Preferred retinal locus and its clinical application

Macular diseases usually lead to central vision loss, accompanied by a significant unstable fixation, resulting in disorders of fine vision, reading, and even face recognition, which seriously affect the quality of life of patients.There is no clear and effective treatment to reverse the visual impairment caused by atrophic macular diseases, yet patients with central vision loss secondary to macular diseases commonly adopt a region outside the central macular area as the surrogate fovea for vision, which is named preferred retinal locus (PRL).However, natural PRLs are not optimal in common for low-vision rehabilitation.Therefore, some patients need eccentric fixation training for PRL relocation to achieve better visual rehabilitation.Studies have shown that eccentric fixation training based on biofeedback can stabilize the natural PRL or induce a new PRL to improve low-vision rehabilitation in patients with macular diseases.So far, the development and location characteristics of PRL and the clinical applications and efficacy of training remain controversial.This review concludes the concept and features of PRL, including the characteristics and possible rationale of PRL development, the location and relocation of PRL, and the evaluation indicators of PRL relocation.Furthermore, in order to provide clinical guidance for low-vision rehabilitation of patients with central vision loss, the programs and efficacy of eccentric fixation training for low-vision rehabilitation are also reviewed.

Preferred retinal locus; Location; Re-location; Biofeedback; Eccentric training