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Metabolic Alterations Within the Primary Visual Cortex in Early Open-angle Glaucoma Patients

A Proton Magnetic Resonance Spectroscopy Study

Guo, Linying, MD, MS*; Wang, Rong, MD, MS*; Tang, Zuohua, MD, PhD*; Sun, Xinghuai, MD, PhD†,‡,§,∥; Wu, Lingjie, MD, MS; Wang, Jie, MD, PhD; Zhong, Yufeng, MD*,#; Xiao, Zebin, MD, MS*; Zhang, Zhongshuai, PhD**

doi: 10.1097/IJG.0000000000001098
Original Studies

Purpose: To detect changes in metabolites and explore cortical plasticity at the metabolic level within the primary visual cortex through proton magnetic resonance spectroscopy in early open-angle glaucoma (OAG) patients.

Methods: A total of 23 symmetrically bilateral early OAG patients and 21 normal controls (NC) were recruited as the early OAG group and NC group, respectively. All subjects underwent a proton magnetic resonance examination, and then, the N-acetylaspartate (NAA), glutamine-glutamate (Glx), myo-inositol (Ins), choline (Cho), and creatine (Cr) concentrations within the bilateral primary visual cortex were determined. The mean NAA/Cr ratio, mean Cho/Cr ratio, mean Glx/Cr ratio, and mean Ins/Cr ratio of the bilateral sides were compared between early OAG patients and NC using the independent samples t test.

Results: Compared with NC, the mean Glx/Cr ratio (corrected P=0.003) in primary visual cortex was significantly higher, whereas the mean Ins/Cr ratio (corrected P=0.001) was statistically lower in early OAG patients. However, no apparent difference was found in the mean Cho/Cr ratio or mean NAA/Cr ratio between the OAG group and NC group.

Conclusions: Abnormal metabolites were found in our study through proton magnetic resonance spectroscopy and could contribute to cortical plasticity of the primary visual cortex in early OAG patients.

Departments of *Radiology


Ophthalmology and Visual Science, Eye & ENT Hospital of Shanghai Medical School

State Key Laboratory of Medical Neurobiology, Institutes of Brain Science

§Key Laboratory of Myopia, NHFPC

Shanghai Key Laboratory of Visual Impairment and Restoration

#Department of Radiology, Jinshan Hospital of Shanghai Medical School, Fudan University

**Siemens Healthcare Ltd, Shanghai, P.R. China

L.G., R.W., and Z.T. contributed equally.

Supported by the State Key Program of National Natural Science Foundation of China (grant no. 81430007) and the Grant of Science and Technology Commission of Shanghai Municipality (no. 14411962000).

Disclosure: The authors declare no conflict of interest.

Reprints: Zuohua Tang, MD, PhD, Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, 83 Fenyang Road, Shanghai 200031, P.R. China (e-mail:

Received February 12, 2018

Accepted September 7, 2018

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