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Editors Selection IGR 16-4
Basic Research - LGN: Lateral geniculate nucleus and clinical stage
Comment by Yeni Yucel on:
46678 Assessment of lateral geniculate nucleus atrophy with 3T MR imaging and correlation with clinical stage of glaucoma, Dai H; Mu KT; Qi J et al., American Journal of Neuroradiology, 2011; 32: 1347-1353
Dai et al. (1178) investigated prospectively lateral geniculate nucleus (LGN) atrophy in patients with primary openangle glaucoma (POAG) using 3T MR imaging and correlation with the clinical stage of disease. The clinical stage for each eye of each glaucoma patient was assessed using The Hodapp-Anderson- Parrish system (stages 0-5) based on MDs of visual fields. POAG (n = 26) were compared with 26 age-matched healthy volunteers. All subjects underwent imaging on a 3T MR imaging system using Proton Density (PD) and Gray Matter (GM) sequences. Dai and coworkers confirmed that LGN height and volume are reduced in glaucoma previously described.1,2 The original finding of this work by Dai and coworkers is that both LGN height and volume correlated with glaucoma disease severity.
There is further evidence for larger studies to establish a common protocol for neuroimaging of visual pathways for use in multi-centric clinical studies
The present study has limitations: the study population used is still relatively small. Important clinical findings were not disclosed, including structural parameters such as optic disk cup-to disk, HRT or OCT measurements, and functional measurements such as visual field parameters. This information should be included, because LGN changes may vary with patterns of visual field loss. For example, LGN changes in bilateral glaucoma may be different than that seen in asymmetrical or unilateral glaucoma. Other highly relevant information that requires disclosure is gender, age, cardiovascular diseases and co-morbid conditions that may affect brain size, and this should be taken into account using multivariate analysis. This article provides further evidence for larger studies to establish a common protocol for neuroimaging of visual pathways for use in multi-centric clinical studies in the future.
References
- Gupta N, Greenberg G, de Tilly LN, Gray B, Polemidiotis M, Yücel YH. Atrophy of the lateral geniculate nucleus in human glaucoma detected by magnetic resonance imaging. Br J Ophthalmol 2009; 93: 56-60.
- Hernowo AT, Boucard CC, Jansonius NM, Hooymans JM, Cornelissen FW. Automated morphometry of the visual pathway in primary open-angle glaucoma. Invest Ophthalmol Vis Sci 2011; 52: 2758-2766.
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