Sustained motion perception deficit following optic neuritis
Behavioral and cortical evidence
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Abstract
Objective: To assess the recovery process in patients after an acute optic neuritis (ON) attack, comparing static and dynamic visual functions.
Methods: In this prospective controlled study, 21 patients with unilateral, first-ever ON were followed over the course of 1 year. Standard visual tests, visual evoked potentials, and optical coherence tomography were assessed repeatedly. In addition, we developed a novel set of motion perceptual tasks to test dynamic visual deficits. fMRI examinations were performed to study the neuronal correlates for the behavioral findings.
Results: Four months after the acute phase, the affected eyes had returned to normal performance levels in the routine visual testing. However, motion perception remained impaired throughout the 12-month period. In agreement with the clinical findings, fMRI studies showed recovery in cortical activation during static object recognition, as opposed to sustained deficit in tasks that require motion perception.
Conclusions: Sustained motion perception deficit following ON may explain the continued visual complaints of patients long after recovery of visual acuity. Cortical activation patterns suggest that if plastic processes in higher visual regions contribute to the recovery of vision, this may be limited to static visual functions. Alternatively, cortical activation may reflect the visual percept (intact for visual acuity and impaired for motion perception), rather than demonstrating plastic processes. We suggest that motion perception should be included in the routine ophthalmologic tests following ON.
Footnotes
Study funding: Supported by the Caesarea Edmond & Benjamin de Rothschild Foundations.
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Editorial, page 2052
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Supplemental data at www.neurology.org
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- AE
- affected eye
- ANOVA
- analysis of variance
- CS
- contrast sensitivity
- FE
- fellow eye
- OCT
- optical coherence tomography
- OFM
- object from motion
- ON
- optic neuritis
- RNFL
- retinal nerve fiber layer
- ROI
- region of interest
- VA
- visual acuity
- VEP
- visual evoked potential.
- Received September 16, 2010.
- Accepted January 10, 2011.
- Copyright © 2011 by AAN Enterprises, Inc.
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