Age-related macular degeneration (AMD), affecting the retina, afflicts
one out of ten people aged 80 years or older in the United States. AMD
often results in vision loss to the central 15–20 deg of the visual
field (i.e. central scotoma), and frequently afflicts both eyes. In most
cases, when the central scotoma includes the fovea, patients will adopt an
eccentric preferred retinal locus (PRL) for fixation. The onset of a
central scotoma results in the absence of retinal inputs to corresponding
regions of retinotopically mapped visual cortex. Animal studies have shown
evidence for reorganization in adult mammals for such cortical areas
following experimentally induced central scotomata. However, it is still
unknown whether reorganization occurs in primary visual cortex (V1) of AMD
patients. Nor is it known whether the adoption of a PRL corresponds to
changes to the retinotopic mapping of V1. Two recent advances hold out the
promise for addressing these issues and for contributing to the
rehabilitation of AMD patients: improved methods for assessing visual
function across the fields of AMD patients using the scanning laser
ophthalmoscope, and the advent of brain-imaging methods for studying
retinotopic mapping in humans. For the most part, specialists in these two
areas come from different disciplines and communities, with few
opportunities to interact. The purpose of this review is to summarize key
findings on both the clinical and neuroscience issues related to questions
about visual adaptation in AMD patients.