Visual pathway white matter alterations in glaucoma

Glaucoma is one of the leading causes of irreversible blindness worldwide. While glaucoma has been traditionally viewed as an eye disease, studies have shown that the entire visual pathway of glaucoma patients exhibits evidence of degeneration. Our understanding of the cause and structural nature of this degeneration, however, is still limited. In my thesis, I addressed this issue by utilizing cutting-edge magnetic resonance imaging (MRI) techniques to analyze white matter (WM) degeneration of the visual pathway in glaucoma patients. Additionally, I conducted the first longitudinal study of visual pathway WM degeneration in glaucoma, which is essential for understanding the source and pattern of spread of this degeneration over time.

The results of my work revealed that visual pathway WM degeneration in glaucoma starts at the level of the eyes and then spreads in the direction of the brain to affect the entire visual pathway. Additionally, I found that the anterior and posterior segments of the visual pathway are not affected simultaneously by this degeneration. Rather, an observable time lag seems to exist between the degeneration of these segments along the course of the disease. This finding could have an impact on the development of novel neuroprotective and stem cell-based treatments of glaucoma. Furthermore, I found that in glaucoma patients the MRI-based measures of visual pathway WM degeneration correlate strongly with standard clinical measures. This suggests that in glaucoma, MRI could potentially serve as a complementary diagnostic tool in cases where current clinical approaches do not perform adequately.