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

To investigate the association of quantitative 3-T diffusion tensor imaging (DTI) with retinal nerve fiber layer (RNFL) thickness measured by optical coherence tomography (OCT) and clinical severity in detecting optic nerve degeneration in patients with primary closed-angle glaucoma. Twenty three patients (42 eyes; 9 men, 14 women) with primary closed-angle glaucoma and 20 healthy controls were enrolled in this study. Both DTI and OCT were performed on the optic nerves of all subjects. The mean diffusivity (MD), fractional anisotropy (FA), and eigenvalue maps were obtained for quantitative analysis. RNFL thickness and quantitative electrophysiology were also performed on all subjects. The association of quantitative DTI with RNFL thickness and glaucoma stage was analyzed. Compared with control nerves, the FA, lambda(aEuro-), and lambda(aSyen) values, and RNFL thickness in affected nerves decreased, while MD increased in patients with primary glaucoma (p < 0.05). There was a significant correlation between FA, MD, lambda(aEuro-), and lambda(aSyen) and the mean RNFL thickness (P < 0.01). The mean FA and lambda(aSyen) values derived with DT MR imaging correlated well with glaucoma stage (P < 0.05), but the mean MD and lambda(aEuro-) values did not correlate with glaucoma stage (P > 0.05). DTI measurement could detect abnormality of the optic nerve in patients with glaucoma and may serve as a biomarker of disease severity.