High-tension glaucoma (HTG) is associated with functional changes in the brain, and elevated intraocular pressure (IOP) is one of the major causes.

To evaluate the effects of high IOP on the brain in patients with HTG by using resting-state functional magnetic resonance imaging (rs-fMRI).

Thirty-six patients with HTG and 20 age- and gender-matched healthy controls (HCs) were recruited and underwent IOP examination and rs-fMRI scan. Voxel-wise functional connectivity (FC) values were obtained between the Brodmann Area (BA) 17 (primary visual cortex) and the rest of the brain, two-sample t test was performed between HTG group and HCs. Correlation analysis was performed between FC and clinical information.

Compared with HCs, HTG patients demonstrated decreased FC between BA 17 and the right precuneus gyrus, decreased FC between BA 17 and the right superior frontal gyrus (SFG) (GRF corrected at voxel level P<0.001 and cluster level P<0.05, two-tailed). FC between BA 17 and the right SFG showed significantly negative correlation with right eyes’ IOP and mean IOP.

HTG patients had abnormal FC changes between the visual cortex and multiple functional brain regions related to visual sense, memory consolidation and cognitive processing, which provided image support for the pathophysiology research of HTG, and revealed new targets for the accurate treatment of HTG.