Relationships between Brain Microstructures and Visual Field Loss Patterns in Glaucoma using Diffusion MRI and Archetypal Analysis

Motivation: In bilateral glaucoma, visual field loss often spares complementary regions between eyes to optimize residual vision, but the underlying mechanisms are unknown. Goal(s): Investigate how brain microstructural environment relates to regional visual field loss patterns in glaucoma. Approach: Advanced diffusion MRI parameters of optic radiation integrity were correlated with glaucomatous visual field loss patterns using partial correlation and archetypal analyses. Results: Diffusion MRI metrics generally correlated with overall visual field loss. Complementary archetypal loss patterns were also found between eyes when associating pointwise visual field to certain MRI metrics sensitive to axonal/glial integrity and neuroinflammation, suggesting their involvement in influencing residual binocular vision. Impact: Advanced neuroimaging combined with computational analysis can provide insights into the brain’s role in influencing preferential damage to maximize retained binocular vision in glaucoma. Diffusion MRI holds promise for assessing glaucoma progression and brain plasticity for guiding vision preservation.