Preferred retinal locus in macular disease: characteristics and clinical implications.
OBJECTIVE
To investigate the location and fixation stability of preferred retinal locations (PRLs) in patients with macular disease, and the relationship among areas of abnormal fundus autofluorescence, the PRL and visual sensitivity.


METHODS
Fifteen patients (15 eyes) were studied. Seven had Stargardt disease, 1 bull's eye maculopathy, 5 age-related macular degeneration, 1 Best disease, and 1 pattern dystrophy. All tested eyes had areas of abnormal fundus autofluorescence. The PRL was evaluated with fundus photography and the Nidek microperimeter. Visual field sensitivity was measured with the Nidek microperimeter.


RESULTS
Of the 15 eyes, 4 had foveal and 11 had eccentric fixation. Eccentric PRLs were above the atrophic lesion and their stability did not depend on the degree of eccentricity from the fovea. Visual sensitivity was markedly decreased in locations corresponding to hypofluorescent areas. Sensitivity was not decreased in hyperfluorescent areas corresponding to flecks but was decreased if hyperfluorescence was in the form of dense annuli.


CONCLUSIONS
Eccentric PRLs were in the superior retina in regions of normal fundus autofluorescence. Fixation stability was not correlated with the degree of eccentricity from the fovea. To assess the outcomes of treatment trials it is important to use methods that relate retinal morphology to visual function.
Greenstein
Vivienne C
VC
Department of Ophthalmology, Columbia University, 630 West 165th Street, New York, NY 10032, USA. vcg17@columbia.edu
Santos
Rodrigo A V
RA
Tsang
Stephen H
SH
Smith
R Theodore
RT
Barile
Gaetano R
GR
Seiple
William
W
D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005403:Fixation, Ocular; D005453:Fluorescence; D005654:Fundus Oculi; D006801:Humans; D008266:Macula Lutea; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000473:pathology / Q000503:physiopathology*; D012164:Retinal Diseases / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D012607:Scotoma / Q000175:diagnosis / Q000209:etiology; D014792:Visual Acuity; D058609:Visual Field Tests; D014794:Visual Fields; D055815:Young Adult