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<meta name="DC.Title" content="Glymphatic System in Ocular Diseases: Evaluation of MRI Findings" />
<meta name="DC.Identifier" content="10.3174/ajnr.A7552" />
<meta name="DC.Date" content="2022-07-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2022 by American Journal of Neuroradiology. Indicates open access to non-subscribers at www.ajnr.org" />
<meta name="DC.AccessRights" content="open-access" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: There is growing evidence of leakage of gadolinium in an impaired blood-retina barrier. We investigated gadolinium enhancement in different eye compartments and correlated the enhancement with specific ophthalmologic diseases.

MATERIALS AND METHODS: In a prospective clinical study (ClinicalTrials.gov Identifier: [NCT05035251][1]), 95 patients (63 with and 32 without ophthalmologic disease) were examined before and after gadolinium administration (20 and 120 minutes) with heavily T2-weighted FLAIR. The cohort was divided according to the location of pathology into anterior and posterior eye compartment groups. Relative signal intensity increase in the anterior eye chamber, vitreous body with retina, optic nerve sheath, and the Meckel cave was analyzed and correlated with the final clinical diagnosis.

RESULTS: In patients with a disorder in the anterior eye compartment, significant signal intensity increases were found in the central anterior eye chamber ( P 20 minutes = .000, P 120 minutes = .000), lateral anterior eye chamber ( P 20 minutes = .001, P 120 minutes = .005), and vitreous body with retina ( P 20 minutes = .02) compared with the control group. Patients with pathologies in the posterior eye compartment showed higher signal intensity levels in the central anterior eye compartment ( P 20 minutes = .041) and vitreous body with retina ( P 120 minutes = .006).

CONCLUSIONS: Increased gadolinium enhancement was found in the central and lateral anterior eye compartments and the vitreous body with retina in patients with anterior eye compartment disorders 20 and 120 minutes after contrast application, suggesting impairment of the blood-aqueous barrier. In patients with a disorder in the posterior eye compartment, pathologic enhancement indicated disruption of the blood-retinal barrier that allows gadolinium to diffuse into the vitreous body with retina from posterior to anterior, opposite to the known physiologic glymphatic pathway.

AC
:   anterior eye chamber
AEC
:   anterior eye compartment
Gd
:   gadolinium
GLOS
:   gadolinium leakage in ocular structures
PEC
:   posterior eye compartment
SI
:   signal intensity
VB
:   vitreous body with retina

 [1]: /lookup/external-ref?link_type=CLINTRIALGOV&amp;access_num=NCT05035251&amp;atom=%2Fajnr%2F43%2F7%2F1012.atom" />
<meta name="DC.Contributor" content="P. Manava" />
<meta name="DC.Contributor" content="C. Eckrich" />
<meta name="DC.Contributor" content="F. Luciani" />
<meta name="DC.Contributor" content="J. Schmidbauer" />
<meta name="DC.Contributor" content="M.M. Lell" />
<meta name="DC.Contributor" content="K. Detmar" />
<meta name="article:published_time" content="2022-07-01" />
<meta name="citation_title" content="Glymphatic System in Ocular Diseases: Evaluation of MRI Findings" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;There is growing evidence of leakage of gadolinium in an impaired blood-retina barrier. We investigated gadolinium enhancement in different eye compartments and correlated the enhancement with specific ophthalmologic diseases.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;In a prospective clinical study (ClinicalTrials.gov Identifier: NCT05035251), 95 patients (63 with and 32 without ophthalmologic disease) were examined before and after gadolinium administration (20 and 120 minutes) with heavily T2-weighted FLAIR. The cohort was divided according to the location of pathology into anterior and posterior eye compartment groups. Relative signal intensity increase in the anterior eye chamber, vitreous body with retina, optic nerve sheath, and the Meckel cave was analyzed and correlated with the final clinical diagnosis.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;In patients with a disorder in the anterior eye compartment, significant signal intensity increases were found in the central anterior eye chamber (&lt;i&gt;P&lt;/i&gt; 20 minutes = .000, &lt;i&gt;P&lt;/i&gt; 120 minutes = .000), lateral anterior eye chamber (&lt;i&gt;P&lt;/i&gt; 20 minutes = .001, &lt;i&gt;P&lt;/i&gt; 120 minutes = .005), and vitreous body with retina (&lt;i&gt;P&lt;/i&gt; 20 minutes = .02) compared with the control group. Patients with pathologies in the posterior eye compartment showed higher signal intensity levels in the central anterior eye compartment (&lt;i&gt;P&lt;/i&gt; 20 minutes = .041) and vitreous body with retina (&lt;i&gt;P&lt;/i&gt; 120 minutes = .006).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Increased gadolinium enhancement was found in the central and lateral anterior eye compartments and the vitreous body with retina in patients with anterior eye compartment disorders 20 and 120 minutes after contrast application, suggesting impairment of the blood-aqueous barrier. In patients with a disorder in the posterior eye compartment, pathologic enhancement indicated disruption of the blood-retinal barrier that allows gadolinium to diffuse into the vitreous body with retina from posterior to anterior, opposite to the known physiologic glymphatic pathway.&lt;/p&gt;" />
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<meta name="citation_doi" content="10.3174/ajnr.A7552" />
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<meta name="citation_author" content="P. Manava" />
<meta name="citation_author_institution" content="aFrom the Departments of Radiology and Nuclear Medicine (P.M., C.E., M.M.L., K.D.)" />
<meta name="citation_author_institution" content="cInstitute of Radiology (P.M., M.M.L.), Friedrich-Alexander University, University of Erlangen-Nuremberg, Erlangen, Germany" />
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<meta name="citation_author" content="C. Eckrich" />
<meta name="citation_author_institution" content="aFrom the Departments of Radiology and Nuclear Medicine (P.M., C.E., M.M.L., K.D.)" />
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<meta name="citation_author_institution" content="aFrom the Departments of Radiology and Nuclear Medicine (P.M., C.E., M.M.L., K.D.)" />
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<meta name="twitter:title" content="Glymphatic System in Ocular Diseases: Evaluation of MRI Findings" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: There is growing evidence of leakage of gadolinium in an impaired blood-retina barrier. We investigated gadolinium enhancement in different eye compartments and correlated the enhancement with specific ophthalmologic diseases.

MATERIALS AND METHODS: In a prospective clinical study (ClinicalTrials.gov Identifier: [NCT05035251][1]), 95 patients (63 with and 32 without ophthalmologic disease) were examined before and after gadolinium administration (20 and 120 minutes) with heavily T2-weighted FLAIR. The cohort was divided according to the location of pathology into anterior and posterior eye compartment groups. Relative signal intensity increase in the anterior eye chamber, vitreous body with retina, optic nerve sheath, and the Meckel cave was analyzed and correlated with the final clinical diagnosis.

RESULTS: In patients with a disorder in the anterior eye compartment, significant signal intensity increases were found in the central anterior eye chamber ( P 20 minutes = .000, P 120 minutes = .000), lateral anterior eye chamber ( P 20 minutes = .001, P 120 minutes = .005), and vitreous body with retina ( P 20 minutes = .02) compared with the control group. Patients with pathologies in the posterior eye compartment showed higher signal intensity levels in the central anterior eye compartment ( P 20 minutes = .041) and vitreous body with retina ( P 120 minutes = .006).

CONCLUSIONS: Increased gadolinium enhancement was found in the central and lateral anterior eye compartments and the vitreous body with retina in patients with anterior eye compartment disorders 20 and 120 minutes after contrast application, suggesting impairment of the blood-aqueous barrier. In patients with a disorder in the posterior eye compartment, pathologic enhancement indicated disruption of the blood-retinal barrier that allows gadolinium to diffuse into the vitreous body with retina from posterior to anterior, opposite to the known physiologic glymphatic pathway.

AC
:   anterior eye chamber
AEC
:   anterior eye compartment
Gd
:   gadolinium
GLOS
:   gadolinium leakage in ocular structures
PEC
:   posterior eye compartment
SI
:   signal intensity
VB
:   vitreous body with retina

 [1]: /lookup/external-ref?link_type=CLINTRIALGOV&amp;access_num=NCT05035251&amp;atom=%2Fajnr%2F43%2F7%2F1012.atom" />
<meta name="og-title" property="og:title" content="Glymphatic System in Ocular Diseases: Evaluation of MRI Findings" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/43/7/1012" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: There is growing evidence of leakage of gadolinium in an impaired blood-retina barrier. We investigated gadolinium enhancement in different eye compartments and correlated the enhancement with specific ophthalmologic diseases.

MATERIALS AND METHODS: In a prospective clinical study (ClinicalTrials.gov Identifier: [NCT05035251][1]), 95 patients (63 with and 32 without ophthalmologic disease) were examined before and after gadolinium administration (20 and 120 minutes) with heavily T2-weighted FLAIR. The cohort was divided according to the location of pathology into anterior and posterior eye compartment groups. Relative signal intensity increase in the anterior eye chamber, vitreous body with retina, optic nerve sheath, and the Meckel cave was analyzed and correlated with the final clinical diagnosis.

RESULTS: In patients with a disorder in the anterior eye compartment, significant signal intensity increases were found in the central anterior eye chamber ( P 20 minutes = .000, P 120 minutes = .000), lateral anterior eye chamber ( P 20 minutes = .001, P 120 minutes = .005), and vitreous body with retina ( P 20 minutes = .02) compared with the control group. Patients with pathologies in the posterior eye compartment showed higher signal intensity levels in the central anterior eye compartment ( P 20 minutes = .041) and vitreous body with retina ( P 120 minutes = .006).

CONCLUSIONS: Increased gadolinium enhancement was found in the central and lateral anterior eye compartments and the vitreous body with retina in patients with anterior eye compartment disorders 20 and 120 minutes after contrast application, suggesting impairment of the blood-aqueous barrier. In patients with a disorder in the posterior eye compartment, pathologic enhancement indicated disruption of the blood-retinal barrier that allows gadolinium to diffuse into the vitreous body with retina from posterior to anterior, opposite to the known physiologic glymphatic pathway.

AC
:   anterior eye chamber
AEC
:   anterior eye compartment
Gd
:   gadolinium
GLOS
:   gadolinium leakage in ocular structures
PEC
:   posterior eye compartment
SI
:   signal intensity
VB
:   vitreous body with retina

 [1]: /lookup/external-ref?link_type=CLINTRIALGOV&amp;access_num=NCT05035251&amp;atom=%2Fajnr%2F43%2F7%2F1012.atom" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node97888--5" data-node-nid="97888" id="top-node-97888--6694133949" data-pisa="ajnr;43/7/1012" data-pisa-master="ajnr;ajnr.A7552" data-apath="/ajnr/43/7/1012.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
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      <h1 class="highwire-cite-title" id="page-title">Glymphatic System in Ocular Diseases: Evaluation of MRI Findings</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">P. Manava</span>, <span class="highwire-citation-author" data-delta="1">C. Eckrich</span>, <span class="highwire-citation-author" data-delta="2">F. Luciani</span>, <span class="highwire-citation-author" data-delta="3">J. Schmidbauer</span>, <span class="highwire-citation-author" data-delta="4">M.M. Lell</span> and <span class="highwire-citation-author" data-delta="5">K. Detmar</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">July 2022,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">43 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(7) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1012-1017; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A7552 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-97888--6694133949" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">P. Manava </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology and Nuclear Medicine (P.M., C.E., M.M.L., K.D.)</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Institute of Radiology (P.M., M.M.L.), Friedrich-Alexander University, University of Erlangen-Nuremberg, Erlangen, Germany</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=P.%2BManava%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Manava%20P&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AP.%2BManava%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-1766-4650" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for P. Manava</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">C. Eckrich </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology and Nuclear Medicine (P.M., C.E., M.M.L., K.D.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.%2BEckrich%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Eckrich%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AC.%2BEckrich%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-1765-7183" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C. Eckrich</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">F. Luciani </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Ophthalmology and Visual Science (F.L., J.S.), Klinikum Nuernberg, Paracelsus Medical University, Nuernberg, Germany</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=F.%2BLuciani%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Luciani%20F&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AF.%2BLuciani%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">J. Schmidbauer </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Ophthalmology and Visual Science (F.L., J.S.), Klinikum Nuernberg, Paracelsus Medical University, Nuernberg, Germany</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.%2BSchmidbauer%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Schmidbauer%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AJ.%2BSchmidbauer%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">M.M. Lell </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology and Nuclear Medicine (P.M., C.E., M.M.L., K.D.)</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Institute of Radiology (P.M., M.M.L.), Friedrich-Alexander University, University of Erlangen-Nuremberg, Erlangen, Germany</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.M.%2BLell%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Lell%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AM.M.%2BLell%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">K. 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