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Spatial Alignment over Retinal Scotomas

¹From the University College London Institute of Ophthalmology, London, United Kingdom; ²Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; and ³Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts.

PURPOSE. Perceptual completion can mask the presence of physiological and pathologic retinal scotomas. This psychophysical study used a spatial alignment task to examine the processes underlying this perceptual completion. Similarities between the completion of pathologic and physiological scotomas would be consistent with large-scale reorganization of the visual system in eye disease

METHODS. In five control subjects with no eye disease, Vernier alignment thresholds were measured over the physiological blind spot at the optic nerve head and over equally eccentric temporal retina. For nine subjects with retinal scotomas, alignment thresholds were measured over the maximum vertical extent of the larger scotoma in one eye and at an equal separation and eccentricity in the eye with a smaller or no scotoma

RESULTS. In control subjects, alignment thresholds were better over the physiological blind spot than over equally eccentric temporal retina (P < 0.05). Alignment thresholds were no better over pathologic retinal scotomas than more intact, equally eccentric retina (P = 0.9)

CONCLUSIONS. These quantitative differences implicate different mechanisms for perceptual completion over pathologic and physiological retinal scotomas. Filling in across pathologic scotomas appears to involve higher level image processing-based mechanisms that operate even when their input is interrupted. Filling-in at the optic nerve head involves additional low-level processes that may be hardwired, in which receptive fields span the blind spot and support fine orientation discriminations. These results argue against low-level reorganization of the visual system in people with retinal disease.