Proton Magnetic Resonance Spectroscopy ((1)H-MRS) Reveals Geniculocalcarine and Striate Area Degeneration in Primary Glaucoma

BACKGROUND: Glaucoma is a collection of neurodegenerative diseases that affect both the retina and the central visual pathway. We investigated whether metabolites' concentrations changed in the geniculocalcarine (GCT) and the striate area of occipital lobe by proton magnetic resonance spectroscopy ((1)H-MRS), suggesting neurodegeneration of the central visual pathway in primary glaucoma. METHODOLOGY/PRINCIPAL FINDINGS: 20 patients with glaucoma in both eyes were paired with 20 healthy volunteers in same gender and an age difference less than 3 years. All the participants were examined by MR imaging including T(1) Flair, T(2) FSE and (1)H-MRS. The T(1) intensity and T(2) intensity of their GCTs and striate areas were measured. The ratio of N-acetylaspartate (NAA)/Creatine (Cr), Choline (Cho)/Cr, glutamine and glutamate (Glx)/Cr were derived by multi-voxels (1)H-MRS in the GCT and the striate area of each brain hemisphere. The T(1) intensity and T(2) intensity had no difference between the groups. Significant decreases in NAA/Cr and Cho/Cr but no difference in Glx/Cr was found between the groups in both the GCT and the striate area. CONCLUSIONS/SIGNIFICANCE: Primary glaucoma affects metabolites' concentrations in the GCT and the striate area suggesting there is ongoing neurodegenerative process.