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Association between contrast sensitivity function and structural damage in primary open-angle glaucoma
  1. Ruiqi Pang1,
  2. Jieting Peng1,2,
  3. Kai Cao1,
  4. Yunxiao Sun1,
  5. Xue-Ting Pei1,
  6. Diya Yang1,
  7. Zhong-Lin Lu3,4,5,
  8. Ningli Wang1
  1. 1 Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
  2. 2 Eye College of Chengdu University of TCM, Chengdu, Sichuan, China
  3. 3 Division of Arts and Sciences, NYU Shanghai, Shanghai, China
  4. 4 Center for Neural Science and Department of Psychology, New York University, New York, New York, USA
  5. 5 NYU-ECNU Institute of Brain and Cognitive Neuroscience, Shanghai, China
  1. Correspondence to Professor Ningli Wang, Beijing Tongren Eye Center, Beijing 100730, China; wningli{at}


Aims To evaluate the association between contrast sensitivity function (CSF) and glaucomatous structural damage in primary open-angle glaucoma (POAG).

Methods A cross-sectional study was performed with 103 patients (103 eyes) aged 25–50 years who had POAG without any other ocular disease. CSF measurements were obtained by the quick CSF method, a novel active learning algorithm that covers 19 spatial frequencies and 128 contrast levels. The peripapillary retinal nerve fibre layer (pRNFL), macular ganglion cell complex (mGCC), radial peripapillary capillary (RPC) and macular vasculature were measured by optical coherence tomography and angiography. Correlation and regression analyses were used to assess the association of area under log CSF (AULCSF), CSF acuity and contrast sensitivities at multiple spatial frequencies with structural parameters.

Results AULCSF and CSF acuity were positively associated with pRNFL thickness, RPC density, mGCC thickness and superficial macular vessel density (p<0.05). Those parameters were also significantly associated with contrast sensitivity at 1, 1.5, 3, 6, 12, 18 cycles per degree spatial frequencies (p<0.05) and, the lower the spatial frequency, the higher the correlation coefficient. RPC density (p=0.035, p=0.023) and mGCC thickness (p=0.002, p=0.011) had significant predictive value for contrast sensitivity at 1 and 1.5 cycles per degree, with adjusted R 2 of 0.346 and 0.343, respectively.

Conclusions Full spatial frequency contrast sensitivity impairment, most notably at low spatial frequencies, is a characteristic change in POAG. Contrast sensitivity is a potential functional endpoint for the measurement of glaucoma severity.

  • glaucoma

Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information.

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  • RP and JP are joint first authors.

  • RP and JP contributed equally.

  • Contributors NW contributed to design, acquisition of funding and general supervision of the research group. RP and JP contributed to design, analysis of results, collection of data and drafting of the manuscript. KC contributed to the data analysis. Z-LL contributed to the manuscript revision. YS, X-TP and DY contributed to the collection of data. NW is responsible for the overall content as the guarantor. All authors reviewed and edited the manuscript and approved the final version of the manuscript.

  • Funding Funded by National Natural Science Foundation of China (82130029).

  • Competing interests Z-LL holds intellectual property interests in visual function measurement and rehabilitation technologies, and equity interests in Adaptive Sensory Technology (San Diego, California, USA) and Jiangsu Juehua Medical Technology (Jiangsu, China).

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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