DTI parameters of axonal integrity and demyelination of the optic radiation correlate with glaucoma indices

  • Georg Michelson
  • Tobias Engelhorn
  • Simone Wärntges
  • Ahmed El Rafei
  • Joachim Hornegger
  • Arnd Doerfler



In glaucoma, damage of retinal ganglion cells may continue to the linked optic radiations. This study investigates the correlation of glaucoma severity indicators with parameters of axonal and myelin integrity of the optic radiations.


In this observational case–control study, 13 patients with normal-tension glaucoma, 13 patients with primary open-angle glaucoma, and seven control subjects (mean age, 57.6 ± 12.5 years) were randomly selected for diffusion tensor imaging (DTI) of the optic radiations. The results of the frequency doubling test (FDT) and the HRT-based linear discriminant functions of Burk (BLDF) and Mikelberg (MLDF) were correlated with the mean of the fractional anisotropy (FA), apparent diffusion coefficient (ADC), and radial diffusivity (RD) of the optic radiations. Multiple correlation analysis, corrected for age, stage of cerebral microangiopathy, diagnosis group, and gender was conducted at increasing thresholds of linear anisotropy (CL) to reduce mismeasurements because of complex fiber situations.


The best correlations were found for BLDF with FA at CL threshold 0.3 (0.594, p = 0.001), with ADC at CL 0.4 (−0.511, p = 0.005), and with RD at CL 0.4 (−0.585, p = 0.001). MLDF correlated with FA at CL 0.4 (0.393, p = 0.035). The FDT score correlated with FA at CL 0 (−0.491, p = 0.007) and with RD at CL 0 (−0.375, p = 0.045).


In glaucoma, DTI-derived parameters of the axonal integrity (FA, ADC) and demyelination (RD) of the optic radiation are linked to HRT-based indices of glaucoma severity and to impairment of the spatial-temporal contrast sensitivity.


Diffusion tensor imaging Glaucoma Optic nerve head Optic radiation 



This study was supported by the Federal Ministry of Education and Research (BMBF), Bonn, Germany (excellence cluster Medical Valley EMN, Grant MVEMN-A-02), and the Johannes und Frieda Marohn-Stiftung at the University of Erlangen, Germany.

The funding organizations had no role in the design or conduct of this research, in the collection, management, analysis, and interpretation of the data, or in preparation, review, or approval of the manuscript. .

None of the authors has any financial/ conflicting interests to disclose. The authors had full control of all primary data and agree to allow Graefe’s Archive for Clinical and Experimental Ophthalmology to review their data if requested.

Supplementary material

417_2011_1887_MOESM1_ESM.pdf (55 kb)
ESM 1 (PDF 54 kb)


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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Georg Michelson
    • 1
    • 4
    • 5
  • Tobias Engelhorn
    • 2
  • Simone Wärntges
    • 1
    • 4
  • Ahmed El Rafei
    • 3
    • 5
  • Joachim Hornegger
    • 3
    • 5
  • Arnd Doerfler
    • 2
  1. 1.Department of OphthalmologyUniversity Erlangen-NurembergErlangenGermany
  2. 2.Department of NeuroradiologyUniversity Erlangen-NurembergErlangenGermany
  3. 3.Department of Computer Science - Pattern Recognition LabUniversity Erlangen-NurembergErlangenGermany
  4. 4.Interdisciplinary Center of Ophthalmologic Preventive Medicine and Imaging (IZPI)University Erlangen-NurembergErlangenGermany
  5. 5.Graduate School in Advanced Optical Technologies (SAOT)ErlangenGermany

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