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C.A. Applegate, J.S. Sunness; Retention of Preferred Retinal Locus Site in the Geographic Atrophy Natural History Study . Invest. Ophthalmol. Vis. Sci. 2004;45(13):3068.
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Purpose: To determine whether there is a shift in the location of the preferred retinal locus (PRL) over long–term follow–up in patients with central scotomas from geographic atrophy (GA) associated with age–related macular degeneration. Methods: We have previously reported (Sunness JS, Applegate CA, et al: Ophthalmology 103:1458–1466, 1996) on the fixation patterns seen in GA eyes with visual acuities between 20/80 and 20/200 inclusive. We looked at the long–term follow–up of these patients, to determine whether the original preferred retinal locus site was retained, using the scanning laser ophthalmoscope. Results: Twenty–six patients (39 eyes) had available follow–up (median 5.3 years, range 1.1–7.2 years; 21 patients had four or more years of follow–up. 28 of 39 eyes (72%) retained the same location of the PRL relative to the atrophy. At the final SLO evaluation, 5 fixated within the atrophy, 2 had not developed a fixation site, 6 fixated to the right of the scotoma, 20 fixated to the left, 5 fixated below the scotoma, and 1 fixated above the scotoma. Of the 13 patients for whom both eyes were evaluated, 9 had symmetric fixation both at baseline and at the final visit, 3 were asymmetric at baseline but became symmetric by the final visit, and 1 was and remained asymmetric. Conclusions: The PRL remained in the same location relative to the atrophy in 72% of eyes. The preference for fixation to the left rather than to the right of the scotoma, and below rather than above the scotoma remains.
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