AIM:To study the microscopic changes of visual pathology in ocular hypertension(OHT)patients using magnetic resonance diffusion tensor imaging(DTI)technology and three-dimensional optical coherence tomography(3D-OCT)technology.

METHODS: Twenty-six patients with 52 eyes diagnosed as OHT in our hospital from January 2016 to October 2019 were included in the case group. Twenty-six healthy patients who were matched with age and gender in the same period were included in the control group. All eyes were examined for best corrected visual acuity, central corneal thickness(CCT), non-contact intraocular pressure, while all eyes were examined by optical disc 3D-OCT combined optic nerve, optic chiasma, optic tract, and optic radiation DTI. Compared the differences between the two groups.

RESULTS: The CCT of the OHT group was thinner than that of the normal control group; the intraocular pressure was higher than that of the normal control group, and the difference was statistically significant(all P<0.05). The optic disc area of the OHT group was larger than that of the normal control group, while the optic cup area was increased, and the average CP-RNFL thickness and nasal CP-RNFL thickness were thinner than those of the normal control group(all P<0.05). There was no statistic difference in the superior, inferior and temporal CP-RNFL(all P>0.05). The FA values of bilateral optic nerve and optic radiation decreased compared with the normal control group, and the difference was statistically significant(all P<0.05). There was no significant difference of optic chiasma, bilateral visual tract's FA value, and bilateral visual pathway ADC value between the two groups(all P>0.05).

CONCLUSION: 3D-OCT can obtain the thickness of CP-RNFL and the parameters of optic disc, DTI can reconstruct the intracranial visual pathway and can detect the microscopic changes of optic nerve, optic chiasma, optic tract, and optic radiation at early stage. Combining 3D-OCT and DTI technology can effectively understand the microscopic changes of the visual pathway and provide new models for clinical research of ocular hypertension patients.