BACKGROUND In this retrospective study the relationship between intraocular pressure (IOP), retinal nerve fiber layer (RNFL) thickness and pathologic hypersignal in optic nerve segments on 3D double inversion recovery (DIR) MR sequence in 21 patients with proven glaucoma of different origin was evaluated. METHODS All patients were examined on a 3 T MR Philips® scanner. Pathologic optic nerve DIR hypersignal was determined in four different nerve segments. IOP was measured in mmHg by applanation tonometry. RNFL thickness was measured in μm with optical coherence tomography (OCT Heidelberg Engineering Spectralis® apparatus). Wilcoxon rank sum tests, student's t-tests and (multivariate) linear regression models were appied. RESULTS 3D DIR hypersignal was present in 17 (41.5%) optic nerves. 3D DIR hypersignal was not related to ischemic or demyelinating optic nerve pathology but was associated with increased IOP (19.8 [24-18]; versus 15.45; [18.85-13.75] mmHg; p = 0.008) and decreased RNFL thickness (61.06 ± 12.1 versus 82.5 ± 21.6 μm; p < 0.001) in comparison to optic nerves of glaucoma patients without DIR hypersignal. Specifically, presence of DIR hypersignal in optic nerves in at least one optic nerve segment lowered RNFL thickness on average by 17.54 μm (p = 0.005) in comparison to optic nerves without DIR hypersignal. CONCLUSIONS In patients with glaucomatous optic neuropathy (GON) and pathologic optic nerve DIR hypersignal, significantly increased IOP and significantly decreased RNFL thickness values are present. DIR hypersignal seems to be a marker for disease severity in GON related to decreased RNFL thickness and may thus represent long-segment severe axonal degeneration in optic nerves in patients with GON. Venous congestion and edema within the optic nerve related to high IOP may contribute to the DIR hypersignal as well.

中文翻译：

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青光眼视神经病变的MRI长段3D双反转恢复（DIR）高信号。

背景：在这项回顾性研究中，评估了21例已证实患有不同来源青光眼的患者的3D双反转恢复（DIR）MR序列中眼压（IOP），视网膜神经纤维层（RNFL）厚度和视神经段病理性高信号之间的关系。 。方法所有患者均在3 T MRPhilips®扫描仪上进行检查。在四个不同的神经节段中确定了病理性视神经DIR高信号。通过压平眼压法以mmHg测量IOP。RNFL厚度通过光学相干断层扫描（OCT Heidelberg Engineering Spectralis？设备）以μm为单位进行测量。应用Wilcoxon秩和检验，学生t检验和（多元）线性回归模型。结果3D DIR高信号存在于17个（41.5％）视神经中。3D DIR高信号与缺血性或脱髓鞘性视神经病理无关，但与IOP增加有关（19.8 [24-18]； 15.45； [18.85-13.75] mmHg； p = 0.008）和RNFL厚度减少（61.06±12.1 vs与没有DIR高信号的青光眼患者的视神经相比，为82.5±21.6μm; p <0.001）。具体而言，与没有DIR高信号的视神经相比，至少一个视神经节段的视神经中存在DIR高信号使RNFL厚度平均降低17.54μm（p = 0.005）。结论在患有青光眼性视神经病变（GON）和病理性视神经DIR信号增高的患者中，眼压显着升高，RNFL厚度值显着降低。DIR高信号似乎是与RNFL厚度减少有关的GON疾病严重程度的标志，因此可能代表GON患者视神经中的长段严重轴突变性。与高眼压相关的视神经内的静脉充血和水肿也可能导致DIR高信号。