[Perception of objects and scenes in age-related macular degeneration]

Vision related quality of life questionnaires suggest that patients with AMD exhibit difficulties in finding objects and in mobility. In the natural environment, objects seldom appear in isolation. They appear in a spatial context which may obscure them in part or place obstacles in the patient's path. Furthermore, the luminance of a natural scene varies as a function of the hour of the day and the light source, which can alter perception. This study aims to evaluate recognition of objects and natural scenes by patients with AMD, by using photographs of such scenes. Studies demonstrate that AMD patients are able to categorize scenes as nature scenes or urban scenes and to discriminate indoor from outdoor scenes with a high degree of precision. They detect objects better in isolation, in color, or against a white background than in their natural contexts. These patients encounter more difficulties than normally sighted individuals in detecting objects in a low-contrast, black-and-white scene. These results may have implications for rehabilitation, for layout of texts and magazines for the reading-impaired and for the rearrangement of the spatial environment of older AMD patients in order to facilitate mobility, finding objects and reducing the risk of falls.