leonardo Mastropasqua, and Giorgio Marchini. "Advanced morphological and functional magnetic resonance techniques in glaucoma." BioMed Research International 2015, no. 1 (2015): 160454.
Furlanetto, Rafael Lacerda, Sergio Henrique Teixeira, Carolina Pelegrini Barbosa Gracitelli, Claudio Luiz Lottenberg, Fabiano Emori, Michel Michelan, Edson Amaro Jr, and Augusto Paranhos Jr. "Structural and functional analyses of the optic nerve and lateral geniculate nucleus in glaucoma." PloS one13, no. 3 (2018): e0194038.
Ramli, Norlina M., Sabrilhakim Sidek, Fadzlina A. Rahman, Mohammadreza Peyman, Mimiwati Zahari, Kartini Rahmat, and Norlisah Ramli. "Novel use of 3T MRI in assessment of optic nerve volume in glaucoma." Graefe's Archive for Clinical and Experimental Ophthalmology 252, no. 6 (2014): 995-1000.
Hernowo, Aditya T., Christine C. Boucard, Nomdo M. Jansonius, Johanna MM Hooymans, and Frans W. Cornelissen. "Automated morphometry of the visual pathway in primary open-angle glaucoma." Investigative ophthalmology & visual science 52, no. 5 (2011): 2758-2766.
Yücel, Y.H., Kalichman, M.W., Mizisin, A.P., Powell, H.C. and Weinreb, R.N., 1999. Histomorphometric analysis of optic nerve changes in experimental glaucoma. Journal of glaucoma, 8(1), pp.38-45.
Hata, Masayuki, Kazuaki Miyamoto, Akio Oishi, Yukiko Makiyama, Norimoto Gotoh, Yugo Kimura, Tadamichi Akagi, and Nagahisa Yoshimura. "Comparison of optic disc morphology of optic nerve atrophy between compressive optic neuropathy and glaucomatous optic neuropathy." PLoS One 9, no. 11 (2014): e112403.
El-Rafei, A., Engelhorn, T., Wärntges, S., Dörfler, A., Hornegger, J., & Michelson, G. (2011). A framework for voxel-based morphometric analysis of the optic radiation using diffusion tensor imaging in glaucoma. Magnetic resonance imaging, 29(8), 1076-1087.
Mardin, Christian Y., and Anselm GM Jünemann. "The diagnostic value of optic nerve imaging in early glaucoma." Current opinion in ophthalmology 12, no. 2 (2001): 100-104.
Ominde, Beryl S., Gloria E. Abadom, Joyce E. Ikubor, Lawrence C. Achapu, Princess O. Enakpoya, and Patrick S. Igbigbi. "Normal diameter of the optic nerve using magnetic resonance imaging: A retrospective Nigerian study." Saudi Journal of Ophthalmology 38, no. 1 (2024): 53-58.
Lagreze, W. A., Lazzaro, A., Weigel, M., Hansen, H. C., Hennig, J., & Bley, T. A. (2007). Morphometry of the retrobulbar human optic nerve: comparison between conventional sonography and ultrafast magnetic resonance sequences. Investigative ophthalmology & visual science, 48(5), 1913-1917.
Jing, Liang, Tingqin Yan, Jian Zhou, Yuanzhong Xie, Jianfeng Qiu, Yi Wang, and Weizhao Lu. "Elevated intraocular pressure moderated brain morphometry in high-tension glaucoma: a structural MRI study." Clinical Neuroradiology 34, no. 1 (2024): 173-179.
Beatty, S., P. A. Good, J. McLaughlin, and E. C. O’Neill. "Echographic measurements of the retrobulbar optic nerve in normal and glaucomatous eyes." British journal of ophthalmology 82, no. 1 (1998): 43-47.
Kang, L., & Wan, C. (2022). Application of advanced magnetic resonance imaging in glaucoma: a narrative review. Quantitative Imaging in Medicine and Surgery, 12(3), 2106.
Zhang, Ya Q., Jing Li, Liang Xu, Li Zhang, Zhen C. Wang, Hua Yang, Chang X. Chen, Xi S. Wu, and Jost B. Jonas. "Anterior visual pathway assessment by magnetic resonance imaging in normal‐pressure glaucoma." Acta ophthalmologica 90, no. 4 (2012): e295-e302.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
