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Sarah Amanullah, Joseph Okudolo, Michael Waisbourd, Kamran Rahmatnejad, Shuai-Chun Lin, Sheryl S Wizov, Remy Manzi, Tingting Zhan, Cindy Xin Zheng, Jonathan S Myers, Scott S Fudemberg, Anand Mantravadi, L. Jay Katz, Marlene Moster, Michael Pro, George L. Spaeth; The relationship between contrast sensitivity and retinal nerve fiber layer thickness in patients with glaucoma. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5811.
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© ARVO (1962-2015); The Authors (2016-present)
The structure-function relationship between the retinal nerve fiber layer (RNFL) and the visual field in glaucoma is widely studied; however, there is limited data on the relationship between the RNFL and contrast sensitivity (CS). We performed a subanalysis on a prospective, longitudinal cohort study to determine the relationship between areas of CS and sectors of the RNFL.
The relationship between CS and RNFL thickness was assessed in 161 participants with moderate to advanced glaucoma. At four annual visits, CS was measured in five areas of vision using the Spaeth/Richman Contrast Sensitivity (SPARCS) test, and RNFL thickness was measured using Cirrus-HD optical coherence tomography (OCT). Images obtained via OCT with signal strength <7 were excluded. As SPARCS measures CS in multiple areas of vision, hypotheses regarding which areas would correlate were based on Garway-Heath’s map: the upper SPARCS areas were mapped to the inferior RNFL quadrant, the lower SPARCS areas to the superior RNFL quadrant, and the central SPARCS area to the temporal RNFL quadrant. Pearson correlation coefficients with significance level determined by F- test and multivariate linear regressions were used to assess the relationship between CS and RNFL.
The SPARCS left upper quadrant score correlated the most strongly with the RNFL inferior quadrant for both eyes at each visit, as expected by the Garway-Heath map (p<0.05; Table 1). There were no discernible trends for the correlations between the other areas of CS and RNFL quadrants. Multivariate linear regression between the SPARCS total score and average RNFL thickness showed a significant direct relationship at each visit (p<0.01).
Contrast sensitivity in the left upper area of vision for both eyes correlated most strongly with inferior quadrant of the RNFL. These fibers project to the temporal portion of the right occipital lobe, implying a potential center for contrast in this area. Further, SPARCS had predictive value for RNFL thickness. Contrast’s importance in vision-related quality of life of glaucoma patients warrants further research in understanding how it can be used as a tool in clinical practice.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
Table 1. Pearson correlation coefficients (p<0.05) between the SPARCS left upper quadrant and RNFL inferior quadrant for each eye at each visit.
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