Gray matter volume alterations in patients with strabismus and amblyopia: voxel-based morphometry study.

This study proposes the use of the voxel-based morphometry (VBM) technique to investigate structural alterations of the cerebral cortex in patients with strabismus and amblyopia (SA). Sixteen patients with SA and sixteen healthy controls (HCs) underwent magnetic resonance imaging. Original whole brain images were analyzed using the VBM method. Pearson correlation analysis was performed to evaluate the relationship between mean gray matter volume (GMV) and clinical manifestations. Receiver operating characteristic (ROC) curve analysis was applied to classify the mean GMV values of the SA group and HCs. Compared with the HCs, GMV values in the SA group showed a significant difference in the right superior temporal gyrus, posterior and anterior lobes of the cerebellum, bilateral parahippocampal gyrus, and left anterior cingulate cortex. The mean GMV value in the right superior temporal gyrus, posterior and anterior lobes of the cerebellum, and bilateral parahippocampal gyrus were negatively correlated with the angle of strabismus. The ROC curve analysis of each cerebral region confirmed the accuracy of the area under the curve. Patients with SA have reduced GMV values in some brain regions. These findings might help to reveal the potential pathogenesis of SA and its relationship with the atrophy of specific regions of the brain.

Altered brain network centrality in patients with retinal vein occlusion: a resting-state fMRI study.

AIM: To explore the intrinsic brain activity variations in retinal vein occlusion (RVO) subjects by using the voxel-wise degree centrality (DC) technique. METHODS: Twenty-one subjects with RVO and twenty-one healthy controls (HCs) were enlisted and underwent the resting-state functional magnetic resonance imaging (rs-fMRI) examination. The spontaneous cerebrum activity variations were inspected using the DC technology. The receiver operating characteristic (ROC) curve was implemented to distinguish the DC values of RVOs from HCs. The relationships between DC signal of definite regions of interest and the clinical characteristics in RVO group were evaluated by Pearson's correlation analysis. RESULTS: RVOs showed notably higher DC signals in right superior parietal lobule, middle frontal gyrus and left precuneus, but decreased DC signals in left middle temporal gyrus and bilateral anterior cingulated (BAC) when comparing with HCs. The mean DC value of RVOs in the BAC were negatively correlated with the anxiety and depression scale. CONCLUSION: RVO is associated aberrant intrinsic brain activity patterns in several brain areas including pain-related as well as visual-related regions, which might assist to reveal the latent neural mechanisms.

Functional connectivity density alterations in middle-age retinal detachment patients.

OBJECTIVE: Middle-age patients with retinal detachment (RD) exhibit a loss of visual information, and previous studies of functional magnetic resonance imaging (fMRI) have demonstrated abnormal spontaneous activity in the RD brain. Therefore, this study assessed changes in local functional connectivity density (lFCD) and long-range functional connectivity density (longFCD) in middle-age RD patients during resting-state FC. METHODS: In total, 32 middle-age patients with RD (18 men and 14 women), and 32 age-, sex-, and education-matched normal controls (NCs) (18 men and 14 women) were recruited and underwent functional magnetic resonance examination in the resting state. Two-sample t test was performed to compare lFCD and longFCD between groups. Receiver operating characteristic (ROC) curves were generated to distinguish middle-age RD patients from NCs. RESULTS: Compared with NCs, middle-age RD patients demonstrated increased lFCD values in the right inferior temporal gyrus, and increased longFCD values in the bilateral inferior frontal gyri, left superior and middle frontal gyrus, bilateral inferior temporal gyri, and left cerebellum posterior lobe. Middle-age RD patient exhibited decreased lFCD values in the left cuneus, right lingual gyrus, and left middle frontal gyrus. They also had lower longFCD values in the left lingual gyrus and left inferior occipital gyrus. ROC curve analysis showed excellent accuracy of the specific areas under the curve. CONCLUSION: Our results reveal that middle-age RD patients exhibited variations of binarized lFCD and longFCD in specific brain areas, which provides insight into the pathological mechanism of RD patients with acute visual loss.

Surgical correction of recurrent epiblepharon in Chinese children using modified skin re-draping epicanthoplasty.

AIM: To evaluate the clinical efficacy of the modified skin re-draping epicanthoplasty procedure for correction of recurrent lower lid epiblepharon in Chinese children. METHODS: From 2016 to 2018, 18 children (10 males and 8 females, average age 6.2±1.7y; 30 eyes) with recurrent epiblepharon who attended Beijing Children's Hospital were included in the study. All the children had undergone lower eyelid surgery for epiblepharon. Surgical design included using an additional incision along the upper palpebral margin, to avoid vertical scarring on the upper lid. The re-draping method was used to correct recurrent epiblepharon. Follow-up ranged from 3 to 24mo. Postoperative surgical outcomes, complications, and subjective satisfaction were evaluated. RESULTS: Complete correction of cilia touching the cornea was observed in all patients during an average follow-up of 7.1mo. No "dog ears" or obvious scars were formed after surgery. All parents were satisfied with the cosmetic results and none complained. Mean astigmatism decreased from 2.39±0.79 diopter (D) preoperatively to 2.19±0.79 D at 6mo after surgery; however, the difference was not significant. Best-corrected visual acuity improved, although the change in mean visual acuity was not significant. No recurrence occurred during the follow-up period. CONCLUSION: This surgical modified skin re-draping technique is effective and highly satisfactory for correction of recurrent epiblepharon. The approach is characterized by a simple design, a straightforward procedure, inconspicuous scarring, and good postoperative appearance.

Apolipoprotein A1 and Low-Density Lipoprotein as Risk Factors for Intraocular Metastases in Postmenopausal Breast Cancer.

BACKGROUND: The outcomes of patients with postmenopausal breast cancer(PBC) can be improved through the early detection of intraocular metastases(IOMs). In this study, we investigated patients with PBC, and compared those with IOMs with those with non-intraocular metastases(NIOMs) in terms of blood lipid levels, and then differentiated the risk factors associated with IOMs. METHODS: Student's t-test and a chi-square test were used to discriminate between the IOMs and NIOMs groups. After establishing a Poisson regression model to analyze risk factors, we plotted receiver operating characteristic curves(ROC) to assess the quality of risk factors predicting IOMs. RESULTS: The incidence of IOMs in PBC was 1.16%. There was no significant difference in terms of histopathology between the 2 groups. The levels of total cholesterol (TC), apolipoprotein A1(APOA1) and low-density lipoprotein(LDL) in IOMs were significantly lower than in NIOMs groups. Poisson regression suggested that low levels of APOA1 and LDL were risk factors for IOMs (P = 0.002 and P < 0.001, respectively). ROC curve analysis demonstrated that the cut-off values of APOA1 and LDL were 1.025 g/L and 2.415 mmol/L. The highest prediction accuracy for IOMs involved the combination of APOA1 and LDL (AUC = 0.881, P < 0.001). CONCLUSION: Our research demonstrates that low levels of APOA1 and LDL efficiently predict IOMs in PBC as risk factors, and the combination of APOA1 and LDL was more predictive than single factors.

Altered brain network centrality in middle-aged patients with retinitis pigmentosa: A resting-state functional magnetic resonance imaging study.

OBJECTIVE: The purpose of this study is to explore the underlying functional network brain activity changes of patients in middle-aged with retinitis pigmentosa (RP) and the relationships with clinical features such as depression scale and visual functioning using voxel-wise degree centrality (DC) method. METHODS: We included 16 patients with RP (11 men, 5 women) and 16 healthy controls (HCs; 11 men, 5 women). Participants were matched in terms of age, weight, gender and handedness (age and weight between the two groups were compared using independent sample t-tests, gender and handedness were compared using chi-square test). We use the voxel-wise DC method to assess spontaneous brain activity. Receiver operating characteristic (ROC) curve analysis was performed to distinguish between RP patients and HCs. Correlation analysis was used to examine the relationships between mean DC values in various brain regions and clinical features (such as depression scale and visual functioning) in RP patients. RESULTS: Compared with HCs, the DC values of patients with RP were reduced in the right medial frontal gyrus, bilateral cuneus, bilateral precuneus, and bilateral superior frontal gyrus, and increased in the right cerebellum posterior lobe, left inferior temporal gyrus, and right fusiform gyrus. The mean DC values in the bilateral cuneus negatively correlated with the depression scale, and those in the bilateral precuneus positively correlated with the Visual Functioning Questionnaire-25. CONCLUSIONS: Middle-aged patients with RP exhibit abnormal brain network activity in various brain regions, and this may underlie the pathological mechanism of RP.

Altered regional homogeneity in patients with diabetic vitreous hemorrhage.

BACKGROUND: Diabetic vitreous hemorrhage (DVH) is a common complication of diabetes. While the diagnostic methods nowadays only concentrate on the eye injury in DVH patients, whether DVH leads to abnormalities of other visual systems, including the eye, the visual cortex, and other brain regions, remains unknown. AIM: To explore the potential changes of brain activity in DVH using regional homogeneity (ReHo) and their relationships with clinical features. METHODS: Thirty-one DVH patients and 31 matched healthy controls (HCs) were recruited. All subjects were examined by resting-state functional magnetic resonance imaging. The neural homogeneity in the brain region was estimated by ReHo method. Pearson correlation analysis was used to evaluate the relationships between average ReHo values and clinical manifestations in DVH patients. RESULTS: Compared with HCs, the ReHo values in the bilateral cerebellar posterior lobes, right superior (RS)/middle occipital gyrus (MOG), and bilateral superior frontal gyrus were significantly increased. In contrast, in the right insula, bilateral medial frontal gyri, and right middle frontal gyrus, the ReHo values were significantly decreased. Furthermore, we found that best-corrected visual acuity of the contralateral eye in patients with DVH presented a positive correlation with the mean ReHo value of the RS/MOG. We also found that depression score of the DVH group presented a negative correlation with the mean ReHo values of the right insula, bilateral medial frontal gyrus, and right middle frontal gyrus. CONCLUSION: We found that DVH may cause dysfunction in multiple brain areas, which may benefit the exploration of pathologic mechanisms in DVH patients.

Resting-State Functional MRI Study Demonstrates That the Density of Functional Connectivity Density Mapping Changes in Patients with Acute Eye Pain.

PURPOSE: Brain function in patients with acute eye pain (EP) has not been extensively studied. An understanding of the alterations in short-range functional connectivity density (shortFCD) and long-range functional connectivity density (longFCD) in patients with EP remains elusive. The aim of the present study was to compare the functional connectivity density (FCD) between patients with EP and healthy controls (HCs) using resting-state functional connectivity. METHODS: A total of 40 patients with EP (26 males and 14 females) and 40 HCs (26 males and 14 females) of similar age underwent functional magnetic resonance (MR) examination at the resting state. The shortFCD and longFCD values were compared using the one-sample t-test. The differences between patients with EP and the HCs were evaluated using receiver operating characteristic (ROC) curves. RESULTS: In the patients with EP, significantly reduced shortFCD values were observed in the left posterior lobe of the cerebellum, right inferior parietal lobule, and left anterior lobe of the cerebellum, and significantly reduced longFCD values were observed in both the left and right posterior lobe of the cerebellum. Significantly increased shortFCD values were also observed in both superior frontal gyri (Brodmann area 6), and increased longFCD values were observed in the left inferior temporal gyrus and left superior frontal gyri (Brodmann area 11). Compared with the HCs, less reduction was noted among the shortFCD values of patients with EP in the right posterior lobe of the cerebellum, right supramarginal gyrus, left middle temporal gyrus, bilateral superior frontal gyri, and bilateral caudate nuclei. CONCLUSION: EP patients shown variation of binarized shortFCD and long FCD in brain areas including premotor cortex, ventral cortical visual system, newest part of the cerebellum, cerebellum control unconscious proprioception, inhibition of involuntary movement, somatosensory association cortex, nucleus involving reward system and ventral cortical visual system which might provide an explanation of brain functional compensation for chronic eye pain and visual impairment in the EP patients.

Altered spontaneous brain activity patterns in diabetic patients with vitreous hemorrhage using amplitude of low­frequency fluctuation: A resting­state fMRI study.

The aim of the present study was to assess the local character of spontaneous brain activity in type­2 diabetic patients with vitreous hemorrhage (VH) and its relationship with clinical features via the amplitude of low­frequency fluctuations (ALFF) method. A total of 31 subjects (15 females and 16 males) with type­2 diabetic VH and 31 normal controls (NCs) with similar characteristics (sex, age and educational level) were recruited in the present study. All subjects underwent resting­state functional magnetic resonance imaging scans. The local character of spontaneous brain activity was assessed using the ALFF method. The difference between the type­2 diabetic patients with VH and NCs was determined using receiver operating characteristic curves. Pearson's correlation analysis was applied to evaluate the relationship between the mean ALFF values of specific brain areas and related clinical manifestations in type­2 diabetic patients with VH. The ALFF values of type­2 diabetic patients with VH were significantly increased in the right and left cerebellum posterior lobes, left cerebellum posterior lobe/left lingual gyrus and bilateral superior frontal gyrus/left postcentral gyrus, compared with those obtained for NCs (P<0.05). By contrast, these values were significantly decreased in the left and right middle frontal gyri, right medial frontal gyrus/left anterior cingulate, right inferior frontal gyrus, right superior frontal gyrus, right middle frontal gyrus, right superior frontal gyrus/middle frontal gyrus and left middle frontal gyrus of the former group compared with the NCs (P<0.05). Nevertheless, there was no significant association between the mean ALFF values and clinical characteristics in different brain areas. Unusual spontaneous activity occurred in multiple brain areas, which may suggest the neuropathological mechanisms of visual impairment in type­2 diabetic patients with VH.

Altered Intrinsic Functional Connectivity of the Primary Visual Cortex in Patients with Neovascular Glaucoma: A Resting-State Functional Magnetic Resonance Imaging Study.

PURPOSE: The purpose was to investigate the differences in spontaneous functional connectivity (FC) of the primary visual cortex (V1) between patients with neovascular glaucoma (NVG) and healthy controls (HCs) using resting-state functional magnetic resonance imaging data. METHODS: A total of 18 patients with NVG (nine males and nine females) and 18 HCs with similar age and sex background were enrolled in the study and inspected using resting-state functional magnetic resonance imaging. The differences in FC of the V1 between the two groups were compared using the independent samples t-test. We used the receiver operating characteristic (ROC) curve to compare the average FC values of NVG subjects with those of HCs. RESULTS: FC in the left V1 and right fusiform gyrus, bilateral cuneus, and left precuneus was significantly decreased in the NVG group compared with that reported in the HC group. Meanwhile, patients with NVG presented increased FC between the right V1 and bilateral middle frontal gyrus. However, they also exhibited declining FC between the right V1 and left precuneus, and bilateral cuneus. The ROC curve analysis of each brain region indicated that the accuracy of the area under the ROC curves regarding NVG was excellent. CONCLUSION: NVG involves aberrant FC in the V1 in different brain areas, including the visual-related and cognitive-related regions. These findings may assist in unveiling the underlying neural mechanisms of impaired visual function in NVG.

Carbohydrate antigen-125, calcium, and hemoglobin as predictive clinical indicator for ocular metastasis in male liver cancer patients.

Background Primary liver cancer (PLC) is a common type of cancer among men worldwide. Little is known regarding the relationship of liver cancer with ocular metastasis (OM). Drinking has been also reported to be related not only to the occurrence of liver cancer but also to the causes of some ocular lesions. Purpose A diagnostic standard for the levels of serum biomarkers associated with OM derived from liver cancer in men is urgently needed. Material and methods We examined the association between OM in liver cancer and its serum biomarkers. A total of 1254 male patients with liver cancer were recruited in this retrospective study between July 2002 and December 2012. We assessed the relationship between drinking preference and OM in male patients with liver cancer, and aimed to identify an independent prognostic factor or establish a quantitative indicator for OM. Results By assessing the potential indicators, carbohydrate antigen-125 (CA-125), calcium, and hemoglobin (Hb) were found to be most valuable in the diagnosis of OM in male patients with liver cancer. Conclusion CA-125, calcium, and Hb are independent risk factors of OM in patients with liver cancer who consume alcohol.

Netrin-1 promotes epithelium repair in corneal injury.

AIM: To explore netrin-1 functions on corneal epithelium in vitro and in vivo. METHODS: In vitro the human corneal epithelial (HCE) cells were treated with serum free DMEM-F12 basic media containing 0, 50, 100, 200, 300, 500, 800, and 1000 ng/mL of netrin-1, respectively. The cells viability was detected by cell counting kit-8 (CCK-8). The wound-healing assay was applied to assess the migration proficiency of HCE cells. Flow cytometry was used to analyze the cell-cycle distribution and apoptosis. In vivo, normal c57 (6wk) mice were demarcated with a trephine in the middle of the cornea to produce a 3-mm circular wound. Mice corneas were inflicted no epithelium with a 3-mm wound displayed, but remained the limbal epithelium intact. A blunt scalpel blade was used to remove the corneal epithelian cells, followed by topical netrin-1 application (200 ng/mL), and the group treated by PBS as control. The treated group was injected netrin-1 into the normal c57 mice inferior subconjunctival 4h before trauma. Mouse corneal inflammation and neovascularization were observed under slit lamp microscope. The apoptosis of corneal cells was determined by TUNEL staining. RESLUTS: A concentration of 200 ng/mL netrin-1 enhanced 25% of the HCE viability. The relative migration rates were 76.3% and 100% in control and netrin-1 treated group after cultured 72h. Treated with netrin-1 (200 ng/mL) decreased the apoptosis of HCE cells, as well as decreased their percentage from 19.3%±0.57% to 12.7%±0.42% of the total. The remaining wound area was 1.22 mm2 in control group but 0.22 mm2 in the netrin-1 treated group. Exogenous Netrin-1 inhibits apoptosis of corneal epithelial cells of c57 mice. TUNEL-positive cells at the epithelial layer of the corneas of the control and netrin-1 treated c57 mice at 24h after wounding were 43.3% and 16.7% respectively. CONCLUSION: Netrin-1 can reduce HCE apoptosis as well as promote its proliferation and migration. Topical application of netrin-1 promotes the injuryed cornea epithelial wound repair and inhibits apoptosis of corneal epithelial cells. These findings may offer potential therapies to repair the defects of corneal epithelial based on netrin-1.

Altered spontaneous brain activity pattern in patients with ophthalmectomy: an resting-state fMRI study.

AIM: To use the voxel-wise degree centrality (DC) method to explore the underlying functional network brain-activity in patients with ophthalmectomy. METHODS: A total of 32 ophthalmic surgery patients (10 women and 22 men), and 32 healthy subjects (10 women and 22 men) highly matched in gender, age, and the same operation method. Everyone experienced a resting-state functional magnetic resonance imaging scan. The spontaneous brain activity could be assessed by DC. Correlation analysis was used to explore the relationships between the average DC signal values and behavior performance in different regions. Receiver operating characteristic (ROC) curve analysis was utilized to differentiate between ophthalmectomy patients and healthy controls (HCs). RESULTS: Compared with HCs, ophthalmectomy patients had greatly reduced DC values in left lingual gyrus, bilateral lingual lobe, left cingulate gyrus, and increased DC values of left cerebellum posterior lobe, left middle frontal gyrus1, right supramarginal gyrus, left middle frontal gyrus2, right middle frontal gyrus. However, we did not find that there was a correlation between the average DC values from various brain regions and clinical manifestations. CONCLUSION: Dysfunction may be caused by ophthalmectomy in lots of cerebral areas, which may show the potential pathological mechanism of ophthalmectomy and it is beneficial to clinical diagnosis.

CEA as a risk factor in predicting ocular metastasis from colorectal cancer.

OBJECTIVE: Colorectal, closely following pulmonary and breast, is the third predilection site of cancer that lead to death all over the world. Ocular metastasis (OM) of colorectal cancer (CRC) is becoming increasingly common and presents a poor prognosis. In this study, we detected some recognized tumor biomarkers and tried to differentiate the discrepancy between CRC patients with and without OM in order to clarify the risk factor for OM in patients with colorectal cancer. METHODS: 1735 patients with colorectal cancer in total from August 2005 to August 2017 were involved in this study. Nonparametric rank sum test and Chi-square test were applied to prescribe whether there were significant differences between OM group and non-ocular metastasis (NOM) group. And binary logistic regression analysis was used to determine the risk factor. Then, we used receiver operating curve (ROC) to assess the diagnostic value of OM in CRC patients. RESULTS: The incidence of OM in CRC patients was 1.12%. No significant differences were found in gender, age, histopathological type, tumor classification and tumor differentiation between OM group and NOM group. Nonparametric rank sum test approved that OM group had higher serum CEA level compared with NOM group. Binary logistic regression indicated that CEA was a risk factor for OM in colorectal cancer patients (p<0.001). ROC curve showed that AUC of CEA was 0.877. The cutoff value of CEA was 12.45 ng/ml, whose sensitivity is 1.000 and its specificity is 0.877. CONCLUSION: Based on our study, CEA was a risk factor of ocular metastasis in colorectal cancer patients.

Diagnostic value of CA-153 and CYFRA 21-1 in predicting intraocular metastasis in patients with metastatic lung cancer.

Lung cancer is prone to metastasis to various organs. Although intraocular metastasis (IOM) occurs at a later stage than metastasis to other organs, it often adversely affects the quality of life and suggests a poor prognosis. In this study, we selected 1608 patients with lung cancer who had metastasis to at least one site and explored clinical differences between those with IOM and non-IOM (NIOM). An independent t test and chi-squared test were used to analyze the clinical features of the patients. The statistically significant parameters were analyzed by binary logistic regression to determine the risk factors for IOM. A receiver operating characteristic curve was constructed to assess their diagnostic value in IOM. The results showed that no significant differences were noted in age, gender, and pathological type between the IOM and NIOM groups. However, the IOM group had higher levels of alpha-fetoprotein, carcinoembryonic antigen, cancer antigen (CA)-125, CA-153, cytokeratin fragment 19 (CYFRA 21-1), and total prostate-specific antigen, compared with the NIOM group. Binary logistic regression indicated that CA-153 and CYFRA 21-1 were risk factors for IOM in patients with MLC (P < 0.05). Area under the curve of CA-153, CYFRA 21-1 and their combination were 0.791, 0.860, and 0.872 respectively. The cutoff values for CA-153 and CYFRA 21-1 were 22.2 U/mL and 6.785 ng/mL. In conclusion, both CA-153 and CYFRA 21-1 were independent risk factors for IOM in patients with metastatic lung cancer (MLC), whereas the combination of CA-153 and CYFRA 21-1 assessment yields the most value in the detection of IOM in patients with MLC.

The Cerebellum Posterior Lobe Associates with the Exophthalmos of Primary Hyperthyroidism: A Resting-State fMRI Study.

BACKGROUND: Exophthalmos occurs in patients with primary hyperthyroidism. There were few studies about the changes of brain functional networks of patients with exophthalmos of primary hyperthyroidism (EOPH). However, differences in spontaneous brain activity in patients with EOPH remain unclear. OBJECTIVE: This study explored alterations in the brain functional networks of patients with EOPH using a voxel-wise degree centrality (DC) method. METHODS: A total of 20 patients with EOPH (8 men and 12 women) were enrolled. In addition, 20 patients with primary hyperthyroidism without exophthalmos, matched in age, sex, and education status, were enrolled as a control group. The Hospital Anxiety and Depression Scale was used to assess the anxiety and depression status of participants. All participants were examined using resting-state functional MRI. Changes in spontaneous brain activity were investigated using the DC method. To distinguish between the DC values of the patients with EOPH and those of the control group, we analyzed the receiver operating characteristic (ROC) curve. The interrelationships between the DC values and clinical variables in the patients with EOPH were evaluated using Pearson's correlation coefficient. RESULTS: Patients with EOPH exhibited notably lower DC values in the cerebellum posterior lobe than the control group. In addition, there were negative correlations between the anxiety scores (AS) and the depression scores (DS) and DC values of the cerebellum posterior lobe. The ROC curve analysis of the cerebellum posterior lobe demonstrated that the area under the curve method had a high diagnostic accuracy. CONCLUSIONS: Our study was the first, to our knowledge, to explore changes in the brains of patients with EOPH using the DC method. The DC value was significantly different in the cerebellum posterior lobe in patients with EOPH, indicating that the cerebellum posterior lobe is associated with EOPH.

Central network changes in patients with advanced monocular blindness: A voxel-based morphometric study.

OBJECTIVE: To study the changes in gray matter volume (GMV) in patients with advanced monocular blindness (MB) using voxel-based morphometry (VBM). METHODS: Thirty-one patients with advanced MB (25 males and six females) and 31 normal controls (25 males and six females) were enrolled. The t test was applied to determine the differences in GMV, white matter volume (WMV), and volume of cerebrospinal fluid in different regions of the brain. The local characteristics of spontaneous concentrations of brain tissue were evaluated by the VBM method. The effects of blindness duration on differences in the GMV were evaluated by correlation and regression analyses. RESULTS: Compared with the control group, the GMV was decreased in the upper right margin, bilateral insular cortex, right cingulate gyrus, left occipital gyrus, and right suboccipital lobe, and negatively correlated with blindness duration in the upper right posterior margin, bilateral insular cortex, and right cingulate cortex. CONCLUSIONS: We found that patients with MB showed abnormal WMV and GMV, as evidenced by local changes in the brain. In addition, reduced GMV in specific parts of the brain was associated with the duration of blindness, which may indicate neuropathological mechanisms of visual loss in patients with MB.

The predictive potential of altered spontaneous brain activity patterns in diabetic retinopathy and nephropathy.

OBJECTIVE: The amplitude of low-frequency fluctuation (ALFF) fMRI technique was used to study the changes of spontaneous brain activity in patients with diabetic retinopathy and nephropathy (DRN), and to explore the application of ALFF technique in the potential prediction and the targeted prevention of diabetic microangiopathy. METHODS: Nineteen patients with diabetic retinopathy and nephropathy and 19 healthy controls (HCs) were matched for age and gender. Spontaneous cerebral activity variations were investigated using the ALFF technique. The average ALFF values of the DRN patients and the HCs were classified utilizing receiver operating characteristic (ROC) curves. RESULTS: In contrast to the results in the HCs, the patients with DRN had significantly higher ALFF values in the cerebellum (bilaterally in the posterior and anterior lobes) and the left inferior temporal gyrus, but the ALFF values of the bilateral medial frontal gyrus, right superior temporal gyrus, right middle frontal gyrus, left middle/inferior frontal gyrus, bilateral precuneus, and left inferior parietal lobule were lower. ROC curve analysis of each brain region showed the accuracy of AUC was excellent. However, the mean ALFF values in the different regions did not correlate with clinical performance. The subjects showed abnormal neuronal synchronization in many areas of the brain, which is consistent with cognitive and visual functional deficits. CONCLUSION: Abnormal spontaneous activity was detected in many areas of the brain, which may provide useful information for understanding the pathology of DRN. Abnormal ALFF values of these brain regions may be of predictive value in the development of early DRN and be a targeted intervention indicator for individualized treatment of diabetic microvascular diseases.