Changes in eye movement parameters in the presence of an artificial central scotoma

Central vision loss, such as in the case of age-related macular degeneration (AMD), has a a major negative impact on patients' quality of life. However, some patients have shown spontaneous adaptive strategies development, mostly relying on their peripheral vision.

This study assesses eye movement and eccentric visual function adaptive behaviors of a healthy population in the presence of simulated central vision loss. We wished to determine how central vision loss affects eye movements, specifically the foveal-target alignment.

Fifteen healthy participants (7 females, M = 21.69, SD = 2.13) discriminated the orientation of a Gabor relative to the vertical located at 12 deg of eccentricity to the right of fixation, in the presence of a gaze-contingent artificial central scotoma either visible or invisible. The artificial central scotoma was 4° diameter in order to simulate an earlier stage of degenerative disease while still impairing foveal vision. The target's orientation varied between 10° counter-clockwise and 10° clockwise. Each participant performed four blocks of 75 trials each per day over 10 days, the first day being a baseline without scotoma.

We found changes in the endpoints of the 1st saccade over the practice days. The most common pattern was a gradual upward shift. We also observed a significant increase in discrimination performance over the 9 days of practice. We did not find any difference linked to the scotoma types.

These findings suggest that the presence of an artificial central scotoma combined with a challenging discrimination task induces both changes in saccade planning mechanisms, resulting in a new eccentric-target alignment, and improvements in eccentric visual functions. This demonstrates the potential of this research paradigm to understand and potentially improve visual function in patients with central vision loss.