Lg. Gray et al., THE CENTRAL VISUAL-FIELD IN HOMONYMOUS HEMIANOPIA - EVIDENCE FOR UNILATERAL FOVEAL REPRESENTATION, Archives of neurology, 54(3), 1997, pp. 312-317
Background: Controversy exists regarding the cortical representation o
f the foveal region in man. The most plausible explanation for foveal
sparing in homonymous hemianopia is dual blood supply to the occipital
pole. However, bilateral cortical representation has also been sugges
ted. Objective: To determine the representation of the foveal region i
n the primary human visual cortex. Design: A case series correlating m
agnetic resonance imaging to the visual field defects of 6 patients wi
th occipital lobe injuries. Results: Four patients with foveal-sparing
hemianopic defects demonstrated unilateral sparing of the posterior o
ccipital cortex. In contrast, 2 patients with central homonymous defec
ts showed isolated involvement of the posterior pole. One patient also
demonstrated 5 degrees of field sparing along the horizontal meridian
. Conclusions: On the basis of correlating the findings of magnetic re
sonance imaging and visual field defects in patients with occipital lo
be injury, we conclude that the foveal region is unilaterally represen
ted in the primary human visual cortex and that a major portion of the
striate cortex is dedicated to the central 10 degrees of vision. The
horizontal meridian of the visual field is represented deep within the
calcarine banks at the fissure base.