Strongest Correlation Between Contrast Sensitivity and Morphological Characteristics in Bilateral nAMD

Abstract

In patients with neovascular age-related macular degeneration (nAMD) there is often an inconsistency between their subjective visual impairment and a still relatively preserved standard Early Treatment of Diabetic Retinopathy Study (ETDRS) best corrected visual acuity. Therefore, in order to better capture the specific functional defects in nAMD, other tests need to be evaluated. In a previous study, we reported contrast sensitivity of the better eye to best correlate with near distance and distance vision related quality of life in patients with bilateral nAMD. Here, we evaluated Pelli-Robson contrast sensitivity, ETDRS visual acuity, low luminance visual acuity and Radner maximum reading speed and correlated them with several morphologic parameters as measured on fundus autofluorescence imaging, optical coherence tomography and optical tomography angiography in 54 patients. A multiple regression analysis was performed which correlated each visual function parameter with the anatomic features. The results showed the strongest correlations between the total area of macular geographic atrophy as well as the percentage of geographic atrophy in the central 1 mm and contrast sensitivity. Further, the regression model selected the total area of macular geographic atrophy, the photoreceptor inner and outer segments interface disruption score, the presence of subretinal fibrosis in the central 1 mm and the central retinal thickness as the variables that explained 71% of the variation in contrast sensitivity when including all eyes. Hence, our results suggest that among the evaluated measures of vision, contrast sensitivity is best correlated with the morphologic impairment in bilateral nAMD. Thus, contrast sensitivity may complement ETDRS visual acuity in clinical trials and serve as a standard diagnostic tool in clinical practice.

Contrast Sensitivity Is Associated With Chorioretinal Thickness and Vascular Density of Eyes in Simple Early-Stage High Myopia

“…Campbell and Robson ( 36 ) suggested that contrast sensitivity in low spatial frequencies may be related to the function of Y-cell channels in peripheral retina, and contrast sensitivity in high spatial frequencies may be related to the function of X-cell channels in central vision. Under well controlled conditions, CSF has been used to evaluate retinal function in many studies ( 12 – 16 ). For example, Hoffmann et al ( 12 ) measured visual functions and morphologic parameters of the retina in patients with age-related macular degeneration (AMD) and found that among all the measures of visual function, the CSF correlated best with anatomic features of the retina.…”

“…Under well controlled conditions, CSF has been used to evaluate retinal function in many studies ( 12 – 16 ). For example, Hoffmann et al ( 12 ) measured visual functions and morphologic parameters of the retina in patients with age-related macular degeneration (AMD) and found that among all the measures of visual function, the CSF correlated best with anatomic features of the retina. As previous studies have shown, damages in the retinal and choroidal vascular support, such as vascular bed disease, can lead to severe visual impairment ( 37 ).…”

“…It has been reported that patients with simple high myopia had reduced CSF compared to people with normal vision ( 10 , 11 ), yet the cause of the CSF deficits remains unclear. In addition, CSF has been used to evaluate retinal function in many studies ( 12 – 16 ). We hypothesized that decreased contrast sensitivity is associated with structural changes of the fundus in patients with simple high myopia.…”

Effect of macular vascular density on visual quality in young myopic adults

“…Wang et al ( 36 ) also found the correlation between decreased macular sensitivity and morphologic degeneration of photoreceptors in high myopes using microperimetry and adaptive optics. Hoffmann et al ( 37 ) measured visual function and retinal morphologic parameters in patients with age-related macular degeneration and found correlations between contrast sensitivity and retinal anatomic features. They suggested that CSF may serve as a better biomarker in early disease stages.…”

Contrast Sensitivity Deficits and Its Structural Correlates in Fuchs Uveitis Syndrome

“…In addition, OCTA is non-invasive, which means it is safer in clinics. There have been other studies on diseases, such as diabetes ( 31 ) and age-related macular degeneration ( 32 ), found that the reduced contrast sensitivity was associated with VD. So we chose OCTA to explore the correlation between retinal structure and contrast sensitivity.…”