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Abstract #94746 Published in IGR 22-2
Low-Contrast High-Pass Visual Acuity Might Help to Detect Glaucoma Damage: A Structure-Function Analysis
Wen Y; Chen Z; Zuo C; Yang Y; Xu J; Kong Y; Cheng H; Yu MFrontiers in medicine 2021; 8: 680823
The conventional visual acuity (VA) test is not sensitive enough to detect glaucoma macular damage. We aimed to investigate whether VA measurements using low-contrast high-pass optotypes are more sensitive to macular dysfunction in glaucoma and to find the potential structural basis of this difference. A total of 147 subjects were recruited, including 118 patients with glaucoma (mean age: 46.08 ± 14.64 years) and 29 healthy controls (mean age: 39.83 ± 9.81 years). For each participant, monocular best-corrected VA was measured using a conventional chart and six high-pass charts at 100, 50, 10, 5, 2.5, and 1.25% contrast levels, respectively. The macular retinal thickness and circumpapillary retinal nerve fiber layer (cpRNFL) thickness of all the glaucoma patients were obtained by spectral-domain optical coherence tomography (SD-OCT). Compared with healthy subjects, glaucoma patients with normal vision demonstrated worse VAs in high-pass acuity measurements (0.22-0.93 vs. 0.28-1.08, < 0.05). Receiver operating characteristic curve (ROC) showed that 1.25% low-contrast high-pass VA was optimal for discriminating between the controls and glaucoma patients (AUC: 0.918, < 0.001; sensitivity: 77.33%; specificity: 96.55%). Compared with conventional VA, 1.25% high-pass VA correlated better with nasal-side macular retinal ganglion cell (RGC)-related parameters ( = -0.419 to -0.446 vs. = -0.538 to -0.582; Fisher's Z transformation, < 0.05). There was no difference in the strength of correlations between the VAs measured using different charts and cpRNFL thickness (Fisher's Z transformation; > 0.05). VA measurement taken with low-contrast (1.25%) high-pass acuity chart is more sensitive in detecting central visual loss in glaucoma than that taken with the conventional chart. Macular RGC damage appears to be associated with low-contrast (1.25%) high-pass visual loss in glaucomatous eyes.
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Full articleClassification:
6.6.3 Special methods (e.g. color, contrast, SWAP etc.) (Part of: 6 Clinical examination methods > 6.6 Visual field examination and other visual function tests)
