Reading Assessment and Eye Movement Analysis in Bilateral Central Scotoma Due to Age-Related Macular Degeneration

Abstract

This study investigates reading performances and eye movements in individuals with eccentric fixation due to age-related macular degeneration (AMD). Overall, 17 individuals with bilateral AMD (7 males; mean age 77.47 ± 5.96 years) and 17 controls (10 males; mean age 72.18 ± 5.98 years) were assessed for reading visual acuity (VA), reading speed (Minnesota low vision reading chart in Slovene, MNREAD-SI), and near contrast sensitivity (Pelli-Robson). Microperimetry (NIDEK MP-3) was used to evaluate preferential retinal locus (PRL) location and fixation stability. Eye movements were recorded with Tobii Pro-glasses 2 and analyzed for reading duration, saccade amplitude, peak velocity, number of saccades, saccade duration, and fixation duration. Individuals with AMD exhibited significantly reduced reading indices (worse reading VA (p < 0.001), slower reading (p < 0.001), and lower near contrast sensitivity (p < 0.001)). Eye movement analysis revealed prolonged reading duration, longer fixation duration, and an increased number of saccades in individuals with AMD per paragraph. The number of saccades per paragraph was significantly correlated with all measured reading indices. These findings provide insights into reading adaptations in AMD. Simultaneously, the proposed approach in analyzing eye movements puts forward eye trackers as a prospective diagnostic tool in ophthalmology.