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C. G. Batiste, L. E. L. Lorenzana, G. L. Spaeth; Decreased Contrast Sensitivity Is Associated With Increased Disability in Patients With Glaucoma. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1607.
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To evaluate the impact of contrast sensitivity on the ability of patients with glaucoma to perform the activities of daily living.
A prospective observational case series in which 194 patients with glaucoma were evaluated using a third-generation, performance-based measure of disability related to vision, The Assessment of Disability Related to Vision (ADREV). Patients had to be at least 18 years old, and have a diagnosis of primary open-angle glaucoma, chronic angle-closure glaucoma, pigmentary glaucoma, or glaucoma in association with the pseudoexfoliation syndrome. Patients with neurological or musculoskeletal conditions that prevented them from carrying out the activities of daily living were excluded. Contrast sensitivity for each patient was scored using the Pelli-Robson contrast sensitivity chart. Pearson's correlation was used to relate contrast sensitivity to the scores of the various task-oriented subtests of ADREV which include: (1) placing a stick into holes of different sizes; (2) finding red and beige boxes spread around a room; (3) following a prescribed obstacle walking course; (4) recognizing facial expressions; (5) using a calculator; (6) matching socks of different colors; (7) reading signs at a set distance; (8) recognizing motion, and (9) reading in reduced illumination. Contrast sensitivity was also related to the total ADREV score.
Contrast sensitivity was closely related to the total ADREV score and the ability to find red and beige boxes spread around a room (Pearson’s correlation of 0.790 and 0.744 respectively). Weaker associations were seen with tasks of using a calculator (0.603), recognizing facial expressions (0.624), computer motion (0.648), matching socks (0.658), placing a stick into different sized holes (0.561), and reading signs (0.669). Subtests involving navigating an obstacle course (0.392) and reading in reduced lighting (0.425) were not closely related to contrast sensitivity.
Decreased contrast sensitivity is an important determinant of why patients with glaucoma have difficulty performing the tasks of daily living. Measuring contrast sensitivity may be as or more important than more standard methods of assessing the well-being of patients with glaucoma.
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