Korean J Ophthalmol.  2019 Oct;33(5):406-413. 10.3341/kjo.2019.0022.

Evaluation of Metabolite Changes in the Occipital Cortex of Patients with Idiopathic Infantile Nystagmus or Bilateral Ametropic Amblyopia by Magnetic Resonance Spectroscopy

• Konus I
• Ozsoy E
• Turkcuoglu P
• Emre S
• Duman F

• KMID: 2459521
• DOI: http://doi.org/10.3341/kjo.2019.0022

Abstract

PURPOSE
To evaluate the effects of idiopathic infantile nystagmus (IN) and bilateral ametropic amblyopia on metabolites in the occipital cortex by magnetic resonance spectroscopy.
METHODS
The children included in this prospective study were divided into three groups. Group 1 consisted of 11 patients with idiopathic IN, group 2 consisted of 10 patients with bilateral ametropic amblyopia and group 3 consisted of nine normal children. A single-voxel magnetic resonance spectroscopy examination was performed by placing a region of interest on the occipital cortex of each participant. N-acetyl aspartate (NAA), creatine (Cr) and choline (Cho) concentrations were measured in the occipital cortex. This was followed by calculating and comparing the NAA/Cr and Cho/Cr ratios between the three groups. The Kruskal-Wallis test, Mann-Whitney U-test, and chi-square test were used for statistical analysis.
RESULTS
There was no statistically significant difference in NAA/Cr ratios between patients with idiopathic IN and normal children, but there was a statistically significant difference between these groups when Cho/Cr ratios were compared; the ratio was higher in the idiopathic IN group. There were no statistically significant differences in NAA/Cr or Cho/Cr ratios between patients with bilateral ametropic amblyopia and normal children.
CONCLUSIONS
Our findings suggest that the neurochemical profile of the occipital cortex is partially affected by idiopathic IN, but not by bilateral ametropic amblyopia.

Keyword

Amblyopia; Choline; Creatine; Resonance; Spectrum

MeSH Terms

Amblyopia*
Aspartic Acid
Child
Choline
Creatine
Humans
Magnetic Resonance Spectroscopy*
Occipital Lobe*
Prospective Studies
Aspartic Acid
Choline
Creatine

Figure

• 

  Fig. 1 (A) Axial, (B) sagittal, and (C) coronal views of the area where the region of interest was placed. Written informed consents were obtained from the parents of each child for the publication of the images.

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  Fig. 2 A spectrum obtained from the occipital cortex of a patient with idiopathic infantile nystagmus. Cho = choline; Cr = creatine; NAA = N-acetyl aspartate; ppm = parts per million. Intensity *10-3 arbitrary unit= relative proton concentration.

• 

  Fig. 3 A spectrum obtained from the occipital cortex of a patient with bilateral ametropic amblyopia. Cho = choline; Cr = creatine; NAA = N-acetyl aspartate; ppm = parts per million. Intensity *10-3 arbitrary unit= relative proton concentration.

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  Fig. 4 The mean N-acetyl aspartate (NAA)/creatine (Cr) ratios of groups 1, 2, and 3. Group 1, patients with idiopathic infantile nystagmus; group 2, patients with bilateral ametropic amblyopia; group 3, normal children.

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  Fig. 5 The mean choline (Cho)/creatine (Cr) ratios of groups 1, 2, and 3. Group 1, patients with idiopathic infantile nystagmus; group 2, patients with bilateral ametropic amblyopia; group 3, normal children.

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