Abstract
Purpose :
Traditional letter visual acuity does not always adequately describe a patient’s visual limitations or pathologic changes in a variety of maculopathies. Herein, we evaluate the utility of a computerized contrast testing device in patients with macular telangiectasia (mac tel) and central retinal vein occlusion (CRVO).
Methods :
Prospective, observational, IRB-approved study. All patients had a history of mac tel or CRVO in one or both eyes. Exclusion criteria was cataract status >2+ nuclear sclerosis, or visual acuity (VA) <20/200. All patients underwent quick contrast sensitivity function (qCSF) testing in each eye using the Sentio Platform (Adaptive Sensory Technologies, San Diego, CA) and SD-OCT at their regularly scheduled visit. The qCSF method uses computerized, Bayesian, adaptive testing to track changes in a patient’s contrast sensitivity with varying spatial frequencies to calculate an area under the curve (AUC). Contrast sensitivity was compared to previously collected data for 81 age-matched healthy controls, represented by calculating a Z-score (AUC-AgeMean)/AgeStdDev.
Results :
6 patients with mac tel (11 eyes) and 7 patients with CRVO (8 eyes) were tested with a mean age of 64.5 years ± 15.0. In mac tel, the mean BCVA was logMAR 0.197±0.18 (20/33) with a mean area under the CSF curve (AULCSF) of 0.609±0.20. In CRVO, the mean BCVA was logMAR 0.207±0.16 (20/32) with a mean AULCSF of 0.716±0.31. Compared to the healthy controls, we found a statistically significant reduction in mean AULCSF for both mac tel (p=9.63x10-9) and CRVO (p=0.00004). This reduction in contrast function can be further illustrated by Z-scores, demonstrating a nearly 2 standard deviation difference; Z=-1.97±0.6 in mac tel and Z=-1.91±0.9 in CRVO. Even when looking at all patients with greater than 20/30 letter acuity, the difference in AULCSF reached statistical significance (AULCSF=0.857±0.18, p=0.002).
Conclusions :
We present a novel contrast test that demonstrated a statistically significant difference in contrast sensitivity function in patients with CRVO and mac tel. Further analysis of high letter acuity patients still revealed a statistically significant reduction in contrast function. CSF assessment may provide another useful clinical endpoint in disease monitoring of patients with CRVO with macular edema and macular telangiectasia.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.