Preferred Retinal Locus in Patients with Age-related Macular Degeneration

Purpose To evaluate the status and location of the preferred retinal locus (PRL) and visual function in age-related macular degeneration (AMD). Subjects and Methods Thirty-five patients were examined. They were diagnosed as having bilateral AMD in the disciform stage. Scanning laser ophthalmoscopic microperimetry was performed to detect the PRL. The retinal conditions of the PRL were classified using color fundus photographs and fluorescein angiography. The eccentricities of PRL from the fovea were measured. The relationships among visual acuity, retinal sensitivity, and the eccentricities of the PRL were evaluated. Results In 34 of the 35 eyes, PRLs had shifted from the fovea to the closest extrafoveal site, either an area of healthy retina or an atrophic lesion of the retinal pigment epithelium, whichever was closest to the fovea. In the eye in which the healthy retina was located distant from the fovea, the PRL had shifted to the atrophic pigment epithelium nearest the fovea. When it was possible for a PRL to move with similar eccentricity away from the fovea, it moved to the upper or temporal retina. The PRL eccentricities from the fovea ranged from 0.5 to 11 degrees, and the visual acuities ranged from 0.08 to 0.4. There were differences in visual acuity even in eyes with the same eccentricity of PRLs, depending on the status of the retina in those eyes. Conclusions If there is scar formation in the fovea, the PRL moves to the nearest edge of the scar. Visual acuity and retinal sensitivity are determined by the status of the PRL. Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc 107:602–606, 2003)