ABSTRACT

Background: Identification of fixation location is an integral part of low vision assessment and subsequent rehabilitation. We performed a study to determine whether retinal photography is able to identify fixation location in eyes with age-related macular degeneration (AMD).

Methods: In a prospective, observational case series, consecutive patients with AMD attending a low-vision clinic underwent monocular fixation attempts at a fixation target of a standard ophthalmic fundus camera. Inclusion criteria included AMD with documented macular disease, low vision in both eyes and best-corrected visual acuity of 20/50 to 20/200 in the tested eye. Retinal photography was used to document retinal location of attempted fixation. Macular perimetry was used to confirm acceptable fixation maintenance behaviour. Outcome measures included acceptable fixation maintenance during retinal photography and retinal location of fixation pattern.

Results: Twenty-one patients (14 women and 7 men with an average age of 78 [range 53 to 86] years) met the inclusion criteria. In nine cases both eyes met the study criteria, for a total of 30 eyes. Of the 30 eyes, 24 (80%) had acceptable fixation maintenance with retinal photography (p = 0.939). In 17 (71%) of the 24 eyes the retinal fixation location was superior to the macular scar.

Interpretation: The results suggest that retinal photography may provide a reliable method to identify retinal location of fixation in eyes with AMD.