Structure-function relationships in the human visual system using DTI, fMRI and visual field testing: pre- and post-operative assessments in patients with anterior visual pathway compression.

ABSTRACT

The focus of this project is to improve our understanding of the relationships between brain structure and function in patients presenting with anterior visual pathway compression using functional MRI (fMRI), visual field(VF) maps and diffusion tensor imaging (DTI). Significant visual loss can occur when large pituitary lesions compress the optic chiasm. Surgical resection of these lesions decompresses the chiasm and can lead to visual recovery. In this preliminary study, we selected patients presenting with slowly progressive visual loss secondary to a compressive pituitary region mass. Using preoperative DTI data, we reconstructed white matter projections of the optic radiations and demonstrated a structural correlation with functional vision as quantified by formal visual field mapping and fMRI. The structural data generated through a fiber tracking algorithm may represent a potentially powerful tool to better understand functional visual deficits in patients with anterior visual pathway compression. Furthermore, we believe that specific patterns in preoperative DTI data may predict the likelihood of postoperative visual recovery in a select group of patients.