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Fractional anisotropy of the optic radiations correlates with the visual field after epilepsy surgery

  • Functional Neuroradiology
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Abstract

Purpose

This study assessed whether optic radiations (OR) microstructure after temporal lobe epilepsy (TLE) surgery correlated with visual field defects (VFD).

Methods

Patients were subjected to diffusion tensor imaging (DTI) tractography of the OR and Humphrey perimetry after TLE surgery. We used Spearman’s test to verify correlations between tractographic parameters and perimetry mean deviation. Tractographic variables were compared between patients with VFD or intact perimetry. Multiple logistic regression was applied between DTI and perimetry values. DTI sensitivity and specificity were assessed with a receiver operating characteristic (ROC) curve to evaluate VFD.

Results

Thirty-nine patients had reliable perimetry and OR tractography. There was a significant correlation between (1) fractional anisotropy (FA) and both total (rho = 0.569, p = 0.0002) and quadrant (rho = 0.453, p = 0.0037) mean deviation and (2) radial diffusivity and total mean deviation (rho = − 0.350, p = 0.0286). There was no other significant correlation. Patients with VFD showed a significantly lower FA compared with patients with normal perimetry (p = 0.0055), and a 0.01 reduction in FA was associated with a 44% increase in presenting VFD after surgery (confidence interval, CI = 1.10–1.88; p = 0.0082). Using a FA of 0.457, DTI tractography showed a specificity of 95.2% and a sensitivity of 50% to detect VFD after surgery (area under the curve = 0.7619, CI = 0.6020–0.9218).

Conclusion

The postoperative OR microstructure correlated with visual loss after epilepsy surgery. DTI postoperative OR tractography may be helpful in evaluating VFD.

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Funding

This work was funded by the São Paulo Research Foundation (FAPESP).

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Authors and Affiliations

  1. Neuroimaging Laboratory (LNI), University of Campinas (UNICAMP), Rua Vital Brazil, 251. Cidade Universitária Zeferino Vaz., Campinas, SP, 13083-888, Brazil

    João Paulo Sant Ana Santos de Souza, Pamela Castro Pereira, Clarissa Yasuda, Brunno Machado Campos & Fernando Cendes

  2. Department of Ophthalmology, University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126. Cidade Universitária Zeferino Vaz., Campinas, SP, 13083-887, Brazil

    Gabriel Ayub & José Paulo Cabral Vasconcellos

  3. Department of Neurology and Neurosurgery, University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126. Cidade Universitária Zeferino Vaz., Campinas, SP, 13083-887, Brazil

    Clarissa Yasuda, Andrei Fernandes Joaquim, Helder Tedeschi, Fernando Cendes & Enrico Ghizoni

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  1. João Paulo Sant Ana Santos de Souza
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  2. Gabriel Ayub
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Correspondence to João Paulo Sant Ana Santos de Souza.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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ESM. 1

Scatterplots that show the distribution of DTI and perimetry variables according to the surgical approach. Red dots and blue triangles represent patients who underwent modified anterior temporal lobectomy (mATL) and the transsylvian approach, respectively (PDF 474 kb)

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de Souza, J.P.S.A.S., Ayub, G., Pereira, P.C. et al. Fractional anisotropy of the optic radiations correlates with the visual field after epilepsy surgery. Neuroradiology 61, 1425–1436 (2019). https://doi.org/10.1007/s00234-019-02281-2

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