The topography of training-induced visual field recovery: Perimetric maps and subjective representations

Abstract

The cognitive representation of blind regions varies considerably between patients with vision loss and may influence compensatory behaviour and treatment motivation. We therefore measured “objective” visual field topography (perimetry) in 19 patients with postgeniculate visual system lesions and related this to the subjective scotoma representation as expressed by patients’ drawings of the defect and monitored changes of these measures during training-induced recovery of function. Blind regions were mostly adequately represented; however, central regions were overestimated and peripheral areas underestimated in size. Perimetric and subjective defect size decreased significantly during training. Again, training-induced visual field border shifts in central regions were larger in subjective than in perimetric maps but vice versa in the peripheral field. Thus, vision restoration therapy improves “objective” visual field size along with its cognitive representation. The subjective topography is shaped by the functional importance of visual field regions and is a function of cortical magnification, thus resembling the neural representation in visual cortex.