The natural preferred retinal locus in patients with macular disease

This study aimed to explore the characteristics of the natural Preferred Retinal Locus (PRL) in eyes with different macular lesions. In this retrospective study, 37 patients (39 eyes) suffered from macular diseases (MD) were included, and the following data were collected: best corrected visual acuity (BCVA), mean sensitivity of macular area in 10 deg diameter (MS), bivariate contour ellipse area (63% BCEA and 95% BCEA), fixation stability, and fundus images and sectional images of the fovea. A natural PRL did not develop in 10 eyes with macular disease. A total of 29 eyes developed natural PRLs: 42% developed superior PRLs, 17% developed temporal PRLs, 24% developed nasal PRLs, 7% developed multiple PRLs, 10% developed PRLs inside the "dark area", and there were no independent inferior PRLs. In the inside group, the mean MS was significantly lower than that of the other four groups; and the variations in log BCEA were greater in group M compared with group S (P < 0.01), group T (P < 0.01) and group N (P < 0.01), but there were no obvious differences among group S, group T and group N. A natural PRL tends to be more localized in the upper retina, possibly to preserve the lower visual field, followed by nasal and temporal, and rarely localized in the lower retina, and multiple scattered PRLs can be formed when the lesion was widespread. If the function of the fovea exists, even if the lesion in the macular area is clear, the patient still uses the fovea for central fixation and does not form PRL.