Functional and structural abnormalities of visual cortex in infantile strabismus

Background To investigate the structural basis for functional deficits in infantile strabismus we used a neuroanatomic tracer and a histochemical label to examine the primary visual cortex (area V1) of adult esotropic macaque monkeys. Animals and methods The animals had developed natural esotropia in the first months of life, alternated fixation, and exhibited the ocular motor signs that typify strabismus with onset in infancy. After behavioral and VEP testing, ocular dominance columns (ODCs) in V1 were injected with a neuronal traser and labeled for cytochrome oxidase activity. Results The strabismic monkeys showed striking deficits in binocular luminance visually-evoked potentials (VEPs) and characteristic directional asymmetries in motion VEPs. Binocular horizontal connections between ODCs were reduced an average of 50-60% in strabismic as compared to normal monkeys. ODCs also showed unequal metabolic activity with contralaterally (i.e. nasal retina) driven ODCs showing greater activity in each V1. Discussion and conclusion The maldevelopment of connections in upper V1 layers correlates with the abnormalities in binocular and motion VEPs. The unequal metabolic activity suggests interocular suppression. These results provide the first neuroanatomic evidence for cerebral cortex maldevelopments in natural infantile esotropia.