Monocular and binocular smooth pursuit in central field loss

Macular degeneration results in heterogeneous central field loss (CFL) and often has asymmetrical effects in the two eyes. As such, it is not clear to what degree the movements of the two eyes are coordinated. To address this issue, we examined smooth pursuit quantitatively in CFL participants during binocular viewing and compared it to the monocular viewing case. We also examined coordination of the two eyes during smooth pursuit and how this coordination was affected by interocular ratios of acuity and contrast, as well as CFL-specific interocular differences, such as scotoma sizes and degree of binocular overlap. We hypothesized that the coordination of eye movements would depend on the binocularity of the two eyes. To test our hypotheses, we used a modified step-ramp paradigm, and measured pursuit in both eyes while viewing was binocular, or monocular with the dominant or non-dominant eye. Data for CFL participants and age-matched controls were examined at the group, within-group, and individual levels. We found that CFL participants had a broader range of smooth pursuit gains and a significantly lower correlation between the two eyes, as compared to controls. Across both CFL and control groups, smooth pursuit gain and correlation between the eyes are best predicted by the ratio of contrast sensitivity between the eyes. For the subgroup of participants with measurable stereopsis, both smooth pursuit gain and correlation are best predicted by stereoacuity. Therefore, our results suggest that coordination between the eyes during smooth pursuit depends on binocular cooperation between the eyes.