Reading strategies in Stargardt's disease with foveal sparing.
BACKGROUND
Subjects with a ring scotoma can use two retinal loci, a foveal and a peripheral, for reading. Our aim was to investigate the relative use of both retinal loci as a function of the spared foveal area size and the spatial resolution at both retinal loci.


RESULTS
Two patients with Stargardt's disease and ring scotomas read through a scanning laser ophthalmoscope a series of letters and words at various character sizes. The number of fixations made using each retinal locus was quantified. The relative use of each retinal locus depended on character size of the stimulus. Both patients used exclusively the eccentric retinal locus to read words of large character sizes. At small character sizes, the central retinal locus was predominantly used. For reading letters or words, once foveal fixation was used, patients did not shift back to the eccentric retinal locus. When spatial resolution allowed deciphering at both the eccentric and the central areas, patients consistently fixated with the eccentric retinal locus.


CONCLUSIONS
Spatial resolution at the eccentric locus appears as a determinant factor to select the retinal area for reading. Reading strategies in patients with Stargardt's disease and a ring scotoma demonstrate a pattern of coordination of both eccentric and central retinal loci, reflecting a high degree of adaptation.
Goldschmidt
Mira
M
Ophthalmology Clinic, Department of Clinical Neurosciences, Geneva University Hospitals, Alcide-Jentzer 22, 1211 Geneva 14, Switzerland. mira@urbanet.ch.
Déruaz
Anouk
A
Lorincz
Erika N
EN
Whatham
Andrew R
AR
Mermoud
Christophe
C
Safran
Avinoam B
AB