Tu Yunhai, Huang Pingping, Mao Chuanwan, Liu Xiaozheng, Gao Jianlu
Liaocheng People's Hospital, Cheeloo College of Medicine Shandong University, Liaocheng, China.
The Eye Hospital, Wenzhou Medical University, Wenzhou, China.
Ophthalmic Res. 2022;65(2):171-179. doi: 10.1159/000512755. Epub 2020 Nov 3.
Functional connectivity density (FCD) mapping was used to investigate abnormalities and factors related to brain functional connectivity in cortical regions of patients with dysthyroid optic neuropathy (DON) and to analyze the pathogenesis of DON further.
Patients diagnosed with thyroid-associated opthalmology (TAO) in the Eye Hospital were enrolled. All patients underwent comprehensive eye examinations and best-corrected visual acuity, visual field (VF) test. MRI data collection and analysis were completed in the 2nd Affiliated Hospital of Wenzhou Medical University. The patients were divided into 2 groups: the DON group, with an average VF, mean deviation (MD) of both eyes < -5 dB, and the non-DON group (nDON group), with an average VF MD of both eyes ≥ -2 dB.
A total of 30 TAO patients (14 men, 16 women) with complete data who met the experimental requirements were enrolled. The average age was 48.79 (40-57) years. There were 16 patients in the DON group and 14 patients in the nDON group. No significant differences in age, gender, education level, and the maximum horizontal diameter of either medial rectus muscle were found between the 2 groups. The difference of brain FCD between the 2 groups showed significant abnormal connectivity in the right orbital gyri of the frontal lobe (Frontal_Inf_Orb_R) and the left precuneus in the DON group compared with the nDON group. As demonstrated by decreased FCD values in the right inferior frontal gyrus/orbital part, the relevant brain regions were the left middle temporal gyrus, left precuneus, left middle frontal gyrus, right postcentral gyrus, and brain gyri (excluding the supramarginal gyrus and angular gyrus) below the left parietal bone. The FCD associated with the left precuneus was increased, and the relevant brain areas were the left middle temporal gyrus, right cuneus, superior occipital gyrus, and right fusiform gyrus. A significant correlation was identified between the MD of the binocular VF and brain FCD.
The abnormal FCD in the cortex of DON patients suggests that a central nervous system mechanism may be related to the pathogenesis of the DON.
采用功能连接密度（FCD）图谱研究甲状腺功能异常性视神经病变（DON）患者皮质区域脑功能连接的异常情况及相关因素，进一步分析DON的发病机制。
选取在眼科医院被诊断为甲状腺相关性眼病（TAO）的患者。所有患者均接受全面的眼部检查及最佳矫正视力、视野（VF）检查。MRI数据采集及分析在温州医科大学附属第二医院完成。将患者分为两组：DON组，双眼平均VF、平均偏差（MD）＜-5 dB；非DON组（nDON组），双眼平均VF MD≥-2 dB。
共纳入30例符合实验要求且数据完整的TAO患者（男14例，女16例）。平均年龄为48.79（40 - 57）岁。DON组16例，nDON组14例。两组在年龄、性别、教育程度及内直肌最大水平直径方面无显著差异。两组间脑FCD差异显示，与nDON组相比，DON组额叶右侧眶回（Frontal_Inf_Orb_R）和左侧楔前叶存在显著异常连接。右侧额下回/眶部FCD值降低，相关脑区为左侧颞中回、左侧楔前叶、左侧额中回、右侧中央后回及左侧顶骨下方的脑回（不包括缘上回和角回）。与左侧楔前叶相关的FCD增加，相关脑区为左侧颞中回、右侧楔叶、枕上回及右侧梭状回。双眼VF的MD与脑FCD之间存在显著相关性。
DON患者皮质的FCD异常提示中枢神经系统机制可能与DON的发病机制有关。
