Early life maturation of human visual system white matter is altered by monocular enucleation

Monocular enucleation early in life and the resultant lack of binocular visual input during visual development results in functional and structural brain changes in adulthood, including alterations in white matter microstructure. However, the time courses of these neurodevelopmental changes are unknown. Here, we investigated whether structural brain changes were present at 8 to 12 years of age in a group of children with a history of monocular enucleation prior to 3 years of age (the ME group) relative to control participants with normal binocular vision (the BC group). Structural connectivity was measured using diffusion tensor imaging (DTI). Relative to the BC group, the ME group exhibited significantly increased radial and mean diffusivity in the optic radiation contralateral to the enucleated eye, the bidirectional interhemispheric V1 to V1 tracts and the V1 to MT tract ipsilateral to the enucleated eye. These changes indicate abnormal myelinization and reduced axonal density in subcortical and cortical visual pathway white matter structures following unilateral enucleation and loss of binocular vision. Our findings are broadly consistent with those recently reported for older uniocular individuals suggesting that these effects are present in childhood and persist into adulthood.