Selectivity as well as sensitivity loss characterizes the cortical spatial frequency deficit in amblyopia

Efficacy of binocular vision training and Fresnel press-on prism on children with esotropia and amblyopia

PURPOSE

In the process of clinical diagnosis and treatment of amblyopia, we have found that the treatment time of this disease was significantly different among different patients. The purpose of this study was to compare the efficacy of binocular vision training (BVT) and Fresnel press-on prism (FPP) on children with esotropia combined with amblyopia.

METHODS

From May 2015 to December 2018, a total of 101 children aged 3-9 years with esotropia and amblyopia who were in our hospital were enrolled in this randomized clinical trial. They were randomly divided into combined group (48 cases) and prism group (53 cases): the children in the prism group received FPP treatment, and those in the combined group received the combined treatment of BVT and FPP. The visual acuity, the binocular function and the strabismic therapeutic effects were compared between two groups.

RESULTS

After treatment, the visual acuity in both groups was both significantly improved compared with that before treatment (P = 0.0079). The binocular-monocular function, including synoptophore visual function and the Titmus stereopsis, in both groups was significantly improved compared with those before treatment (P < 0.05), and it was more significant in the combined group compared with the prism group (P < 0.05). The cure rate of strabismus was 87.50% (42/48) and 30.19% (16/53) in the combined group and the prism group, respectively, and there was significant difference between groups (P = 0.0036). The cure time was shortened with the lower of the degree of esotropia.

CONCLUSION

BVT combined with FPP can effectively promote the recovery of binocular vision in children with esotropia combined with amblyopia, and some children can achieve complete cure of strabismus.

Mapping spatial frequency preferences across human primary visual cortex

Neurons in primate visual cortex (area V1) are tuned for spatial frequency, in a manner that depends on their position in the visual field. Several studies have examined this dependency using functional magnetic resonance imaging (fMRI), reporting preferred spatial frequencies (tuning curve peaks) of V1 voxels as a function of eccentricity, but their results differ by as much as two octaves, presumably owing to differences in stimuli, measurements, and analysis methodology. Here, we characterize spatial frequency tuning at a millimeter resolution within the human primary visual cortex, across stimulus orientation and visual field locations. We measured fMRI responses to a novel set of stimuli, constructed as sinusoidal gratings in log-polar coordinates, which include circular, radial, and spiral geometries. For each individual stimulus, the local spatial frequency varies inversely with eccentricity, and for any given location in the visual field, the full set of stimuli span a broad range of spatial frequencies and orientations. Over the measured range of eccentricities, the preferred spatial frequency is well-fit by a function that varies as the inverse of the eccentricity plus a small constant. We also find small but systematic effects of local stimulus orientation, defined in both absolute coordinates and relative to visual field location. Specifically, peak spatial frequency is higher for pinwheel than annular stimuli and for horizontal than vertical stimuli.

Loss and enhancement of layer-selective signals in geniculostriate and corticotectal pathways of adult human amblyopia

How abnormal visual experiences early in life influence human subcortical pathways is poorly understood. Using high-resolution fMRI and pathway-selective visual stimuli, we investigate the influence of amblyopia on response properties and the effective connectivity of subcortical visual pathways of the adult human brain. Compared to the normal and fellow eyes, stimuli presented to the amblyopic eye show selectively reduced response in the parvocellular layers of the lateral geniculate nucleus and weaker effective connectivity to V1. Compared to the normal eye, the response of the amblyopic eye to chromatic stimulus decreases in the superficial layers of the superior colliculus, while response of the fellow eye robustly increases in the deep SC with stronger connectivity from the visual cortex. Therefore, amblyopia leads to selective parvocellular alterations of the geniculostriate and corticotectal pathways. These findings provide the neural basis for amblyopic deficits in visual acuity, ocular motor control, and attention.

Disrupted neural signals in patients with concomitant exotropia

PURPOSE

Decreased binocular and oculomotor function in strabismics has recently been considered as cortical in origin. This study aimed to investigate functional abnormalities using a frequency-specific neuroimaging method in patients with concomitant exotropia (XT), and to demonstrate the clinical implications.

METHODS

Resting-state functional magnetic resonance imaging data were collected in 26 XT patients and 26 matched controls. To evaluate the local spontaneous neural activity, the amplitude of low frequency fluctuations (ALFF) was calculated in the typical frequency band (0.01-0.08 Hz) as well as five narrowly-defined frequency bands (slow-6: 0-0.01 Hz, slow-5: 0.01-0.027 Hz, slow-4: 0.027-0.073 Hz, slow-3: 0.073-0.167 Hz, and slow-2: 0.167-0.25 Hz), respectively.

RESULTS

Patients with XT showed decreased ALFF in the bilateral parieto-occipital sulcus (POS), and increased ALFF in the bilateral thalamus within the typical frequency band. Frequency-dependent ALFF alterations were found in the higher visual areas such as the right lateral occipital complex (LOC). Furthermore, ALFF in the right LOC in the slow-5 band was positively correlated with fusion control score (r = 0.70, p < 0.0001) and binocular function score (r = 0.67, p = 0.0002). Regression analyses showed that early age of onset remained the only significant explanatory factor for ALFF reduction in the right POS in the typically-measured frequency band (also referred to as the typical frequency band) (Odds ratio, 0.038; 95% confidence interval, 0.001 to 0.075).

CONCLUSIONS

Our findings provide spatial information regarding the functionally disrupted regions in XT. Moreover, the frequency-dependent ALLF alteration in the right LOC might reflect a potential plastic capacity in binocular function, which could be a potential objective index for evaluating disease severity.

Psychomotor, Psychosocial and Reading Skills in Children with Amblyopia and the Effect of Different Treatments

Amblyopia influences psychomotor and psychosocial skills, although not all studies are unanimous. Different treatments coexist, but the effect on those variables is not clear. This study aims to probe whether children with amblyopia have impairments in these areas and if different optometric treatments reduce them effectively. 50 children, diagnosed with amblyopia, and 33 without amblyopia participated in this study. Eye-hand coordination, psychosocial skills and reading abilities, were measured before and after three months of different treatments (patch, patch and near vision activities and perceptual learning). Results revealed lower scores in eye-hand coordination and some reading issues in children with amblyopia, without differences in psychosocial skills in regard to the control group. Moreover, optometric treatments improved eye-hand coordination.

Population spatial frequency tuning in human early visual cortex

Neurons within early visual cortex are selective for basic image statistics, including spatial frequency. However, these neurons are thought to act as band-pass filters, with the window of spatial frequency sensitivity varying across the visual field and across visual areas. Although a handful of previous functional (f)MRI studies have examined human spatial frequency sensitivity using conventional designs and analysis methods, these measurements are time consuming and fail to capture the precision of spatial frequency tuning (bandwidth). In this study, we introduce a model-driven approach to fMRI analyses that allows for fast and efficient estimation of population spatial frequency tuning (pSFT) for individual voxels. Blood oxygen level-dependent (BOLD) responses within early visual cortex were acquired while subjects viewed a series of full-field stimuli that swept through a large range of spatial frequency content. Each stimulus was generated by band-pass filtering white noise with a central frequency that changed periodically between a minimum of 0.5 cycles/degree (cpd) and a maximum of 12 cpd. To estimate the underlying frequency tuning of each voxel, we assumed a log-Gaussian pSFT and optimized the parameters of this function by comparing our model output against the measured BOLD time series. Consistent with previous studies, our results show that an increase in eccentricity within each visual area is accompanied by a drop in the peak spatial frequency of the pSFT. Moreover, we found that pSFT bandwidth depends on eccentricity and is correlated with the pSFT peak; populations with lower peaks possess broader bandwidths in logarithmic scale, whereas in linear scale this relationship is reversed.NEW & NOTEWORTHY Spatial frequency selectivity is a hallmark property of early visuocortical neurons, and mapping these sensitivities gives us crucial insight into the hierarchical organization of information within visual areas. Due to technical obstacles, we lack a comprehensive picture of the properties of this sensitivity in humans. Here, we introduce a new method, coined population spatial frequency tuning mapping, which circumvents the limitations of the conventional neuroimaging methods, yielding a fuller visuocortical map of spatial frequency sensitivity.

Towards a state-space geometry of neural responses to natural scenes: A steady-state approach

Our understanding of information processing by the mammalian visual system has come through a variety of techniques ranging from psychophysics and fMRI to single unit recording and EEG. Each technique provides unique insights into the processing framework of the early visual system. Here, we focus on the nature of the information that is carried by steady state visual evoked potentials (SSVEPs). To study the information provided by SSVEPs, we presented human participants with a population of natural scenes and measured the relative SSVEP response. Rather than focus on particular features of this signal, we focused on the full state-space of possible responses and investigated how the evoked responses are mapped onto this space. Our results show that it is possible to map the relatively high-dimensional signal carried by SSVEPs onto a 2-dimensional space with little loss. We also show that a simple biologically plausible model can account for a high proportion of the explainable variance (~73%) in that space. Finally, we describe a technique for measuring the mutual information that is available about images from SSVEPs. The techniques introduced here represent a new approach to understanding the nature of the information carried by SSVEPs. Crucially, this approach is general and can provide a means of comparing results across different neural recording methods. Altogether, our study sheds light on the encoding principles of early vision and provides a much needed reference point for understanding subsequent transformations of the early visual response space to deeper knowledge structures that link different visual environments.

Beyond Rehabilitation of Acuity, Ocular Alignment, and Binocularity in Infantile Strabismus

Infantile strabismus impairs the perception of all attributes of the visual scene. High spatial frequency components are no longer visible, leading to amblyopia. Binocularity is altered, leading to the loss of stereopsis. Spatial perception is impaired as well as detection of vertical orientation, the fastest movements, directions of movement, the highest contrasts and colors. Infantile strabismus also affects other vision-dependent processes such as control of postural stability. But presently, rehabilitative therapies for infantile strabismus by ophthalmologists, orthoptists and optometrists are restricted to preventing or curing amblyopia of the deviated eye, aligning the eyes and, whenever possible, preserving or restoring binocular vision during the critical period of development, i.e., before ~10 years of age. All the other impairments are thus ignored; whether they may recover after strabismus treatment even remains unknown. We argue here that medical and paramedical professionals may extend their present treatments of the perceptual losses associated with infantile strabismus. This hypothesis is based on findings from fundamental research on visual system organization of higher mammals in particular at the cortical level. In strabismic subjects (as in normal-seeing ones), information about all of the visual attributes converge, interact and are thus inter-dependent at multiple levels of encoding ranging from the single neuron to neuronal assemblies in visual cortex. Thus if the perception of one attribute is restored this may help to rehabilitate the perception of other attributes. Concomitantly, vision-dependent processes may also improve. This could occur spontaneously, but still should be assessed and validated. If not, medical and paramedical staff, in collaboration with neuroscientists, will have to break new ground in the field of therapies to help reorganize brain circuitry and promote more comprehensive functional recovery. Findings from fundamental research studies in both young and adult patients already support our hypothesis and are reviewed here. For example, presenting different contrasts to each eye of a strabismic patient during training sessions facilitates recovery of acuity in the amblyopic eye as well as of 3D perception. Recent data also demonstrate that visual recoveries in strabismic subjects improve postural stability. These findings form the basis for a roadmap for future research and clinical development to extend presently applied rehabilitative therapies for infantile strabismus.

Partial correlation analysis reveals abnormal retinotopically organized functional connectivity of visual areas in amblyopia

Amblyopia is a prevalent developmental visual disorder of childhood that typically persists in adults. Due to altered visual experience during critical periods of youth, the structure and function of adult visual cortex is abnormal. In addition to substantial deficits shown with task-based fMRI, previous studies have used resting state measures to demonstrate altered long-range connectivity in amblyopia. This is the first study in amblyopia to analyze connectivity between regions of interest that are smaller than a single cortical area and to apply partial correlation analysis to reduce network effects. We specifically assess short-range connectivity between retinotopically defined regions of interest within the occipital lobe of 8 subjects with amblyopia and 7 subjects with normal vision (aged 19–45). The representations of visual areas V1, V2, and V3 within each of the four quadrants of visual space were further subdivided into three regions based on maps of visual field eccentricity. Connectivity between pairs of all nine regions of interest in each quadrant was tested via correlation and partial correlation for both groups. Only the tests of partial correlation, i.e., correlation between time courses of two regions following the regression of time courses from all other regions, yielded significant differences between resting state functional connectivity in amblyopic and normal subjects. Subjects with amblyopia showed significantly higher partial correlation between para-foveal and more eccentric representations within V1, and this effect associated with poor acuity of the worse eye. In addition, we observed reduced correlation in amblyopic subjects between isoeccentricity regions in V1 and V2, and separately, between such regions in V2 and V3. We conclude that partial correlation-based connectivity is altered in an eccentricity-dependent pattern in visual field maps of amblyopic patients. Moreover, results are consistent with known clinical and psychophysical vision loss. More broadly, this provides evidence that abnormal cortical adaptations to disease may be better isolated with tests of partial correlation connectivity than with the regular correlation techniques that are currently widely used.

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Cortical functional connectivity abnormalities exist in amblyopia at a scale finer than previously reported.

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Connectivity changes within primary visual cortex are consistent with known loss of function.

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Connectivity changes between visual areas are consistent with concept of deafferentation.

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Partial correlation differentiates patients from controls, whereas correlation does not.

Non-uniform phase sensitivity in spatial frequency maps of the human visual cortex

KEY POINTS

Just as a portrait painting can come from a collection of coarse and fine details, natural vision can be decomposed into coarse and fine components. Previous studies have shown that the early visual areas in the brain represent these components in a map-like fashion. Other studies have shown that these same visual areas can be sensitive to how coarse and fine features line up in space. We found that the brain actually jointly represents both the scale of the feature (fine, medium, or coarse) and the alignment of these features in space. The results suggest that the visual cortex has an optimized representation particularly for the alignment of fine details, which are crucial in understanding the visual scene.

ABSTRACT

Complex natural scenes can be decomposed into their oriented spatial frequency (SF) and phase relationships, both of which are represented locally at the earliest stages of cortical visual processing. The SF preference map in the human cortex, obtained using synthetic stimuli, is orderly and correlates strongly with eccentricity. In addition, early visual areas show sensitivity to the phase information that describes the relationship between SFs and thereby dictates the structure of the image. Taken together, two possibilities arise for the joint representation of SF and phase: either the entirety of the cortical SF map is uniformly sensitive to phase, or a particular set of SFs is selectively phase sensitive - for example, greater phase sensitivity for higher SFs that define fine-scale edges in a complex scene. To test between these two possibilities, we constructed a novel continuous natural scene video whereby phase information was maintained in one SF band but scrambled elsewhere. By shifting the central frequency of the phase-aligned band in time, we mapped the phase-sensitive SF preference of the visual cortex. Using functional magnetic resonance imaging, we found that phase sensitivity in early visual areas is biased toward higher SFs. Compared to a SF map of the same scene obtained using linear-filtered stimuli, a much larger patch of areas V1 and V2 is sensitive to the phase alignment of higher SFs. The results of early areas cannot be explained by attention. Our results suggest non-uniform sensitivity to phase alignment in population-level SF representations, with phase alignment being particularly important for fine-scale edge representations of natural scenes.

Strabismic amblyopia disrupts the hemispheric asymmetry for spatial stimuli in cortical visual processing

Hemispheric asymmetry in processing visual stimuli was assessed in anisometropic and strabismic amblyopia and control subjects. Measurements of contrast sensitivity for low and high spatial frequencies were performed psychophysically and tested under functional magnetic resonance imaging (fMRI) using a stimulus configuration that generates measurements for each temporal and nasal hemifield. The fMRI and the psychophysics results showed a marked hemispheric asymmetry in processing spatial frequencies for normal and anisometropic adults, in which low spatial frequencies were mainly processed in the left visual field – right hemisphere (LVF-RH: 0.3 cycles per degree [cpd]; F = 12.548; p = .002) and the high spatial frequencies were predominating processed in the right visual field – left hemisphere (RVF-LH: 2.0 cpd; F = 4.582; p = .021 and 8.3 cpd; F = 8.561; p = .001). No asymmetry was present in the amblyopic and the fellow eye of the strabismic amblyopia subjects. We conclude that the developmental organization of visual cortex in strabismic amblyopia is impaired differently from what happens in the anisometropic amblyopia and support the impairment of high-level visual-related functions observed in strabismic children.

Maximum likelihood estimation for second level fMRI data analysis with expectation trust region algorithm

The trust region method which originated from the Levenberg-Marquardt (LM) algorithm for mixed effect model estimation are considered in the context of second level functional magnetic resonance imaging (fMRI) data analysis. We first present the mathematical and optimization details of the method for the mixed effect model analysis, then we compare the proposed methods with the conventional expectation-maximization (EM) algorithm based on a series of datasets (synthetic and real human fMRI datasets). From simulation studies, we found a higher damping factor for the LM algorithm is better than lower damping factor for the fMRI data analysis. More importantly, in most cases, the expectation trust region algorithm is superior to the EM algorithm in terms of accuracy if the random effect variance is large. We also compare these algorithms on real human datasets which comprise repeated measures of fMRI in phased-encoded and random block experiment designs. We observed that the proposed method is faster in computation and robust to Gaussian noise for the fMRI analysis. The advantages and limitations of the suggested methods are discussed.

Organization of myelin in the mouse somatosensory barrel cortex and the effects of sensory deprivation

In rodents, the barrel cortex is a specialized area within the somatosensory cortex that processes signals from the mystacial whiskers. We investigated the normal development of myelination in the barrel cortex of mice, as well as the effects of sensory deprivation on this pattern. Deprivation was achieved by trimming the whiskers on one side of the face every other day from birth. In control mice, myelin was not present until postnatal day 14 and did not show prominence until postnatal day 30; adult levels of myelination were reached by the end of the second postnatal month. Unbiased stereology was used to estimate axon density in the interbarrel septal region and barrel walls as well as the barrel centers. Myelin was significantly more concentrated in the interbarrel septa/barrel walls than in the barrel centers in both control and sensory-deprived conditions. Sensory deprivation did not impact the onset of myelination but resulted in a significant decrease in myelinated axons in the barrel region and decreased the amount of myelin ensheathing each axon. Visualization of the oligodendrocyte nuclear marker Olig2 revealed a similar pattern of myelin as seen using histochemistry, but with no significant changes in Olig2+ nuclei following sensory deprivation. Consistent with the anatomical results showing less myelination, local field potentials revealed slower rise times following trimming. Our results suggest that myelination develops relatively late and can be influenced by sensory experience.

Abnormal cortical processing of pattern motion in amblyopia: evidence from fMRI

Converging evidence from human psychophysics and animal neurophysiology indicates that amblyopia is associated with abnormal function of area MT, a motion sensitive region of the extrastriate visual cortex. In this context, the recent finding that amblyopic eyes mediate normal perception of dynamic plaid stimuli was surprising, as neural processing and perception of plaids has been closely linked to MT function. One intriguing potential explanation for this discrepancy is that the amblyopic eye recruits alternative visual brain areas to support plaid perception. This is the hypothesis that we tested. We used functional magnetic resonance imaging (fMRI) to measure the response of the amblyopic visual cortex and thalamus to incoherent and coherent motion of plaid stimuli that were perceived normally by the amblyopic eye. We found a different pattern of responses within the visual cortex when plaids were viewed by amblyopic as opposed to non-amblyopic eyes. The non-amblyopic eyes of amblyopes and control eyes differentially activated the hMT+ complex when viewing incoherent vs. coherent plaid motion, consistent with the notion that this region is centrally involved in plaid perception. However, for amblyopic eye viewing, hMT+ activation did not vary reliably with motion type. In a sub-set of our participants with amblyopia we were able to localize MT and MST within the larger hMT+ complex and found a lack of plaid motion selectivity in both sub-regions. The response of the pulvinar and ventral V3 to plaid stimuli also differed under amblyopic vs. non-amblyopic eye viewing conditions, however the response of these areas did vary according to motion type. These results indicate that while the perception of the plaid stimuli was constant for both amblyopic and non-amblyopic viewing, the network of neural areas that supported this perception was different.

Relationship of visual cortex function and visual acuity in anisometropic amblyopic children

PURPOSE

To detect the functional deficit of the visual cortex in anisometropic amblyopia children using functional magnetic resonance imaging (fMRI) technique, and investigate the relationship between visual acuity and visual cortex function.

METHODS

Blood oxygenation level-dependent fMRI (BOLD-fMRI) was performed in ten monocular anisometropic amblyopia children and ten normal controls. fMRI images were acquired in two runs with visual stimulation delivered separately through the sound and amblyopic eyes. Measurements were performed in cortical activation of striate and extrastriate areas at the occipital lobe. The relationship between cortex function and visual acuity was analyzed by Pearson partial analysis.

RESULTS

The activation areas of both the striate and extrastriate cortices in the amblyopic eyes were significantly lower than that of the sound fellow eyes. No relationship was found between the striate and extrastriate cortex activation. No relationship was found between the visual cortical activation of striate, extrastriate areas and visual acuity of anisometropic amblyopes.

CONCLUSIONS

BOLD-fMRI revealed the independent striate and extrastriate cortical deficits in anisometropic amblyopes. In addition, the visual acuity lesion and the striate and extrastriate cortical deficits were not parallel, and results of fMRI examination have much potential value in the evaluation of amblyopia.

Long timescale fMRI neuronal adaptation effects in human amblyopic cortex

An investigation of long timescale (5 minutes) fMRI neuronal adaptation effects, based on retinotopic mapping and spatial frequency stimuli, is presented in this paper. A hierarchical linear model was developed to quantify the adaptation effects in the visual cortex. The analysis of data involved studying the retinotopic mapping and spatial frequency adaptation effects in the amblyopic cortex. Our results suggest that, firstly, there are many cortical regions, including V1, where neuronal adaptation effects are reduced in the cortex in response to amblyopic eye stimulation. Secondly, our results show the regional contribution is different, and it seems to start from V1 and spread to the extracortex regions. Thirdly, our results show that there is greater adaptation to broadband retinotopic mapping as opposed to narrowband spatial frequency stimulation of the amblyopic eye, and we find significant correlation between fMRI response and the magnitude of the adaptation effect, suggesting that the reduced adaptation may be a consequence of the reduced response to different stimuli reported for amblyopic eyes.

Impaired spatial and binocular summation for motion direction discrimination in strabismic amblyopia

Amblyopia is characterised by visual deficits in both spatial vision and motion perception. While the spatial deficits are thought to result from deficient processing at both low and higher level stages of visual processing, the deficits in motion perception appear to result primarily from deficits involving higher level processing. Specifically, it has been argued that the motion deficit in amblyopia occurs when local motion information is pooled spatially and that this process is abnormally susceptible to the presence of noise elements in the stimulus. Here we investigated motion direction discrimination for abruptly presented two-frame Gabor stimuli in a group of five strabismic amblyopes and five control observers. Motion direction discrimination for this stimulus is inherently noisy and relies on the signal/noise processing of motion detectors. We varied viewing condition (monocular vs. binocular), stimulus size (5.3-18.5°) and stimulus contrast (high vs. low) in order to assess the effects of binocular summation, spatial summation and contrast on task performance. No differences were found for the high contrast stimuli; however the low contrast stimuli revealed differences between the control and amblyopic groups and between fellow fixing and amblyopic eyes. Control participants exhibited pronounced binocular summation for this task (on average a factor of 3.7), whereas amblyopes showed no such effect. In addition, the spatial summation that occurred for control eyes and the fellow eye of amblyopes was significantly attenuated for the amblyopic eyes relative to fellow eyes. Our results support the hypothesis that pooling of local motion information from amblyopic eyes is abnormal and highly sensitive to noise.

The contrast dependence of the cortical fMRI deficit in amblyopia; a selective loss at higher contrasts

Although there is general agreement that the fMRI cortical response is reduced in humans with amblyopia, the deficit is subtle and has little correlation with threshold-based psychophysics. From a purely contrast sensitivity perspective, one would expect fMRI responses to be selectively reduced for stimuli of low contrasts. However, to date, all fMRI stimuli used in studies of amblyopia have been of high contrast. Furthermore, if the deficit is selective for low contrasts, one would expect it to reflect a selective M-cell loss, because M-cells have much higher contrast gain than P-cells and make a larger contribution to the threshold detection of stimuli of low spatial and medium temporal frequencies. To test these two predictions, we compared % BOLD response between the eyes of normals and amblyopes for low- and high-contrast stimuli using a phase-encoded design. The results suggest that the fMRI deficit in amblyopia depends upon stimulus contrast and that it is greater at high contrasts. This is consistent with a selective P-cell contrast deficit at a precortical or early cortical site.