Clinical Characteristics of Reduced Contrast Sensitivity After Retinal Detachment Repair

Abstract

Purpose : We used active learning to quantify contrast sensitivity (CS) after retinal detachment (RD) repair and evaluated the clinical and surgical characteristics associated with CS after RD.

Methods : This cross-sectional, prospectively-recruited study included 153 eyes of 112 patients that underwent RD repair at a single tertiary care center from April 2016 to August 2021. Visual function evaluation included Snellen visual acuity (VA) and the Quantitative CS function (qCSF) test (Adaptive Sensory Technology), with the following CS metrics: Area under the Log CSF (AULCSF), contrast acuity (CA), and contrast sensitivity (CS) at 1 to 18 cycles per degree (cpd). Preoperative, intra-operative, and post-operative characteristics were recorded. Mixed effects multivariable regression analyses were performed.

Results : Our cohort included 77 fellow eyes and 76 RD eyes, of which 51 eyes (67.1%) were mac-off RD. The median days from diagnosis to surgery was 2 (1-3). The single-surgery reattachment rate was 89.5% and the final reattachment rate was 100%. When visual function was evaluated, the median time since RD repair was 1.4 years (1.0-2.8). LogMAR VA was significantly better among fellow eyes compared to RD eyes (0.03±0.08 vs. 0.14±0.20, p < 0.001). In addition, all the CS metrics were significantly better among fellow eyes, with the largest differences in AULCSF (1.11±0.26 vs. 1.02±0.32, p < 0.001). Mac-on eyes had better logMAR VA (0.08±0.14 vs. 0.17±0.22) and CS (1.10±0.27 vs. 0.98±0.34) compared to mac-off, however this did not reach statistical significance. Regression analyses with backwards stepwise elimination procedure evaluating the association of clinical characteristics with visual function revealed that increased days from diagnosis to surgery, increased RD quadrants, and attachment not achieved in a single-surgery were significantly associated with worse VA and CS. The effect size of total RD quadrants and days from diagnosis to surgery was larger on CS at 6-12 cpd (β = -0.52, β = -0.32, p < 0.001) compared to VA (β = 0.27, β = 0.29, p = 0.002).

Conclusions : We found CS across all spatial frequencies was significantly reduced among RD eyes after repair, compared to fellow eyes. CS appeared to have a stronger association with certain clinical characteristics, suggesting that CS may be a more sensitive functional measure that reflects long-term anatomic and visual outcomes after RD repair.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.