The value of contrast sensitivity in diagnosing central serous chorioretinopathy

An Evaluation of the Repeatability of Visual Function Following Surgical Repair of Macula-Off Rhegmatogenous Retinal Detachment

Purpose

To evaluate the reliability and reproducibility of visual function assessments for patients with macula-off rhegmatogenous retinal detachment (RRD).

Methods

This prospective study included patients with unilateral macula-off RRD of <10-day duration successfully treated with a single, uncomplicated surgery at least 1 year following repair. Visual function assessments were performed at time of enrollment and 1 month later. Testing included Early Treatment Diabetic Retinopathy Study (ETDRS) best-corrected visual acuity (BCVA), low-luminance visual acuity (LLVA), low-contrast visual acuity (VA) 2.5% and 5%, contrast sensitivity assessment with Mars and Gabor patches, reading speed (acuity, speed, and critical print size), color vision testing (protan, deutan, and tritan), and microperimetry. Spectral-domain ocular coherence tomography (SD-OCT) was performed. Paired t-statistics were used to compare values between visits and between the study and fellow eyes.

Results

Fourteen patients (9 male, 5 female) with a mean age of 69 years at time of surgery were evaluated. Correlation coefficients across the two visits were highest for ETDRS BCVA (0.97), tritan color vision testing (0.96), and low-contrast VA 5% (0.96), while the average t-statistic was largest for low-luminance deficit (4.2), ETDRS BCVA (4.1), and reading speed critical print size (3.7). ETDRS BCVA did not correlate with SD-OCT findings.

Conclusions

ETDRS BCVA can be considered a highly reliable and reproducible outcome measure. LLVA, protan color discrimination, contrast sensitivity, and reading speed may be useful secondary outcome measures.

Translational Relevance

This study provides guidance on the selection of visual function outcome measures for clinical trials of patients with macula-off RRD.

The effect of filters and varying illumination on contrast sensitivity in eyes with moderate to severe visual impairment

PURPOSE

To investigate the effect of filters and illumination on contrast sensitivity in persons with cataract, pseudophakia, maculopathy and glaucoma to provide a guide for eye care providers in low vision rehabilitation.

MATERIALS AND METHODS

A within-subjects experimental design with a counter-balanced presentation technique was employed in this study. The contrast sensitivity of eyes with cataract, pseudophakia, maculopathy and glaucoma was measured with filters (no filter, yellow, pink and orange) combined with increasing illumination levels (100 lx, 300 lx, 700 lx and 1000 lx) using the SpotChecks™ contrast sensitivity chart. The data were analyzed using descriptive statistics and two-way repeated measures ANOVA.

RESULTS

The yellow filter at 100 lx significantly improved contrast sensitivity in the maculopathy group. There were no significant improvements with either intervention in the rest of the groups. There was, however, a significant interaction between filters and illumination in the cataract group.

CONCLUSION

There were small improvements in contrast sensitivity at low illumination levels with the yellow filter in the maculopathy group, and this could be considered in clinical practice and low vision rehabilitation. Overall, filters at most illumination levels did not benefit most groups.

The Characteristics of Quick Contrast Sensitivity Function in Keratoconus and Its Correlation with Corneal Topography

INTRODUCTION

To characterize quick contrast sensitivity function (qCSF) in keratoconus and its correlation with corneal topographic parameters.

METHODS

Patients with keratoconus (n = 120) who visited the Fudan Eye and ENT Hospital between April and June 2021 were enrolled in our study. A total of 215 eyes were subdivided into three groups according to maximum keratometry (K_max): Group 1 (K_max ≤ 48 D, 74 eyes), Group 2 (48 D < K_max ≤ 55 D, 64 eyes), and Group 3 (K_max > 55 D, 77 eyes). Manifest refraction, best corrected distance visual acuity (BCVA), corneal topography, and the qCSF test were examined. Intergroup comparisons and correlations among various corneal topographic parameters and qCSF were analyzed.

RESULTS

Significant differences in the area under the log CSF (AULCSF) and CSF Acuity among the three groups were found, which decreased with an increase in K_max. Contrast sensitivity (CS) between spatial frequencies of 3.0 to 18.0 cpd was significantly different (all P < 0.05) between Groups 1 and 2. The CS at all spatial frequencies was significantly different (all P < 0.05) between Group 3 and other two groups. At 3.0-18.0 cpd, CS decreased significantly (all P < 0.05) in Groups 1-3. Manifest refraction and topographic indices correlated significantly with qCSF parameters (all P < 0.05). Multivariable linear regression analysis showed that cylindrical refraction, logMAR BCVA, and index of surface variance had good predictive values for AULCSF and CSF Acuity.

CONCLUSIONS

The use of qCSF test can serve as a feasible tool to evaluate visual quality and severity of keratoconus, since changes in CS significantly correlated with keratoconus severity.

Evaluation of clinical and functional sequels of central serous chorioretinopathy. A case series analysis

OBJECTIVE

To evaluate the clinical and functional sequelae of patients with a diagnosis of resolved CSC, through macular OCT, contrast sensitivity test, visual field 10-2 and Farnsworth D-15 color test.

METHODS

27 eyes of 26 individuals with CSC resolved by macular OCT were included and evaluated; the patients underwent a contrast sensitivity test with the Optec 6500 equipment, a 10-2 visual field with an Octopus 900 Haag-Streit, and a Farnsworth D-15 color test.

RESULTS

Sequelae were observed in 20 eyes (74.1%) by macular OCT and in 21 (77.8%) in contrast sensitivity, predominantly type 2 defect. Also 27 (100%) had a visual field 10-2 altered corresponding to reduced foveal sensitivity, 11 eyes (40.7%) corresponded to central and paracentral scotomas. The color test showed alteration in 11 (40.7%) of the total eyes evaluated, finding tritanomaly in 9 of them (81.8%). No significant differences were observed in the studies between observation group vs the treatment group.

CONCLUSIONS

CSC can leave sequelae in the visual quality of patients despite treatment in the acute phase. Visual acuity before and after treatment in the intervention group had no significant difference.

Clinical Factors Associated with Low-Contrast Visual Acuity after Reduced-Fluence Photodynamic Therapy in Patients with Resolved Central Serous Chorioretinopathy and Good Baseline Visual Acuity

This retrospective study was conducted to investigate the clinical factors associated with low-contrast visual acuity after reduced-fluence photodynamic therapy (RFPDT) in patients with resolved central serous chorioretinopathy (CSC) and good baseline visual acuity. A total of 45 eyes of 45 patients with resolved CSC at post-RFPDT and best-corrected visual acuity of >1.0 (logarithm of the minimal angle of resolution [logMAR], 0) at baseline were examined. Visual acuities of both eyes were measured at four contrast levels (100%, 25%, 12%, and 6%) at post-RFPDT. The low-contrast visual acuity (6%, 12%, and 25%) was significantly lower than the 100% contrast visual acuity in the affected eyes. Visual acuities of affected eyes were significantly worse than those of fellow eyes at any contrast levels. The degree of changes in 6% and 100% contrast visual acuities was significantly greater in affected eyes than that in fellow eyes (p < 0.05). The 6% contrast visual acuities in affected eyes at post-RFPDT were significantly associated with the symptom duration (p < 0.05). Patients with a long duration of symptoms might have disturbed low-contrast visual acuities at post-RFPDT even if their baseline visual acuities were good.

Effect of age and refractive error on quick contrast sensitivity function in Chinese adults: a pilot study

PURPOSE

To evaluate the potential effect of age and refractive error on visual acuity (VA) performance and quick contrast sensitivity function (qCSF) in normal Chinese adults.

METHOD

Ninety-two subjects with normal best corrected distance VA (BCDVA) were enrolled in this pilot study. Measurements included BCDVA, best corrected near VA (BCNVA), unaided VA (UNVA), habitual spectacle-corrected near VA (SCNVA) and qCSF. For analyses, subjects were categorized into three age groups (20~40 years, 41~60 year and >60 years) and four refractive groups (hyperopia, emmetropia, myopia and high myopia). Relationships between age, refractive error, types of VA and qCSF were tested using simple and multiple linear regressions analyses.

RESULT

Mean age and refractive error of the study participants were 44.04 ± 12.68 years and -1.86 ± 2.91D, respectively. Among the stratified age groups, a hyperopic shift of refraction (-3.24 ± 2.88D vs. -1.24 ± 2.64D vs. 0.39 ± 1.42D, respectively; P < 0.001) and a reduction in BCNVA (P = 0.014), SCNVA (P < 0.001) and cut-off spatial frequency (SF) (P = 0.032) were found with increasing age. Among the four refractive groups, the SCNVA and cut-off SF of hyperopia were worse compared to the other refractive statuses (all P < 0.05). Age was significantly associated with cut-off SF (standardized β = -0.29, P = 0.005) after adjustment for SER, gender and all types of VA.

CONCLUSION

For normal Chinese adults with normal BCDVA, age was the main factor associated with CSF, which may be independent of refractive error.

Retinal-image quality and contrast sensitivity function in eyes with epiretinal membrane: a cross-sectional observational clinical study

Background

To investigate the effect of idiopathic epiretinal membrane (ERM) on the retinal-image quality and psychophysical contrast sensitivity function (CSF).

Methods

Forty-four subjects with diagnosis of idiopathic unilateral ERM were enrolled in this cross-sectional observational clinical study. The fellow unaffected eyes were set as the control group. For retinal-image quality assessment, an Optical Quality Analysis System (OQAS) based on double-pass technique was used to evaluate objective scatter index (OSI) and Strehl ratio. For visual performance, the CSF under photopic condition was measured.

Results

For retinal-image quality, the result of double-pass device revealed a significant lower Strehl ratio and larger OSI in the ERM eyes compared to the fellow eyes (all P < 0.05). For visual performance, the CSF at all spatial frequencies under photopic condition were also significantly degraded in the ERM eyes compared to the fellow eyes (all P < 0.05). For the ERM eyes, the reduction of Strehl ratio and CSF was 29.41 and 54.39%, respectively, and the increase of OSI was 164.10% compared to the fellow eyes. Besides, BCVA significantly correlated to the total CSF (ERM eyes, r = − 0.53, P < 0.001; the fellow eyes, r = − 0.467, P = 0.002) and Strehl ratio (ERM eyes, r = − 0.485, P = 0.001; the fellow eyes, r = − 0.311, P = 0.043) in both of the ERM and the fellow eyes.

Conclusion

Eyes affected with ERM showed poorer retinal-image quality and visual performance than the normal eyes. Retinal-image quality measured by OQAS based on double-pass technique could be useful for assessing the retinal-image quality for ERM-affected eyes, in which retinal scattering was significantly increased.

Electronic supplementary material

The online version of this article (10.1186/s12886-018-0957-1) contains supplementary material, which is available to authorized users.

Pattern of Contrast Sensitivity Changes in Acute Central Serous Chorioretinopathy

Purpose

To evaluate contrast sensitivity (CS) changes in acute central serous chorioretinopathy (CSC).

Methods

Visual acuity (VA), CS, and subretinal fluid (SRF) were evaluated monthly for 6 months. Treatment was considered at 3 months in case of persistent SRF.

Results

Twelve of 20 eyes (60%) had spontaneous SRF resolution within 4 months. Five of 8 patients with delayed SRF resolution received either focal laser or photodynamic therapy. The CS was impaired in all spatial frequencies at baseline. There was a negative correlation between the baseline SRF thickness and CS at 3 and 6 cycles per degree (cpd). The CS improved significantly at the time of fluid resolution (p = 0.001) and continued to improve in 3 and 6 cpd. The CS at 6 cpd did not recover if compared to a normal fellow eye at 6 months (p = 0.018). The CS of 12 cpd at 6 months was superior in the spontaneous resolution group.

Conclusion

The impaired CS gradually improved as the SRF reduced at all spatial frequencies. CS at 3 and 12 cpd continued to improve after complete fluid resolution. Despite an excellent final VA, the CS at 6 months did not regain its normal value.

Evaluation of the Radiation Dose-Volume Effects of Optic Nerves and Chiasm by Psychophysical, Electrophysiologic Tests, and Optical Coherence Tomography in Nasopharyngeal Carcinoma

PURPOSE

To evaluate the radiation dose-volume effects of optic nerves and chiasm by visual psychophysical, electrophysiologic tests, and optical coherence tomography in patients with locally advanced nasopharyngeal carcinoma.

MATERIALS AND METHODS

A series of visual tests including visual acuity, visual field, contrast sensitivity, visual evoked potential, and optical coherence tomography were administered to 20 patients with locally advanced (T3-T4) nasopharyngeal carcinoma who were treated with definitive chemoradiotherapy. Volume that received 55 Gy (V55), mean dose (Dmean), highest dose to 5% of the volume (D5), and maximum dose (Dmax) for optic nerves and chiasm were evaluated for each patient. Cutoff values were identified as V55: 50%, Dmean: 50 Gy, D5: 55 Gy, and Dmax: 60 Gy. The effects of radiation dose-volume on ophthalmologic tests were evaluated.

RESULTS

Ophthalmological evaluation revealed optic neuropathy with simultaneous retinopathy in 6 eyes of 4 patients and radiation retinopathy alone in both eyes of 1 patient. Regarding radiation dose-volume effects of the optic nerve, significant detrimental effect of all parameters was observed on visual acuity. Visual field and contrast sensitivity were affected significantly with V55 ≥ 50% and Dmean ≥ 50 Gy. Visual evoked potential latency was affected significantly with Dmean ≥ 50 Gy, D5 ≥ 55 Gy, and Dmax ≥ 60 Gy. For the chiasm, significant detrimental effect of all parameters was observed on visual acuity as well. Retinal nerve fiber layer thickness and visual evoked potential amplitude were not affected by any of the dose-volume parameters neither optic nerves nor chiasm.

CONCLUSION

The volume receiving the threshold dose, mean dose, and 5% of the volume receiving the maximum dose are important parameters besides maximum dose to optic nerves and chiasm. A comprehensive ophthalmological evaluation including visual field, contrast sensitivity, visual evoked potential latency, and amplitude should be performed for these patients. Visual evoked potential latency is an objective predictor of vision loss before the onset of clinical signs.

Binocular summation and visual function with induced anisocoria and monovision

The advances in new techniques for correcting presbyopia, such as a small aperture combined with monovision, require an in-depth study of binocular aspects. In this work, we have studied binocular visual performance of 12 subjects after inducing different degrees of anisocoria combined with two different add powers in the non-dominant eye. We have analysed visual performance in terms of the visual-discrimination capacity (a function to evaluate the strength of bothersome halos) and the contrast-sensitivity. The results show a deterioration of the binocular vision when inducing anisocoria and with any add power, with a higher perception of halos, a lower contrast sensitivity and poorer binocular summation of these visual functions on increasing anisocoria. This deterioration is clinically acceptable in the case of low add power, since positive binocular summation is maintained in contrast sensitivity, and visual discrimination is not altered.

Different Impacts of Luminosity on Contrast Vision in Eyes with Transparent Optic Media and with Cataract Simulation

OBJECTIVE

To evaluate the effect of luminous intensity on contrast vision under different ocular conditions.

MATERIALS AND METHODS

Ninety eyes of 45 persons were included in this study as follows: 30 healthy eyes, 30 eyes with cataract simulation (using translucent glasses), and 30 myopic eyes. Contrast sensitivity was examined using 5 spatial frequencies (1.5, 3.0, 6.0, 12.0, and 18.0 cycles per degree) of sine wave contrast test optotypes for 4 light intensities (34, 68, 154, and 240 cd/m2).

RESULTS

The mean linear contrast sensitivities averaged over the frequencies for each of the 4 light intensities were: healthy eyes: 59 ± 11, 72 ± 16, 79 ± 23, and 80 ± 19; myopic eyes: 52 ± 13, 67 ± 15, 73 ± 21, and 75 ± 18, and cataract simulation eyes: 15 ± 7, 21 ± 8.6, 28.7 ± 13, and 28.6 ± 13, respectively. The linear contrast sensitivities averaged over the light intensities for each of the 5 spatial frequencies were: healthy eyes: 78, 87, 117, 59, and 21; myopic eyes: 65, 84, 109, 54, and 29, and cataract simulation eyes: 37, 41, 28, 8, and 2.

CONCLUSIONS

The light intensity level had a positive effect on the contrast sensitivity of the examined eyes, except for eyes with cataract simulation, where even the maximum light intensity did not improve the contrast vision. This indicates that patients with cataracts require increased contrast of text rather than brighter illumination to improve the quality of their vision.

Effects of ocular dominance on contrast sensitivity in middle-aged people

Purpose. Our aim was to compare contrast sensitivity values of the dominant and nondominant eyes of healthy middle-aged subjects. Material and Methods. Ninety eyes of 45 healthy middle-aged subjects (30 males and 15 females) were included in this study. Patients were aged between 40 and 60 years, having uncorrected visual acuity (UCVA) of 20/25 or better (Snellen chart). Ocular dominance was determined by hole-in-the-card test. Functional acuity contrast testing (F.A.C.T.) was measured using the Optec 6500 vision testing system (Stereo Optical Co. Inc., Chicago, IL, USA) under both photopic and mesopic conditions. Results. At all spatial frequencies (1.5, 3, 6, 12, and 18 cpd), under mesopic conditions, the contrast sensitivity values of the dominant eyes were slightly greater than those of the nondominant eyes; but only 18 cpd spatial frequency measurements' difference was statistically significant (P = 0.035). Under photopic conditions, the contrast sensitivity values of the dominant eyes and non-dominant eyes were similar at all spatial frequencies (P > 0.05). Conclusions. The photopic and mesopic contrast sensitivity values of dominant and nondominant eyes of healthy middle-aged people were similar at all spatial frequencies, except at mesopic 18 cpd spatial frequency.

Contrast visual acuity after multifocal intraocular lens implantation: aspheric versus spherical design

AIM

To evaluate contrast visual acuity (CVA) after implantation of an aspheric apodized diffractive intraocular lens (IOL) or a spherical apodized diffractive IOL in cataract surgery.

METHOD

This prospective randomized controlled study with a 12-month follow-up compared the results of cataract surgery with implantation of an aspheric AcrySof ReSTOR SN6AD3 IOL (30 eyes) and a spherical AcrySof ReSTOR SN60D3 IOL (30 eyes). CVA with best distance correction was measured at 4 contrast levels (100%, 25%, 10% and 5%) under 3 levels of chart luminance [250, 85 and 25 candelas per square meter (cd/m(2))] using a multi-functional visual acuity tester (MFVA-100).

RESULTS

At 12 months after surgery, there were no statistically significant differences in 100% CVA and 25% CVA under 250cd/m(2) (P 100%=0.875 and P 25%=0.057) and 85cd/m(2) (P 100%=0.198 and P 25%=0.193) between the aspheric group and the spherical group. However, the 10% CVA and 5% CVA were significant better in aspheric group than spherical group under 250cd/m(2) (P 10%=0.042 and P 5%=0.007) and 85cd/m(2) (P 10%=0.002 and P 5%=0.039). Under the luminance level of 25cd/m(2), no significant differences was found in the 100% CVA between the 2 group (P 100%=0.245), while aspheric group had better visual acuity in the remaining 3 contracts (P 25%=0.023, P 10%=0.026 and P 5%=0.002, respectively).

CONCLUSION

[corrected] The aspheric AcrySof ReSTOR SN6AD3 IOL provided patients with better low-contrast visual acuity than the spherical AcrySof ReSTOR SN60D3 IOL.

Low luminance visual acuity in patients with central serous chorioretinopathy

BACKGROUND

The aim was to determine the low luminance visual acuity in eyes with central serous chorioretinopathy.

METHODS

Seven eyes of seven patients with central serous chorioretinopathy and six eyes of six age-matched normal volunteers were examined. Low luminance visual acuity charts were created by an Apple Power Mac G5 computer and displayed on a cathode ray tube monitor (SONY GDM-F500). The background luminance was set at six different levels from 78.20 cd/m(2) to 0.37 cd/m(2). The visual acuities of the eyes with central serous chorioretinopathy at each of the six luminance levels were compared to those from their fellow eyes and to normal eyes.

RESULTS

The mean visual acuities varied from 0.13, 0.23, 0.29, 0.42, 0.62 to 0.70 logMAR units as luminance varied from high to low. At the lowest luminance (0.37 cd/m(2)), five of the seven eyes could not read any character. The mean visual acuities of the fellow eyes at the same luminance levels were 0.03, 0.06, 0.11, 0.20, 0.27 and 0.45 logMAR units and those of the normal volunteers were 0, 0.03, 0.08, 0.14, 0.23 and 0.38 logMAR units, respectively. The visual acuities of the eyes with central serous chorioretinopathy were significantly poorer than those of the normal eyes at all luminance levels except 0.37 cd/m(2) (p < 0.05 for all).

CONCLUSIONS

Although the eyes from all three groups had 0 logMAR units visual acuity under standard testing condition, the visual acuity of the eyes with central serous chorioretinopathy were significantly worse at low luminance levels. The low luminance visual acuity may provide information on the visual disturbances reported by central serous chorioretinopathy patients with 0 logMAR units visual acuity.