Mapping Visual Contrast Sensitivity and Vision Loss Across the Visual Field with Model-Based fMRI

Peripheral vision is crucial for daily activities and quality of life, yet traditional measures of visual function like visual acuity primarily assess central vision. Visual field tests can evaluate peripheral vision but require extended focus combined with precise fixation, often very challenging for patients with severe sight loss. Functional MRI (fMRI) with population receptive field (pRF) mapping offers a non-invasive way to map scotomas but is limited by its reliance on single contrast levels and the necessity of accurate fixation. We developed an fMRI-based approach to measure contrast sensitivity across the visual field without the need for precise fixation. By combining large-field stimulation with varying spatial frequencies and contrast levels with either pRF mapping or a retinotopic atlas based on anatomical landmarks, we modeled contrast sensitivity in the primary visual cortex (V1) over a large (40 deg) expanse of the visual field. In seven normal-sighted participants, we characterized differences in V1 cortical sensitivity across eccentricities and visual quadrants, finding reliable and reproducible patterns of sensitivity differences at individual and session levels. Additionally, our method effectively visualized cases of simulated and disease-linked sensitivity loss at the cortical level. Crucially, we demonstrated that these results could be largely recovered using a structure-based retinotopic atlas, eliminating the need for pRF mapping and precise fixation - although such an approach reduced sensitivity. This approach, integrating large-field stimulation with a retinotopic atlas, offers a promising tool for monitoring vision loss and recovery in patients with various visual impairments, addressing a significant challenge in current clinical assessments.