Preferred Retinal Locus in Juvenile Macular Dystrophy

To evaluate foveal lesion and preferred retinal locus (PRL) locations and their effects on visual acuity in juvenile macular dystrophy (JMD) patients.

In this retrospective study, 14 JMD patients (28 eyes) with bilateral central vision loss were examined using scanning laser ophthalmoscope/optical coherence tomography. Best-corrected visual acuity (BCVA), dimensions and location of the macular lesion, PRL location, and PRL stability were evaluated.

Mean BCVA was 0.84±0.17 logarithm of the minimum angle of resolution. PRL was superiorly located in 64.3% of eyes and nasally located in 35.7%. PRL location was significantly associated with patient age (r=0.541, p=0.002); nasally located PRLs were more common in younger patients (mean age 15.1±2.8 years) while superiorly located PRLs were more common in older patients (mean age 22.4±6.9 years). Superiorly located PRLs were significantly closer to the fovea than nasally located PRLs (p=0.014). Visual acuity worsened as lesion size increased and PRL-fovea distance increased. PRL-fovea distance was longer in younger patients and positively correlated with lesion dimensions and PRL-lesion distance.

In JMD patients, PRLs are predominantly located superiorly or nasally. In younger patients, PRLs are typically located nasally and farther from the fovea, with poorer visual acuity compared to older patients. Cortical adaptation mechanisms may play a role in changing PRL location with age. Understanding PRL characteristics in JMD is crucial for developing effective low-vision rehabilitation strategies.