Benefit of adaptive optics aberration correction at preferred retinal locus.

PURPOSE To investigate the effect of eccentric refractive correction and full aberration correction on both high- and low-contrast grating resolution at the preferred retinal locus (PRL) of a single low-vision subject with a long-standing central scotoma. METHODS The subject was a 68-year-old women with bilateral absolute central scotoma due to Stargardt disease. She developed a single PRL located 25° nasally of the damaged macula in her left eye, this being the better of the two eyes. High- (100%) and low-contrast (25 and 10%) grating resolution acuity was evaluated using four different correction conditions. The first two corrections were solely refractive error corrections, namely, habitual spectacle correction and full spherocylindrical correction. The latter two corrections were two versions of adaptive optics corrections of all aberrations, namely, habitual spectacle correction with aberration correction and full spherocylindrical refractive correction with aberration correction. RESULTS The mean high-contrast (100%) resolution acuity with her habitual correction was 1.06 logMAR, which improved to 1.00 logMAR with full spherocylindrical correction. Under the same conditions, low-contrast (25%) acuity improved from 1.30 to 1.14 logMAR. With adaptive optics aberration correction, the high-contrast resolution acuities improved to 0.89/0.92 logMAR and the low-contrast acuities improved to 1.04/1.06 logMAR under both correction modalities. The low-contrast (10%) resolution acuity was 1.34 logMAR with adaptive optics aberration correction; however, with purely refractive error corrections, she was unable to identify the orientation of the gratings. CONCLUSIONS Correction of all aberrations using adaptive optics improves both high- and low-contrast resolution acuity at the PRL of a single low-vision subject with long-standing absolute central scotoma.