Abstract

The purpose of this study is to investigate characteristic alterations of functional connectivity (FC) patterns in the primary visual area (V1) in patients with intermittent exotropia (IXT) using resting-state functional magnetic resonance imaging (rs-fMRI) and how they relate to clinical features. Twenty-six IXT patients and 21 age-, sex-, handedness-, and education-matched healthy controls (HCs) underwent rs-fMRI. We performed FC analyses between bilateral V1 and other brain areas and compared FC strength between two groups. A Pearson correlation analysis was used to evaluate the correlation between the FC differences and clinical features. Compared with HCs, patients with IXT showed significantly lower FC of the right V1 with the right calcarine sulcus and right superior occipital gyrus, and the left V1 with right cuneus and right postcentral gyrus. The Newcastle Control Test score was positively correlated with mean FC values between the left inferior parietal lobule and bilateral V1, and between the left supramarginal gyrus and left V1. The duration of IXT was positively correlated with mean FC values between the right inferior occipital gyrus and right V1. Reduced FC between the V1 and various brain regions involved in vision and eye movement processes may be associated with the underlying neural mechanisms of impaired visual function in patients with IXT.

Highlights

  • Strabismus is one of the most common diseases in the field of ophthalmology, with a prevalence rate between 0.5 and 5% [1]

  • We found that intermittent exotropia (IXT) patients showed significantly lower functional connectivity (FC) between the right V1 and the right calcarine sulcus, which was related to the dysfunction of fusion

  • We found a positive correlation between Newcastle Control Test (NCT) score and FC of both the left and right V1 with the left inferior parietal lobule (IPL) and the left V1 with the left supramarginal gyrus, which suggests that the higher the severity of the disease, the stronger the FC between these regions

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Summary

Introduction

Strabismus is one of the most common diseases in the field of ophthalmology, with a prevalence rate between 0.5 and 5% [1]. Intermittent exotropia (IXT) is the most common subtype of strabismus, with a prevalence ranging from 0.12 to 3.9% worldwide [3,4,5]. IXT is a subtype of comitant exotropia that falls between exophoria and constant exotropia, which manifests as intermittent squinting outward during distance fixation or inattention. The most prominent characteristic of IXT is that the oblique angle of view changes greatly and still having part of Decreased FC in IXT Patients the ability to control the exodeviation. It can impair social interactions and lead to psychological problems [6,7,8]

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