Sheng Yifei, Yang Xiaojing, Qiu Jianfeng, Lu Weizhao
Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Taian, China.
Department of Obstetrics, The Affiliated Taian City Central Hospital of Qingdao University, Taian, China.
Clin Exp Ophthalmol. 2025 Jun 18. doi: 10.1111/ceo.14574.
Primary open-angle glaucoma (POAG) has been increasingly viewed as a neurodegenerative condition, yet whether there are changes in the brain glymphatic function in patients with POAG has remained unclear. This study aimed to investigate the changes of glymphatic function in POAG based on multi-modal magnetic resonance imaging (MRI).
Thirty-eight patients with POAG and 25 age- and sex-matched healthy controls underwent structural MRI and functional MRI scans to assess abnormalities in cerebrospinal fluid circulation by choroid plexus (CP) volume and cortical glymphatic system clearance function by blood-oxygen-level-dependent signals and cerebrospinal fluid signals (BOLD-CSF) coupling. Comparisons of CP volume and BOLD-CSF coupling were conducted between the control and POAG groups. Correlation analysis was performed to assess the association between the function of the glymphatic system and clinical scales of POAG.
The CP volume and the ratio of CP volume to intracranial volume was significantly higher in patients with POAG compared to healthy controls (pFDR < 0.001). Additionally, the strength of BOLD-CSF coupling in the middle and posterior cortical regions were significantly weaker in POAG patients compared to controls (pFDR < 0.05). Negative correlations of glymphatic functional indicators with the thickness of the retinal nerve fibre layer (RNFL) (r from -0.427 to -0.351, p from 0.033 to 0.045) were observed, and positive correlations between BOLD-CSF of the posterior region and intraocular pressure were found (r = 0.375, p = 0.033).
POAG patients experienced impaired glymphatic function, which may be related to the pathophysiology of the disease.
原发性开角型青光眼（POAG）越来越被视为一种神经退行性疾病，然而POAG患者的脑类淋巴功能是否存在变化仍不清楚。本研究旨在基于多模态磁共振成像（MRI）研究POAG患者类淋巴功能的变化。
38例POAG患者和25例年龄及性别匹配的健康对照者接受了结构MRI和功能MRI扫描，以通过脉络丛（CP）体积评估脑脊液循环异常，并通过血氧水平依赖信号和脑脊液信号（BOLD-CSF）耦合评估皮质类淋巴系统清除功能。对对照组和POAG组的CP体积和BOLD-CSF耦合进行比较。进行相关性分析以评估类淋巴系统功能与POAG临床量表之间的关联。
与健康对照相比，POAG患者的CP体积以及CP体积与颅内体积之比显著更高（pFDR < 0.001）。此外，与对照组相比，POAG患者中后皮质区域的BOLD-CSF耦合强度显著较弱（pFDR < 0.05）。观察到类淋巴功能指标与视网膜神经纤维层（RNFL）厚度呈负相关（r为-0.427至-0.351，p为0.033至0.045），并且发现后区域BOLD-CSF与眼压之间呈正相关（r = 0.375，p = 0.033）。
POAG患者存在类淋巴功能受损，这可能与该疾病的病理生理学有关。
