Background: Cortical remapping after peripheral or central visual deafferentation alters visual perception, but it is unclear whether such a phenomenon impinges on areas remote from a scotoma. To investigate this question, we studied variations of perceptual spatial distortion in the visual field of patients with homonymous paracentral scotoma. Methods: Two patients with right inferior homonymous paracentral scotoma were asked to describe their perception of a series of figures showing two isometric vertical lines symmetrically located on either side of a fixation point. In each figure, the fixation point varied by steps of 2° along a hypothetical vertical line equidistant between the test lines. The lines subtended 20° of visual angle, and the right line passed through the scotoma in both cases. Time for spatial distortion to manifest was recorded. Results: Both subjects reported that the right line was perceived as shorter than the left one. The line shortening varied in magnitude with the distance of the fixation point from the end of the line and was more pronounced when the distance increased. Moreover, perceptual line shortening appeared 5-10 seconds after steady fixation, but values of shortening varied during the following 10 seconds. In addition, the right line appeared uninterrupted or slightly blurred in the scotoma region. Conclusions: These observations reflect long-range cortical reorganization after brain damage. Larger receptive fields in the periphery of the visual map could explain why perceptual shortening is more pronounced with increased eccentricity.
