Structural and Functional Deterioration along the Visual Pathways in Glaucoma Patients

Motivation: Glaucoma is a neurodegenerative, multi-faceted disease resulting in irreversible blindness. Previous studies demonstrated both ocular and cerebral involvement, but brain findings remained mixed from small studies. Goal(s): To elucidate structural and functional brain changes associated with glaucoma using big data. Approach: We compared UK Biobank's extensive multi-parametric brain MRI data, ophthalmic parameters, and physiometabolic data between 1,229 glaucoma subjects and 12,290 age- and gender-matched healthy subjects. Results: In addition to clinical ophthalmic and physiometabolic differences, smaller brain volumes and lower fractional anisotropy were found along the posterior visual pathway of glaucoma patients, with weakened functional brain activation upon Hariri faces/shapes task. Impact: Changes in both the structure and function of the posterior visual brain pathways point to trans-synaptic degeneration in glaucoma. Additionally, glaucoma may impair both the lower-level visual processing areas and the structural and functional aspects of higher-level visual processing regions.