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Evaluation of contrast sensitivity in patients with advanced glaucoma: comparison of two tests
  1. Alessandro A Jammal1,2,
  2. Bruna G Ferreira1,
  3. Camila S Zangalli1,
  4. Jayme R Vianna3,
  5. Atalie C Thompson2,
  6. Paul H Artes4,
  7. Vital P Costa1,
  8. Alexandre S C Reis1
  1. 1 Department of Ophthalmology, Universidade Estadual de Campinas, Campinas, Brazil
  2. 2 Duke Eye Center, Duke University, Durham, North Carolina, USA
  3. 3 Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
  4. 4 Eye and Vision Research Group, Institute of Health and Community, Plymouth University, Plymouth, UK
  1. Correspondence to Dr Alexandre S C Reis, Department of Ophthalmology, Universidade Estadual de Campinas, Campinas 05428-001, Brazil; alexandrescreis{at}


Aims To evaluate contrast sensitivity (CS) in patients with advanced glaucomatous visual field damage, and to compare two clinical CS tests.

Methods This was a cross-sectional test–retest study. Twenty-eight patients with open-angle glaucoma, visual acuity (VA) better than 20/40 and visual field mean deviation (MD) worse than −15 dB were enrolled. Patients underwent VA, visual field and CS testing with the Pelli-Robson (PR) chart and the Freiburg Visual Acuity and Contrast Test (FrACT). Retest measurements were obtained within 1 week to 1 month.

Results Median (IQR) age and MD were 61.5 (55.5 to 69.2) years and −27.7 (−29.7 to −22.7) dB, respectively. Median (IQR) VA was 0.08 logarithm minimum angle of resolution (0.02 to 0.16), corresponding to 20/25 (20/20 to 20/30). Median (IQR) CS was 1.35 (1.11 to 1.51) log units with the PR chart and 1.39 (1.24 to 1.64) log units with FrACT. VA explained less than 40% of the variance in CS (adjusted R2=0.36). CS estimates of both tests were closely related (rho=0.88, p=0.001), but CS was 0.09 log units higher with FrACT compared with the PR chart, and the 95% repeatability intervals (Bland-Altman) were 46% tighter with the PR chart.

Conclusions Despite near-normal VA, almost all patients showed moderate to profound deficits in CS. CS measurement provides additional information on central visual function in patients with advanced glaucoma.

  • glaucoma
  • vision

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  • Presented at the ARVO Annual Meeting 2016, Baltimore, Mary Land, USA.

  • Correction notice This paper has been amended since it was published online. The affiliation of author Jayme R Vianna was missing and this has now been added.

  • Funding Supported in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES)—Finance Code 001 (AAJ) and Fight for Sight UK #1736/37 (PHA). The funding organisations had no role in the design or conduct of this research.

  • Competing interests VPC has been paid for developing and delivering educational presentations for Iridex Inc. and is a consultant for Alcon Laboratories, Allergan and Aerie; no other relationships or activities that could appear to have influenced the submitted work. The funding organisations had no role in the design or conduct of this research.

  • Patient consent for publication Obtained from the patients.

  • Ethics approval University of Campinas Institutional Review Board approved the study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon request. The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.