Contrast sensitivity and visual acuity under low light conditions in macular telangiectasia type 2

Müller, S. C.; Heeren, Tjebo; Bonelli, Roberto; Fruttiger, Marcus; Issa, Peter Charbel; Egan, Catherine; Holz, Frank G.

doi:10.1136/bjophthalmol-2017-311785

Cited by 13 publications

(21 citation statements)

References 23 publications

(11 reference statements)

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“…This finding is interesting and important, because we were previously able to show a marked loss of the Stiles-Crawford effect and an impairment of low luminance contrast sensitivity in those eyes of the same observers. 6,8 The impaired contrast sensitivity as opposed to the unimpaired microperimetry sensitivity are indicative of a (postreceptorally) impaired cone system, which would also be in keeping with recent electrophysiological findings in MacTel suggesting an inner retinal dysfunction. 17 Eyes with only minor MPOD loss (class 1) showed a general loss of cyan sensitivity but normal red sensitivity, whereas eyes with more pronounced MPOD loss (classes 2 and 3) showed focal loss of red sensitivity and (more pronounced) loss of cyan function (Fig.…”

Section: Discussionsupporting

confidence: 67%

“…7 Low light conditions have an overly negative effect on contrast sensitivity and visual acuity in MacTel patients compared with controls. 8 Recently, a two-color dark-adapted fundus-controlled perimetry device was introduced that combines the advantage of fundus-controlled perimetry (socalled microperimetry) with the possibility of retinal sensitivity testing under light-and dark-adapted conditions (so-called scotopic microperimetry). 9 In microperimetry, as opposed to conventional perimetry, stimuli are directly projected onto the retina, which allows creating precise retinal sensitivity maps.…”

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confidence: 99%

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Dark-Adapted Two-Color Fundus-Controlled Perimetry in Macular Telangiectasia Type 2

Heeren

Tzaridis

Bonelli

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. Macular telangiectasia type 2 (MacTel) is a bilateral neurodegenerative disorder of the central macula. Previous findings indicated more functional impairment in low light conditions. We sought to further characterize retinal dysfunction using dark-adapted twocolor fundus-controlled perimetry (''scotopic microperimetry''). METHODS.Participants of the MacTel Natural History Observation Registry study and agematched healthy controls underwent retinal imaging including dual wavelength autofluorescence macular pigment optical density (MPOD) measurement. Retinal sensitivity was assessed with scotopic microperimetry using cyan (505 nm) and red (627 nm). Disease was graded into classes of MPOD loss (0 to 3). For perimetry analysis, the differences of the mean sensitivities (MacTel minus controls) were compared at each test location and the results were aggregated to global indices.RESULTS. Thirty-four eyes (19 patients, mean age 62.2 years) were compared with 25 eyes (25 controls, mean age 61.5 years). Both cyan and red sensitivity were lower in MacTel. This was more pronounced at one-and three-degree eccentricity. Eyes with MPOD class 0 did not exhibit a functional deficit. Class 1 had impaired cyan, but normal red sensitivity. Class 2 and 3 behaved similarly and had impaired cyan and red sensitivity with a relatively higher cyan impairment.CONCLUSIONS. Rods might be compromised to a greater extent than cones. Linking to previous studies, our results might also hint toward (postreceptoral) dysfunction of the cone system in very early disease stages. Macular pigment loss and global perimetry indices seemed to reflect functional impairment and might be useful as adjunct measures for disease progression.

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Section: Discussionsupporting

confidence: 67%

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confidence: 99%

Dark-Adapted Two-Color Fundus-Controlled Perimetry in Macular Telangiectasia Type 2

Heeren

Tzaridis

Bonelli

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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“…In five studies, LLD has been shown to be a strong predictor of geographic atrophy progression and subsequent VA loss 10,38,39,41,43 . LLD is significantly reduced in patients with macular telangiectasia type 1, choroideremia and pseudoxanthoma elasticum when compared with healthy controls 44,45,50 . LLVA has been recommended as a clinical trial outcome measure for dry AMD, geographic atrophy and retinitis pigmentosa 25,37,75 .…”

Section: Discussion and Critical Reviewmentioning

confidence: 99%

“…However, most studies delivering useful insights into the impact of luminance levels on VA included only small participant numbers 5,8 . Similarly, in those studying rare diseases, large sample sizes are not feasible, but results can still be valuable 44,45,47,50 …”

Section: Limitationsmentioning

confidence: 99%

Low luminance visual acuity as a clinical measure and clinical trial outcome measure: a scoping review

Wood

Jolly

Buckley

et al. 2021

Ophthalmic Physiologic Optic

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Purpose The measurement of standard visual acuity (VA) is the most well‐known part of any ophthalmic examination to indicate visual function. Despite this, it is insensitive in detecting early disease changes. Therefore, other visual function tests have been developed including low luminance VA (LLVA) and low luminance deficit (LLD). This scoping literature review aims to summarise the current published applications of LLVA and LLD assessments to evaluate their utility as clinical markers and research outcome measures in a variety of ophthalmic conditions. Recent findings Sixty‐five peer‐reviewed publications were included. LLVA was pioneered for use in geographic atrophy, a subtype of age‐related macular degeneration, which remains the mainstay of its clinical application. However, other studies have reported additional useful applications in inherited retinal diseases including rare maculopathies and rod‐cone dystrophies. Although there are some variations in testing methodology, use of the standard Early Treatment Diabetic Retinopathy Study (ETDRS) chart with a 2.0 log unit neutral density filter is the most popular approach. The optimal testing luminance is still to be defined. Summary Overall, LLVA is an earlier clinical marker of change in central retinal function than standard VA. It has been shown to be a risk factor for disease progression and a better indicator of a patient’s level of everyday visual function. It is inexpensive and simple to implement using readily available standard ophthalmic equipment.

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“…Interestingly, an increasing number of studies have explored how CS is altered by extreme environmental conditions, such as low oxygen (Benedek et al., 2002; Pescosolido et al., 2015), sleep deprivation (Koefoed et al., 2015), display terminal fatigue (Gur & Ron, 1992), high gravity (Chou et al., 2003), low light (Müller et al., 2019), and glare (Finlay & Wilkinson, 1984; Puell et al., 2006). The current study is mainly focused on the effect of glare on CS.…”

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Reduced Contrast Sensitivity Function in Central and Peripheral Vision by Disability Glare

Wu¹,

Liu²,

Xu³

et al. 2020

Perception

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Various glares can decrease visual performance and cause discomfort, thus increasing drivers’ risk for traffic accidents in real life. The current study aimed to systematically investigate glare sensitivity in the central and peripheral visual fields by measuring contrast sensitivity function (CSF) under nonglare, steady glare, and transient glare conditions. Nine observers with normal visual acuity in the dominant eye were enrolled. The CSF in central and peripheral vision (the 5° upper left visual field) was measured in a mesopic environment while the stimulus was displayed under three conditions: nonglare, steady glare, and transient glare. An orientation identification task was used to obtain the CSF. After the experiment, the observers were asked to report their level of discomfort in the presence of the glare. The area under the log CSF (AULCSF) and cut-off spatial frequency served as indicators of visual performance. In agreement with previous studies, both steady and transient glare reduced the AULCSF and cut-off frequency. However, the AULCSF and cut-off frequency were reduced more for central vision than for nearly peripheral vision. In addition, the extent of the decreases in the AULCSF and cut-off frequency was greater for steady glare than for transient glare; in contrast, more discomfort was associated with transient glare than steady glare.

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Contrast sensitivity and visual acuity under low light conditions in macular telangiectasia type 2

Cited by 13 publications

References 23 publications

Dark-Adapted Two-Color Fundus-Controlled Perimetry in Macular Telangiectasia Type 2

Dark-Adapted Two-Color Fundus-Controlled Perimetry in Macular Telangiectasia Type 2

Low luminance visual acuity as a clinical measure and clinical trial outcome measure: a scoping review

Reduced Contrast Sensitivity Function in Central and Peripheral Vision by Disability Glare

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