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Microstructural properties of major white matter tracts in constant exotropia before and after strabismus surgery
  1. Yanming Wang1,
  2. Xiaoxiao Wang1,
  3. Hongmei Shi2,3,
  4. Lin Xia2,
  5. Jiong Dong2,
  6. Benedictor Alexander Nguchu1,
  7. Jean De Dieu Uwisengeyimana1,
  8. Yanpeng Liu1,
  9. Du Zhang1,
  10. Lixia Feng2,
  11. Bensheng Qiu1
  1. 1Hefei National Laboratory for Physical Sciences at the Microscale and the Centers for Biomedical Engineering, University of Science and Technology of China, Hefei, Anhui, China
  2. 2Department of Ophthalmology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
  3. 3Department of Ophthalmology, The People's Hospital of Bozhou, Bozhou, Anhui, China
  1. Correspondence to Bensheng Qiu, Hefei National Lab for Physical Sciences at the Microscale and the Centers for Biomedical Engineering, University of Science and Technology of China, Hefei 230022, Anhui, China; bqiu{at}ustc.edu.cn; Lixia Feng, Department of Ophthalmology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China; lixiafeng{at}163.com

Abstract

Aims The purpose of this study was to explore the microstructural properties of the major white matter (WM) tracts in constant exotropia (XT) before and after strabismus surgery, and further investigate the association between microstructural alterations and the ocular dominance (OD).

Methods We collected diffusion tensor imaging data of patients with XT before (n=19) and after (n=15) strabismus surgery and 20 healthy controls and evaluated OD and stereopsis. The probabilistic streamline tractography of the 24 major WM tracts was reconstructed by using the automated fibre quantification package. Fractional anisotropy and mean diffusivity (MD) along each tract were estimated, and their differences between the groups were examined. Furthermore, we evaluated the relationship between OD and the absolute value of altered microstructural parameters.

Results While all postoperative XT patients restored normal stereopsis, most of their OD remained aberrant (9 out of 11). Compared with that of preoperation, the MD of postoperative patients decreased significantly along left anterior thalamic radiation (ATR), left arcuate fasciculus (AF), left corticospinal tract (CST), left cingulum cingulate (CGC) and left inferior fronto-occipital fasciculus. Moreover, OD was negatively correlated with the absolute value of MD changes in left ATR, left AF, left CST and left CGC.

Conclusion Microstructural alterations after surgery in the visuospatial network tracts may contribute to the stereopsis restoration. Additionally, the results of the correlation analysis may signify that the balanced binocular input may be more conducive for the restoration and improvement of binocular visual function, including stereopsis. Thus, restoring normal ocular balance after surgical correction may be necessary to achieve more substantial improvements.

  • treatment surgery
  • visual perception

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Footnotes

  • Contributors Substantial contributions to the conception or design of the work: YW, XW and LF. Contributions to the acquisition, analysis or interpretation of data: YW, HS, LX, JD, JDDU and DZ. Drafting the work or revising it critically for important intellectual content: YW, XW, ANB, YL and BQ. Final approval of the version published: BQ and LF.

  • Funding This work was supported by the National Natural Science Foundation of China (grant number 81701665).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by the Institutional Review Board of Anhui Medical University, and all subjects were informed about the content, purpose and risks before participating in this study.

  • Data availability statement No data are available.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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