Visual exploration of objects and scenes in patients with age-related macular degeneration☆

Summary Objective Studies on people with age-related macular degeneration (AMD) have shown that they are able to detect briefly displayed objects and scenes with high accuracy (above 80%). However, in everyday life we explore our environment to search and to recognize objects. We assessed visual exploration in people with AMD during the identification of objects and scenes. Method Twenty patients with AMD, fifteen age-matched and twelve young controls participated. We used colored photographs of isolated objects, natural scenes and objects in scenes, displayed centrally on a monitor. Participants were asked to name the objects and scenes. Ocular movements were recorded during the identification task. Scan paths, saccades, fixations, and accuracy were also recorded. Results People with AMD exhibited lower accuracy (by about 30%). Eye movement parameters were impaired with a larger number of saccades, shorter fixation durations and a larger scan path than controls. Conclusions Our results are consistent with studies on artificial scotoma in normally sighted people showing that a central scotoma impairs oculomotricity. In contrast to detection tasks, people with central vision loss exhibit impaired performance in identification of objects and scenes (62 to 66%). Eye movement studies suggest that the lower accuracy in patients is likely due to the use of peripheral vision and instability of fixation.