Effect of Background Brightness on Preferred Retinal Loci in Patients With Macular Disease

Purpose: To evaluate the effect of background brightness on the preferred retinal locus (PRL) in patients with macular disease.

Methods: The study included 27 eyes (27 patients) with macular disease. Microperimetry (MP) was performed to evaluate the PRL and retinal sensitivity (RS) at 10 cd/m². A prototypical device was used to evaluate the PRL at 650 cd/m². Patients were divided into two groups: central fixation (CF) and eccentric fixation (EF).

Results: The PRLs under different brightness levels differed significantly (P < 0.001) in 15 of 27 eyes (two of 13 eyes in the CF group and 13 of 14 eyes in the EF group). The best-corrected visual acuities (BCVAs) in eyes with different PRLs were significantly worse (P = 0.019) than in eyes with one PRL, although the foveal RS did not differ significantly. In patients with BCVAs over 0.1, the PRLs differed in four of 13 eyes in the CF group and in three of four eyes in the EF group (P > 0.05); in patients with BCVAs of 0.1 or lower, the PRLs differed in one of four eyes and 10 of 10 eyes, respectively (P = 0.011).

Conclusions: In patients with macular disease, PRLs can change depending on the surrounding brightness. It may be beneficial to evaluate PRLs under brighter background conditions (e.g., in ambient light) when performing visual rehabilitation for these patients.

Translational relevance: This study provides important information for visual rehabilitation of patients with macular disease.