Open Access Short Report

Reading strategies in Stargardt's disease with foveal sparing

Mira Goldschmidt1*, Anouk Déruaz12, Erika N Lorincz1, Andrew R Whatham13, Christophe Mermoud1 and Avinoam B Safran1

  • * Corresponding author: Mira Goldschmidt

  • † Equal contributors

Author Affiliations

1 Ophthalmology Clinic, Department of Clinical Neurosciences, Geneva University Hospitals, Alcide-Jentzer 22, 1211 Geneva 14, Switzerland

2 Perception and Eye Movement Laboratory, Department of Neurology and Department of Clinical Research, University of Bern, Inselspital, Switzerland

3 Institute for Eye Research, University of New South Wales, Sydney, Australia

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BMC Research Notes 2010, 3:15  doi:10.1186/1756-0500-3-15

Published: 22 January 2010



Subjects with a ring scotoma can use two retinal loci, a foveal and a peripheral, for reading. Our aim was to investigate the relative use of both retinal loci as a function of the spared foveal area size and the spatial resolution at both retinal loci.


Two patients with Stargardt's disease and ring scotomas read through a scanning laser ophthalmoscope a series of letters and words at various character sizes. The number of fixations made using each retinal locus was quantified. The relative use of each retinal locus depended on character size of the stimulus. Both patients used exclusively the eccentric retinal locus to read words of large character sizes. At small character sizes, the central retinal locus was predominantly used. For reading letters or words, once foveal fixation was used, patients did not shift back to the eccentric retinal locus. When spatial resolution allowed deciphering at both the eccentric and the central areas, patients consistently fixated with the eccentric retinal locus.


Spatial resolution at the eccentric locus appears as a determinant factor to select the retinal area for reading. Reading strategies in patients with Stargardt's disease and a ring scotoma demonstrate a pattern of coordination of both eccentric and central retinal loci, reflecting a high degree of adaptation.