Structure-Function Associations between Contrast Sensitivity Function and Central Foveal Thickness in Patients with Idiopathic Epiretinal Membrane

Abstract

Purpose : Contrast sensitivity function (CSF) is a visual function metric that might be of clinical value when evaluating intraretinal changes in patients with epiretinal membrane (ERM). Inherent limitations of existing contrast sensitivity tests have prevented its adoption into practice thus far. Employing a novel active learning quantitative CSF (qCSF) device, we aim to investigate structure-function associations between central foveal thickness (CFT) visual acuity (VA) and contrast sensitivity.

Methods : This prospective cross-sectional study included 115 eyes of 88 patients with idiopathic ERM. Patients underwent complete ophthalmic examination and spectral-domain OCT imaging (SD-OCT, SPECTRALIS® Heidelberg). CFT values were obtained from SD-OCT images. Contrast sensitivity (CS) was measured using the Manifold Contrast Vision Meter (Adaptive Sensory Technology, San Diego, CA). Outcomes included Area under the Log CSF (AULCSF), contrast acuity (CA) and CS thresholds at 1, 1.5, 3, 6, 12, and 18 cycles per degree (cpd). Pearson’s correlations and mixed-effects multiple linear regression models were performed to evaluate structure-function associations between CFT, LogMAR VA and CSF outcome measures.

Results : Median LogMAR VA was 0.21 (0.19) and median AULCSF was 0.86 (0.21). Median CFT was 345 (106.2) µm. CFT was moderately correlated with VA (R=0.435, p<0.001), AULCSF (R= -0.489, p<0.001), CA (R=-0.492, p<0.001), and CS thresholds at cpd3 (R=-0.450, p<0.001), cpd6 (R=-0.494, p<0.001), and cpd12 (R=-0.418, p<0.001). CFT showed weak correlation with CS threshold at cpd1.5 (R=-0.291, p=0.002). In the mixed-effects regression models, CFT was positively associated with LogMAR VA (ß=0.0009, p<0.001), and negatively associated with AULCSF (ß=-0.001, p <0.001), CA (ß=-.0009, p<0.001) and CS thresholds at 1cpd (ß=-0.0004, p <0.031), 1.5cpd (ß=-0.0005, p<0.001), 3cpd (ß=-0.001, p<0.001), 6cpd (ß=-0.002, p<0.001), 12cpd (ß=-0.001, p<0.001).

Conclusions : Our results suggest that CFT is more strongly associated with qCSF than VA in patients with ERM. qCSF method may serve as a valuable visual function metric for assessing patients with ERM.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.