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Sarah Nowroozizadeh, Nila Cirineo, Sharon A Henry, Anne L Coleman, Simon K Law, Joseph Caprioli, Kouros Nouri-Mahdavi, Glaucoma; Inferior Macular Thinning and Superior Central Field Sensitivity Loss Are Associated with Reduction of High Frequency Contrast Sensitivity in Glaucoma. Invest. Ophthalmol. Vis. Sci. 2014;55(13):971.
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To explore the association of structural and functional outcome measures with contrast sensitivity in glaucoma patients. We hypothesized that regional SD-OCT macular thickness or central field loss, rather than global measurements, could predict loss of contrast sensitivity (CS) in glaucoma patients.
Seventy eyes (42 patients) from UCLA’s Advanced Glaucoma Progression Study were selected. All patients had 24-2 standard achromatic visual fields, macular SD-OCT imaging with Cirrus and Spectralis, and CS measurement with CSV-1000 device. CSV-1000 measures CS at 3, 6, 12, and 18 cycles/degree. The correlation of various global and regional structural [full macular thickness and ganglion cell/inner plexiform layers (GC/IPL)] and functional (sensitivity loss within the central 10 degrees) outcomes with CS was estimated with correlation and regression analyses adjusting for best-corrected visual acuity (BCVA) and the lens status.
The average (SD) age, LogMAR visual acuity, and mean deviation of the study sample were 67.7 (10.7) years, 0.10 (0.16), and -8.0 (6.8) dB, respectively. Twenty-eight eyes (40%) were pseudophakic. The proportion of a borderline or abnormal CS at 3, 6, 12, and 18 cycles/degree were 40.0%, 38.6%, 60.0%, and 42.9%, respectively. LogMAR visual acuity was significantly related to CS at 6, 12, and 18 cycles/degree frequencies (p<0.03 for all). Pseudophakic eyes tended to have worse CS at 6, 12, and 18 cycles/degree frequencies (P<0.035 for all). A significant correlation was found between CS at 12 degrees and inferotemporal GC/IPL (partial r =0.25, p =0.031), inferior GC/IPL (partial r =0.28, p =0.023), inferior central macular thickness (inferior 6x3 degrees, partial r =0.38, p =0.002) and superior central visual field mean deviation (partial r =0.26, p =0.027). None of the other global or regional correlations were significant (p >0.05 for all).
CS was affected more commonly in the 12 cycles/degree frequency in this group of patients. The major structural and functional determinants of this high-frequency CS reduction were inferior macular thickness measurements and superior paracentral field loss. Glaucoma patients with damage to inferior macular area are at higher risk of functional disability. This finding has potential implications with regard to detection and management of glaucoma.
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