Face recognition in age-related maculopathy.

Patients with age-related maculopathy (ARM) complain frequently of difficulty with face recognition. The authors attempted to quantify the level of impairment by comparing face recognition with clinical tests of visual function, namely contrast sensitivity, grating acuity, letter-chart acuity, and word-reading acuity. For face recognition, we used 32 black-and-white photographs that had been cropped to remove the outline of hair so that identification was predominantly dependent on the facial features. The observer's distance from the screen on which the photographs were projected was varied. The angular size of the faces was indicated by the equivalent viewing distance (EVD). Four male and four female models were used, and for each model, there were four photographs with different facial expressions--happy, sad, angry, and afraid. For each photograph, the subject's task was to name the model and identify the facial expression. Threshold EVD (50%) was determined for correct identity recognition and expression recognition. For eight subjects all experimental procedures were repeated at a lower luminance level. For ARM subjects, increasing task complexity (grating/letters/words) substantially decreased resolution. Face-recognition abilities were most closely related to word-reading acuity when comparisons were made either across subjects or across luminances within subjects. Contrast sensitivity was associated poorly with face-recognition thresholds. In some subjects with more advanced ARM, identity recognition was substantially poorer than expression recognition.