We assessed the impact of central and peripheral vision loss on the cortical morphology (i.e. cortical thickness, CoTks) and neural and synaptic complexity (i.e. rs-fMRI entropy, rs-CoEn). Three findings emerge from our work. First, compared to normally sighted both groups with visual field defects exhibited reduced CoTks in the dorsal region hOc3d; peripheral visual field defect group also presented reduced CoTks in early visual cortex (hOc1 and hOc2) and the ventral region hOc4V, while central visual field defect group in the dorsal region hO4d. Second, compared both to normally sighted and peripheral visual field defect groups, central visual field defect group showed increased rs-CoEn in FG1 area; also, compared with normally sighted, central visual field defect group exhibited increased rs-CoEn in hOc4la area. Finally, areas with altered CoTks had normal rs-CoEn and conversely.
Differences in cortical thickness
Compared to normally sighted only the subjects with peripheral visual loss showed decreased CoTks in hOc1 and hOc2, which correspond to the functional regions V1 and V2 of the early visual cortex (Amunts et al.
2000). Previous studies reported a decreased CoTks in the early visual cortex for both central and peripheral visual loss (Boucard et al.
2009; Plank et al.
2011; Yu et al.
2013; Hernowo et al.
2014; Prins et al.
2016). In our study, only peripheral visual loss was associated with a thinning of the early visual cortex. This difference might be explained by the peculiarities of the retinal degeneration in retinitis pigmentosa. Retinitis pigmentosa is a pan-retinal, rod-cone degeneration and in the tunnel stage, patients exhibit not only the loss of all receptors in the peripheral retina, but also the loss of rods in central retina coupled to a more limited degeneration of central cones (translated by a reduced visual acuity, Sahel et al.
2015). Moreover, rod loss might directly impact certain photopic vision processes such as cone-driven, horizontal cell mediated surround inhibition (Szikra et al.
2014) or mesopic (dim-light) vision processes such as rod-cone or rod–rod gap-junction coupling presumed to help identifying dark objects moving through the visual field (Tsukamoto et al.
2001; Volgyi
2004; Ribelayga et al.
2008; Bloomfield and Völgyi
2009). SMD, on the other hand, associates a photoreceptor loss that is solely localized to central retina (Meunier and Puech
2012). Hence, the loss of cortical thickness in V1 and V2 we report herein, suggests that retinal degeneration in retinitis pigmentosa has a greater trophic impact on early visual areas. The loss of the peripheral vision represents the loss of an extensive visual field area and affects the output of numerous wide-field retinal informational channels (Ölveczky et al.
2003; Roska and Werblin
2003; Hosoya et al.
2005; Münch et al.
2009; Masland
2012). Yet poorly understood these channels might play an important role in the functioning of the early visual cortex.
The reduced hOc3d CoTks in both visual field defects when compared to normally sighted, suggest a comparable contribution of central and peripheral visual field to the dorsal portion of V3 (V3d), which is canonically included in the dorsal stream (Kujovic et al.
2013). Anatomical and functional data indicate that the primarily role of V3d area is the processing kinetic information (Felleman et al.
1997; Gegenfurtner et al.
1997; Rosa and Manger
2005), the extraction of kinetic contours (Zeki
2003), and 3D form (Vanduffel
2002). Moreover, V3d has the particularity that its retinotopical map represents only the lower quadrant of the visual field, while the upper quadrant is being represented in the ventral part of V3, area V3v (hOc3v, Rottschy et al.
2007; Kujovic et al.
2013). It is possible that the spatial nature of information processing in hOc3d/V3d is responsible for the decreased CoTks observed with both central and peripheral visual field loss. Indeed, the build-up of an accurate referential system, essential for functions such as stereopsis (i.e. 3D perception), requires both central vision, which provides high spatial resolution and fixation, and peripheral vision, which provides wide-field sampling (Goldstein and Clahane
1966; Luria
1971; Dessing et al.
2012). In central visual loss, the physiological foveal fixation lacks and compels to fixation in the vicinity of the visual field defect, in the residual functional periphery. These eccentric fixation loci (usually multiple) are used both for detection (Duret et al.
1999) and visuomotor coordination (Timberlake et al.
2012) and occur in different retinal positions for each eye. These peculiarities lead to an inadequate extraction of fixation disparities (Wheatstone
1962) impairing the very mechanism of stereopsis. In peripheral visual field loss, foveal vision, physiologic fixation and visual acuity are preserved, but stereopsis is nevertheless impaired through mechanisms such as a non-uniform drifting of the two eyes in the absence of the peripheral visual field superposition, the loss of fusion due to brief occlusions (i.e. eye-blinks, Fender and Julesz
1967) or “empty-field myopia” (i.e. accommodation impairment due to increased amplitude oscillation of accommodation in the absence of peripheral clues resulting in increased difficulty for detection, Whiteside
1957; Campbell et al.
1959). Hence, cortical thickness reduction of hOc3d CoTks in both visual field defects may account for the important contribution of central and peripheral visual fields to the functioning of this brain area.
Interestingly, compared to normally sighted, central visual field loss also exhibited decreased CoTks in the dorsal area hOc4d, corresponding to the functional region V3A. This area seems to be involved in the processing of kinetic and static 3D shapes (Georgieva et al.
2009), especially contour curvature (Caplovitz and Tse
2006), stereoscopic and chromatic motion (McKeefry et al.
2010; Anzai et al.
2011), perceptual stability during eye movements (Braddick et al.
2001; Fischer et al.
2012), the prediction of the visual motion (Maus et al.
2010), its structural damage commonly resulting in simultanagnosia, namely the inability to interpret complex visual displays despite the preserved capacity to recognize single objects (Coslett and Saffran
1991). Impaired fixation and stereoscopic vision in patients with central visual loss may account for the CoTks loss in this area.
Another intriguing result was the decreased CoTks in area hOc4v in peripheral field loss, when compared to normally sighted. Area hOc4, to the best of our knowledge, probably corresponds to human V4 (hV4) or at least to its ventral subdivision V4v (hV4v). The role of hV4 in colour perception is still debated (Bartolomeo et al.
2014), but its central participation in the figure-ground segmentation through the integration of multiple stimulus properties (i.e. contour, shape, texture, motion, colour, disparity) by bottom-up salience driven attentional mechanism or top-down proactive spatial or feature selection makes consensus (Reynolds and Desimone
2003; Qiu et al.
2007; Poort et al.
2012; Roe et al.
2012). The severely constricted visual field, resulting from the loss of the peripheral visual field, may limit covert visual attention and the sensory input in area hOc4 and consequently impact its CoTks.
Differences in cortical entropy
Compared to normally sighted, central visual field loss group exhibited increased
rs-CoEn in area hOc4la that likely corresponds to functionally defined LO-2 region (Larsson and Heeger
2006) involved in shape processing, object and face recognition, visual attention, action observation, visual tracking, spatial location discrimination, mental imagery and subjective emotional picture discrimination (Malikovic et al.
2016). The increased
rs-CoEn in area hOc4la/ LO-2 suggests an adaptive increase in synaptic complexity points in this area, which is crucial for shape perception, figure-ground segregation and visuomotor coordination (Malikovic et al.
2016). Moreover, in a previous study exploring the resting state functional connectivity of central and peripheral V1 in the exact populations explored here, we found that in central visual field loss, afferented peripheral early visual cortex exhibited increased functional connectivity with LOC compared to the corresponding region in normally sighted (Sabbah et al.
2017). Therefore, in central visual loss, the increased
rs-CoEn in LO-2 might be linked to the increased functional connectivity of this area with the residually afferented peripheral early visual cortex.
Subjects with central visual field loss presented increased
rs-CoEn in area FG1 when compared to normally sighted and peripheral visual field loss participants. This area, located in the posterior part of the fusiform gyrus, medial to the middle fusiform sulcus (Caspers et al.
2013; Lorenz et al.
2015) exhibits a bias for the peripheral visual field representations. More precisely, FG1 and the anteriorly situated FG3 overlap with places, inanimate large objects and peripheral biased representations (Lorenz et al.
2015). This line of evidences suggests that the observed difference in
rs-CoEn may relate to an enhanced peripheral visual field treatment in FG1 area to compensate for the central visual field loss. In accordance with this compensation hypothesis, peripheral early visual cortex in central visual field loss showed increased resting-state functional connectivity with fusiform gyrus compared to peripheral early visual cortex in normally sighted.