Brain activation of eye movements in subjects with refractive error.

Purpose: Recent functional magnetic resonance imaging (fMRI) studies have described reorganized activation of the oculomotor and visual cortex after focal brain lesions. These studies are based on comparison with healthy individuals who may have a very heterogenous refractive error. The influence of refractive error on the cortical control of an oculomotor task such as a prosaccade trial, however, is unknown.

Methods: To investigate the influence of visual acuity on changes of cortical oculomotor control, we studied the representation of visually guided prosaccades in nine subjects with refractive error and 11 normally sighted subjects using fMRI. Correction of refractive error was not allowed during fMRI. Differences in activation between rest and saccades as well as between subjects with refractive error vs subjects with normal vision were assessed with statistical parametric mapping.

Results: In both groups, activation of a frontoparietal network was observed. Subjects with refractive errors showed increased activation compared to normally sighted subjects, with overactivation in bilateral frontal and parietal eye fields, supplementary eye fields, as well as in the bilateral extrastriate cortex.

Conclusions: This group of subjects with refractive error showed increased activation in an extended oculomotor and visual network to maintain performance during simple prosaccades. This observation underlines the importance of using appropriate control groups in fMRI-studies after brain lesions.