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. 2009 Jul;132(Pt 7):1898-906.
doi: 10.1093/brain/awp119. Epub 2009 May 25.

Changes in cortical grey matter density associated with long-standing retinal visual field defects

Christine C Boucard  1 , Aditya T Hernowo, R Paul Maguire, Nomdo M Jansonius, Jos B T M Roerdink, Johanna M M Hooymans, Frans W Cornelissen
Affiliations

Changes in cortical grey matter density associated with long-standing retinal visual field defects

Christine C Boucard et al. Brain. 2009 Jul.

Abstract

Retinal lesions caused by eye diseases such as glaucoma and age-related macular degeneration can, over time, eliminate stimulation of parts of the visual cortex. This could lead to degeneration of inactive cortical neuronal tissue, but this has not been established in humans. Here, we used magnetic resonance imaging to assess the effects of prolonged sensory deprivation in human visual cortex. High-resolution anatomical magnetic resonance images were obtained in subjects with foveal (age-related macular degeneration) and peripheral (glaucoma) retinal lesions as well as age-matched controls. Comparison of grey matter between patient and control groups revealed density reductions in the approximate retinal lesion projection zones in visual cortex. This indicates that long-term cortical deprivation, due to retinal lesions acquired later in life, is associated with retinotopic-specific neuronal degeneration of visual cortex. Such degeneration could interfere with therapeutic strategies such as the future application of artificial retinal implants to overcome lesion-induced visual impairment.

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Figures

Figure 1
Figure 1
Individual binocular sensitivity deviation maps. Upper row shows maps for three representative subjects from the AMD group, the lower row shows maps for three subjects with glaucoma. Subject numbers correspond to those in Table 1.
Figure 2
Figure 2
Analysis of subjects with AMD. (A–C) Sections of the brain showing regions of grey matter density reduction. Colours indicate statistical significance (t-values), with red indicating more significant changes, and yellow/green indicating less significant changes (all changes are at least P < 0.001, uncorrected). (D) Mean visual field sensitivity deviation (in dB). The largest change in sensitivity is located centrally in the visual field. dB = decibel.
Figure 3
Figure 3
Analysis of subjects with glaucoma. (A–C) Sections of the brain showing the regions of grey matter density reduction. Colours indicate statistical significance (t-values), with red indicating more significant changes, and yellow/green indicating less significant changes (all changes are at least P < 0.001, uncorrected). (D) Mean visual field sensitivity deviation (in dB). The largest changes in sensitivity are located peripherally in the visual field, leaving the macular region relatively unaffected. dB = decibel.
Figure 4
Figure 4
Results from a VOI-based analysis. Relative change in grey matter density for the AMD and glaucoma groups compared to the control group in anatomically defined volumes of interest in posterior (approximate foveal projection zone) and anterior (approximate peripheral visual field projection zone) visual cortex. Relative changes were calculated by dividing for each participant group the averaged grey matter density in each VOI by that of the control group.
Figure 5
Figure 5
Summary of visual field sensitivity and grey matter reduction in AMD and glaucoma. (A) Cortical grey matter density reduction in glaucoma is found in the anterior half of the medial occipital cortex (cyan). Cortical grey matter density reduction in AMD (magenta) is found in the posterior part of the occipital cortex. (B) Thresholded mean visual field sensitivity deviation maps indicating central defects in AMD (magenta) and more peripheral defects in glaucoma (cyan). For this thresholded map, for the glaucoma group, sensitivity deviations below −12 dB are shown in cyan. For the AMD group, sensitivity deviations below −8 dB are shown in magenta.
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