Scene perception in age-related macular degeneration.

PURPOSE To assess the scene gist recognition in eyes with age-related macular degeneration (AMD) and to study the relationship between scene recognition and macular function. METHODS Twenty-seven patients with age-related macular degeneration with a visual acuity lower than 20/50 and 17 age-matched controls were included. All patients underwent a visual field test, fundus autofluorescence, and fluorescein angiography to assess the visual field defect and the lesion size. The stimuli were colored photographs of natural scenes displayed on a 30-inch screen. Two scene categorization tasks were performed: natural versus urban and indoor versus outdoor scenes. Participants were given a target (e.g., indoor scenes) and asked to press a key when they saw a picture corresponding to that target. Accuracy and response times were recorded. RESULTS Patients with AMD were able to accomplish both categorization tasks with a high correct detection rate (above 75% correct), though performance was lower than in controls for both natural/urban scenes and indoor/outdoor scenes. Patients with AMD were more accurate and faster for natural/urban scenes than for indoor/outdoor scenes, but performance did not differ between the two categories in controls. No significant correlation was found between performance for scene categorization and clinical variables such as visual acuity, type of AMD, size of the scotoma, and size of the lesion. CONCLUSIONS Scene gist recognition can be accomplished with the low spatial resolution of peripheral vision. These results support the "scene-centered approach" that initial scene recognition is based on the global scene properties and not on the objects it contains.