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Oculoplastics
Thyroid Eye Disease

Neuroimaging markers could aid in early detection of immune-related visual dysfunction in TED

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Combined orbital and brain neuroimaging showed abnormalities of the visual processing system (VPS) in thyroid eye disease (TED), which had a close correlation with immune statuses, according to findings from a recent study. Researchers concluded that vision-related brain regions in TED might be altered by peripheral immunity via a direct or indirect approach.

The study, which investigate the pathological interplay between immunity and the VPS in TED, included a total of 24 active participants (AP), 26 inactive participants (IP) of TED, and 27 healthy controls (HCs). Each participant underwent orbital magnetic resonance imaging (MRI) and resting-state functional MRI (rs-fMRI). Multiple MRI parameters of the intraorbital optic nerve (ON) were also assessed and the amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo) were calculated along with correlation analyses.

Results showed that the ON subarachnoid space and ON sheath diameter were significantly higher in AP than in IP. The researchers identified 6 vision-related brain regions in TED patients: right calcarine (CAL.R), right cuneus (CUN.R), left postcentral gyrus (PoCG.L), right middle temporal gyrus (MTG.R), left superior frontal gyrus (SFG.L), and left caudate (CAU.L). The brain activity of MTG.R, SFG.L, and CAU.L differentiated between the AP and IP groups. The correlation analysis revealed a close association among the vision-related brain regions, MRI parameters of ON, and clinical characteristics in AP and IP, respectively.

“The discovery of this study explained the disparity of visual dysfunction in TED patients with different immune statuses. With the uncovered neuroimaging markers, early detection and intervention of visual dysfunction could be achieved and potentially benefit TED patients,” the researchers said.

Reference:
Zhang H, Liu Y, Jiang M, et al. Immune-related visual dysfunction in thyroid eye disease: a combined orbital and brain neuroimaging study. Eur Radiol. Published online Dec 19, 2023. doi: 10.1007/s00330-023-10309-8

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