A Novel Active Learning Contrast Sensitivity Test to Assess Visual Function in Central Serous Chorioretinopathy

Abstract

Purpose : To characterize the contrast sensitivity function (CSF) in patients with central serous chorioretinopathy (CSCR) compared to healthy controls using novel computerized contrast sensitivity (CS) testing with active learning algorithms.

Methods : CSF was prospectively measured in CSCR eyes and healthy controls between December 2016 and November 2017 at W. K. Kellogg Eye Center and Massachusetts Eye and Ear Infirmary using the novel active learning Sentio Platform (Adaptive Sensory Technology, San Diego, CA). A mixed effects multivariate regression model was employed and outcomes included Area under the Log CSF (AULCSF), CS thresholds at 1, 1.5, 3, 12, and 18 cycles per degree (cpd) and best corrected visual acuity (BCVA). Associations of contrast outcomes with structural findings and subjective symptomatology were investigated.

Results : A total of 40 eyes of 36 CSCR patients and 84 healthy control eyes were included. Median BCVA in CSCR eyes was logMAR 0.10 (0.23) versus 0.00 (0.04) in controls (P = 0.01). The median AULCSF in CSCR eyes was 1.11(0.70) versus 1.24 (0.31) in controls. When accounting for age, the presence of CSR was associated with significantly reduced median AULCSF (P =.02, β= -0.14) and reduced mean CS thresholds at spatial frequencies of 6cpd (P = .009, β= -0.18), 12cpd (P <.001, β= -0.23) and 18cpd (P = .04, β= -0.09), compared to controls. Within the CSCR group, subjectively perceived visual impairment (N=22) was associated with decreased contrast thresholds at all spatial frequencies and in AULCSF, when compared to asymptomatic CSCR eyes (N=18). Ellipsoid zone attenuation was associated with decreased AULCSF (P= 0.002, β=-0.473) and decreased contrast thresholds specifically at 3,6 and 12 cpd, whereas presence of extrafoveal fluid was associated with decreased thresholds at 1, 1.5, 3 and 6 cpd.

Conclusions : Contrast sensitivity is significantly reduced in CSCR, and seems to strongly correlate with subjective visual impairment. Different structural biomarkers correlate with contrast thresholds reductions at different spatial frequencies. The novel qCSF method may serve as a valuable adjunct visual function metric for CSCR patients in the routine clinical practice.

This is a 2021 ARVO Annual Meeting abstract.