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©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
Altered regional homogeneity in patients with diabetic vitreous hemorrhage
Yu-Qing Zhang, Fei-Yin Zhu, Li-Ying Tang, Biao Li, Pei-Wen Zhu, Wen-Qing Shi, Qi Lin, You-Lan Min, Yi Shao, Qiong Zhou
Yu-Qing Zhang, Fei-Yin Zhu, Li-Ying Tang, Biao Li, Pei-Wen Zhu, Wen-Qing Shi, Qi Lin, You-Lan Min, Yi Shao, Qiong Zhou, Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
Yu-Qing Zhang, Fei-Yin Zhu, Li-Ying Tang, Biao Li, Pei-Wen Zhu, Wen-Qing Shi, Qi Lin, You-Lan Min, Yi Shao, Qiong Zhou, Department of Ophthalmology, Jiangxi Province Ocular Disease Clinical Research Center, Nanchang 330006, Jiangxi Province, China
Li-Ying Tang, Department of Ophthalmology, Xiang’an Hospital of Xiamen University, Xiamen 361101, Fujian Province, China
Li-Ying Tang, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen 361102, Fujian Province, China
Li-Ying Tang, Department of Ophthalmology, Eye Institute of Xiamen University, Xiamen 361102, Fujian Province, China
Author contributions: Zhang YQ was involved in the data curation and writing of the original draft; Zhu FT performed the data curation and formal analysis, and participated in the writing and editing of the manuscript; Tang LY was involved in the data curation, and writing, review, and editing of the manuscript; Li B took part in the data curation and supervision of the study; Zhu PW was involved in the study conceptualization and methodology design; Shi WQ was involved in data validation and visualization; Lin Q participated in the methodology design and data visualization; Min LY was involved in methodology design and data validation; Shao Y and Zhou Q was involved in the study conceptualization, data curation, funding acquisition, and project administration; all authors have read and approved the final manuscript.
Institutional review board statement: The study methods and protocols were approved by the Medical Ethics Committee of the First Affiliated Hospital of Nanchang University (Ethical approval number: 2014022), and followed the principles of the Declaration of Helsinki. All subjects were notified of the objectives and content of the study and latent risks, and then provided written informed consent to participate.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: This is not an industry supported study. The authors report no conflicts of interest in this work.
Data sharing statement: The datasets used and/or analyzed during the present study are available from the corresponding author on reasonable request.
CONSORT 2010 statement: The manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Qiong Zhou, MD, Director, Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, No. 17 Yongwai Main Street, Nanchang 330006, Jiangxi Province, China. qiongz-ms@126.com
Received: February 21, 2020
Peer-review started: February 21, 2020
First decision: April 22, 2020
Revised: June 11, 2020
Accepted: September 27, 2020
Article in press: September 27, 2020
Published online: November 15, 2020
ARTICLE HIGHLIGHTS
Research background
Diabetic vitreous hemorrhage (DVH) is a common complication of diabetes. However, there are few studies that have focused on synchronous neural activities in DVH patients. Our study is the first to use the ReHo method to evaluate the synchronous neural activity changes in the brain of DVH patients.
Research motivation
The diagnostic methods nowadays only concentrate on the eye injury in vitreous hemorrhage (VH) patients, and whether VH leads to abnormalities of other visual systems, including the eye, the visual cortex, and other brain regions, remains unknown. In this study, we investigated the underlying regional homogeneity (ReHo) of brain-activity abnormalities in patients with DVH and their relationship with clinical features. Our study may contribute to understanding altered neural mechanisms present in patients with DVH.
Research objectives
To investigate the underlying ReHo of brain-activity abnormalities in patients with DVH and their relationship with behavioral performance. Our findings might provide useful information for exploration of neural mechanisms in DVH patients.
Research methods
Thirty-one DVH patients and 31 matched healthy controls 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.
Research results
We found that DVH may cause dysfunction in multiple brain areas like bilateral cerebellar posterior lobes, right superior/middle occipital gyrus, bilateral superior frontal gyrus, right insula, bilateral medial frontal gyri, and right middle frontal gyrus. And DVH may be associated with depression that occurred in patients. There are some limitations to our study, such as the relatively small sample size. Moreover, for some subjects, the scan time was too long, so body movement could have affected the ReHo findings.
Research conclusions
We hypothesized that DVH might cause altered activity of visual cortex. Our results revealed that spontaneous activity in multiple regions of the brain changed in patients with DVH. The abnormalities of brain neural homogeneity may be associated with the altered best-corrected visual acuity of the contralateral eye and depression that occurred in DVH patients. These findings may point to altered neural mechanisms present in patients with DVH and lay a foundation for further study.
Research perspectives
We found that DVH may cause dysfunction in multiple brain areas, which may benefit the exploration of pathologic mechanisms in DVH patients. We included both right eye and left eye injury patients, which might affect the ReHo findings. Future studies should distinguish the difference and measure brain function activity changes more accurately.
