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R. J. Adams, C. G. M. Bishop, A. L. Barrett, A. M. Surprenant, M. L. Courage; Direct Comparison of New Clinical Tests of Resolution and Recognition of Spatial Contrast Sensitivity in Younger and Older Adults. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2536.
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Over the past few years, new clinically-oriented tests have emerged for measuring spatial contrast sensitivity (CS), arguably the most comprehensive single measure of human vision. Assessment of CS has become particularly important in aiding neuro-ophthalmic diagnoses, and in the pre- and post-surgical evaluation of patients undergoing refractive surgery. However, despite the variety of CS tests and their widespread use in clinical practice, tests are often used interchangeably, and have yet to be compared in any systematic manner. Here we provide these essential data across a broad age range.
Within a single session, 30 young adults (M = 23 yr) and 33 seniors (M = 72 yr) were assessed monocularly with sine-wave grating tests of resolution CS [3m FACT chart (Stereo Optical) and the 60 cm Adams CS booklet], and recognition CS [Rabin CS and the Sloan low contrast CS tests (both Precision Vision)]. To provide a fuller spectrum contrast sensitivity function (CSF), Rabin and Sloan CS tests were assessed at 1, 2, and 3 m. For comparison and validation, we also measured Snellen and Landolt acuity. For all tests, luminance was held constant at 70 cm/m2.
Correlations among tests were significant (r = 0.44 to 0 .84, p< 0.01) with the exception of seniors tested with the CS booklet and young adults tested with Sloan CS vs. FACT. Coefficient of reliability analyses also confirmed that there was excellent agreement among tests. In particular, the Rabin CS test appeared to have the best prediction among the different measures of spatial vision.
Given the diversity of CS tests, the consistency is impressive especially given that most tests were also able to predict maximal spatial resolution. This suggests that current tests are effective and comparable measures of spatial contrast sensitivity, and thus, should have good clinical utility. The shortcoming of the CS booklet among seniors is likely explained by variations in near-accommodation associated with presbyopia.
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