Loss of Binocular Vision in Monocularly Blind Patients Causes Selective Degeneration of the Superior Lateral Occipital Cortices.

Purpose: Chronic ocular pathology, such as glaucoma and macular degeneration, is associated with neuroanatomic changes in the visual pathways. It is a challenge to determine the mechanism responsible for these changes. This could be functional deprivation or transsynaptic degeneration. Acquired monocular blindness provides a unique opportunity to establish which mechanism underlies neuroanatomic changes in ocular pathology in general, since the loss of input is well defined, and it causes selective functional deprivation due to the loss of stereopsis. Here, we assessed whether acquired monocular blindness is associated with neuroanatomic changes, and if so, where these changes are located.

Methods: High-resolution T1-weighted magnetic resonance images were obtained in 15 monocularly blind patients and 18 healthy controls. We used voxel- and surface-based morphometry to compare gray and white matter volume, cortical thickness, mean curvature, and surface area between these groups.

Results: The gray matter volume in the bilateral superior lateral occipital cortices was decreased in the monocular blind patients, in the absence of volumetric differences in their early visual cortex.

Conclusions: The volumetric decrease in the superior lateral occipital cortices is consistent with specific functional deprivation, as the superior lateral occipital cortices play an important role in depth perception. Moreover, in the absence of differences in the early visual cortex, the decrease is inconsistent with transsynaptic degeneration propagating from the degenerated retinal axons.