Contrast sensitivity function in patients with macular disease and good visual acuity

Abstract

IntroductionContrast sensitivity function (CSF) may better estimate a patient’s visual function compared with visual acuity (VA). Our study evaluates the quick CSF (qCSF) method to measure visual function in eyes with macular disease and good letter acuity.MethodsPatients with maculopathies (retinal vein occlusion, macula-off retinal detachment, dry age-related macular degeneration and wet age-related macular degeneration) and good letter acuity (VA ≥20/30) were included. The qCSF method uses an intelligent algorithm to measure CSF across multiple spatial frequencies. All maculopathy eyes combined and individual macular disease groups were compared with healthy control eyes. Main outcomes included area under the log CSF (AULCSF) and six CS thresholds ranging from 1 cycle per degree (cpd) to 18 cpd.Results151 eyes with maculopathy and 93 control eyes with VA ≥20/30 were included. The presence of a maculopathy was associated with significant reduction in AULCSF (β: −0.174; p<0.001) and CS thresholds at all spatial frequencies except for 18 cpd (β: −0.094 to −0.200 log CS, all p<0.01) compared with controls. Reductions in CS thresholds were most notable at low and intermediate spatial frequencies (1.5 cpd, 3 cpd and 6 cpd).ConclusionCSF measured with the qCSF active learning method was found to be significantly reduced in eyes affected by macular disease despite good VA compared with healthy control eyes. The qCSF method is a promising clinical tool to quantify subtle visual deficits that may otherwise go unrecognised by current testing methods.

Hierarchical Bayesian modeling of contrast sensitivity functions in a within-subject design

“…A recent qCSF implementation with a 10-letter identification task enabled assessment of the CSF with a 0.10 log unit standard deviation in about 20 trials (approximately 2 minutes) and reduced the standard deviation of the estimates by 50% ( Hou, Lesmes, Bex, Dorr, & Lu, 2015 ). Accurate and precise qCSF estimates have been obtained in both normal ( Reynaud, Tang, Zhou, & Hess, 2014 ; Rosén, Lundström, Venkataraman, Winter, & Unsbo, 2014 ) and clinical populations ( Hou, Huang, Lesmes, Feng, Tao, Zhou, & Lu, 2010 ; Jia, Zhou, Lu, Lesmes, & Huang, 2015 ; Joltikov, de Castro, Davila, Anand, Khan, Farbman, Jackson, Johnson, & Gardner, 2017 ; Lesmes, Jackson & Bex, 2013 ; Lesmes, Wallis, Jackson, & Bex, 2013 ; Lesmes, Wallis, Lu, Jackson, & Bex, 2012 ; Lin, Mihailovic, West, Johnson, Friedman, Kong, & Ramulu, 2018 ; Ou, Lesmes, Christie, Denlar, & Csaky, 2021 ; Ramulu, Dave, & Friedman, 2015 ; Rosen, Jayaraj, Bharadwaj, Weeber, Van der Mooren, & Piers, 2015 ; Stellmann, Young, Pottgen, Dorr, & Heesen, 2015 ; Thomas, Silverman, Vingopoulos, Kasetty, Yu, Kim, Omari, Joltikov, Choi, Kim, Zacks, & Miller, 2021 ; Vingopoulos, Wai, Katz, Vavvas, Kim, & Miller, 2021 ; Wai, Vingopoulos, Garg, Kasetty, Silverman, Katz, Laíns, Miller, Husain, Vavvas, Kim, & Miller, 2021 ; Yan, Hou, Lu, Hu, & Huang, 2017 ).…”

Measuring the Contrast Sensitivity Function in Non-Neovascular and Neovascular Age-Related Macular Degeneration: The Quantitative Contrast Sensitivity Function Test

“…In our recently published work [79], our team has also examined a large cohort of 151 patients who retained good visual acuity and with different macular diseases including Our team has also previously reported on the qCSF method in eyes with maculaoff rhegmatogenous retinal detachment (RRD) after surgical repair. Eyes with a history of macula-off RRD had statistically significant reductions in AULCSF and in contrast sensitivity thresholds across all spatial frequencies compared to healthy age-matched control eyes [74].…”

“…In our recently published work [79], our team has also examined a large cohort of 151 patients who retained good visual acuity and with different macular diseases including RVO, history of macula RRD, and dry and wet AMD. Similarly, reductions in AULCSF and contrast thresholds at all spatial frequencies were found to be significantly reduced in eyes with various macular diseases with VA as good as 20/30, and even in the eyes with VA 20/20 −1 , compared to 93 healthy control eyes.…”

Contrast Sensitivity Deficits and Its Structural Correlates in Fuchs Uveitis Syndrome

“…Many studies have demonstrated that CSF could reflect the correlation between subjective visual function and vision-guided activities in daily life ( 42 – 44 ). Wai et al showed that eyes with macular disease and good VA have significantly reduced CSF compared with healthy control eyes ( 45 ), and they thought CSF may be able to explain some subjective visual complaints and patients' bad visual experiences while visual acuity may not. Shamsi et al have even put forward the idea that the visual acuity and contrast sensitivity in the foveal region were dissociative ( 46 ).…”

“…Several studies have demonstrated that retinal structure is closely related to contrast sensitivity ( 31 , 45 , 47 ). Wang found that the retinal inner layer is associated with reduced contrast sensitivity in retinal vein occlusion ( 47 ).…”