Department of Ophthalmology, Japan Community Health Care Organization, Mishima General Hospital, Mishima, Japan.
Research Team for Neuroimaging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan.
Neurorehabil Neural Repair. 2024 Jun;38(6):437-446. doi: 10.1177/15459683241247536. Epub 2024 Apr 25.
Homonymous hemianopia caused by cerebrovascular disease may improve over time. This study investigated whether functional neuroimaging can predict the prognosis of hemianopia due to cerebral infarction.
We studied 19 patients (10 men and 9 women) with homonymous hemianopia and compared them with 34 healthy subjects (20 men and 14 women). Cerebral glucose metabolism was measured by F-fluorodeoxyglucose positron emission tomography (FDG-PET), 1 to 6 months after the onset. Bilateral regions of interest (ROIs) were selected from the posterior and, anterior striate cortices, extrastriate cortex, and thalamus. Furthermore, semi-quantitative data on cerebral glucose metabolism were obtained for ROIs and compared with the data obtained for homologous regions in the contralateral hemisphere by calculating the ipsilateral/contralateral (I/C) ratio.
The I/C ratio for the cerebral glucose metabolism in the posterior striate cortex was high (>0.750) in 8 patients, and the central visual field of these patients improved or showed macular sparing. The I/C ratio for cerebral glucose metabolism in the anterior striate cortex was high (>0.830) in 7 patients, and the peripheral visual field of these patients improved. However, no improvement was observed in 9 patients with a low I/C ratio for cerebral glucose metabolism in both the posterior and anterior striate cortices.
Measurement of cerebral glucose metabolism in the striate cortex is useful for estimating visual field prognosis. Furthermore, FDG-PET is useful in predicting the prognosis of hemianopia.
由脑血管病引起的同向偏盲可能会随着时间的推移而改善。本研究旨在探讨功能神经影像学是否可以预测脑梗死所致偏盲的预后。
我们研究了 19 名（10 名男性，9 名女性）同向偏盲患者，并与 34 名健康受试者（20 名男性，14 名女性）进行了比较。在发病后 1 至 6 个月，通过 F-氟代脱氧葡萄糖正电子发射断层扫描（FDG-PET）测量大脑葡萄糖代谢。从后纹状体和前纹状体皮质、外纹状体皮质和丘脑选择双侧感兴趣区（ROI）。此外，获得 ROI 的脑葡萄糖代谢半定量数据，并通过计算同侧/对侧（I/C）比与对侧半球同源区的数据进行比较。
8 名患者的后纹状体皮质脑葡萄糖代谢 I/C 比值较高（>0.750），这些患者的中央视野得到改善或出现黄斑保留。7 名患者的前纹状体皮质脑葡萄糖代谢 I/C 比值较高（>0.830），这些患者的外周视野得到改善。然而，9 名患者的后纹状体和前纹状体皮质脑葡萄糖代谢 I/C 比值均较低，未观察到改善。
纹状体皮质脑葡萄糖代谢的测量有助于估计视野预后。此外，FDG-PET 有助于预测偏盲的预后。
