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Raviv Katz, Rebecca Silverman, Megan Kasetty, June Cho, Luis Andres Lesmes, Leo A. Kim, John B Miller; Active Learning of the Contrast Sensitivity Function as a New Clinical Endpoint for Retina Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2579. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
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 quantitative contrast sensitivity function (qCSF) testing in patients with retinal vein occlusion (RVO).
Prospective, observational, IRB-approved study. All patients had a history of RVO in one or both eyes. Exclusion criteria was cataract status >2+ nuclear sclerosis, or visual acuity (VA) <20/200. Patients were tested using the Manifold Platform (Adaptive Sensory Technology, San Diego, CA) and SD-OCT at their regularly scheduled visits. This active learning approach estimates a CSF model using an information-gain strategy, which provides a global functional vision metric via the area under the CSF (AULCSF), in addition to sensitivities at varying spatial frequencies. Contrast sensitivity was compared to previously collected data for 62 eyes from age-matched healthy controls.
21 patients with RVO (21 eyes) were tested with a mean age of 60.0 years ± 12.0. The mean BCVA was logMAR 0.19 ± 0.14 (~20/32) with a mean AULCSF of 0.811 ± 0.288. Compared to the healthy controls, (AULCSF = 1.20) we found a statistically significant reduction in mean AULCSF of eyes with RVO (p<.0001). The presence of macular edema significantly reduced contrast sensitivity relative to eyes with RVO but NO macular edema (p<.04), but did not reduce acuity (p>.05). For a small set of eyes (n=4), the therapeutic effect of a single anti-VEGF injection was measured: Mean AULCSF improved from 0.816 (SD 0.205) to 1.253 (SD 0.4) (p = 0.027), while logMAR VA did not show analogous statistically significant improvements (p = 0.062).
qCSF testing confirms reduced contrast thresholds in patients with RVO, and demonstrates the potential for measuring large treatment effects in RVO.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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