Introduction Contrast sensitivity function (CSF) may better estimate a patient’s visual function compared with visual acuity (VA). Our study evaluates the quick CSF (qCSF) method to measure visual function in eyes with macular disease and good letter acuity.
Methods Patients with maculopathies (retinal vein occlusion, macula-off retinal detachment, dry age-related macular degeneration and wet age-related macular degeneration) and good letter acuity (VA ≥20/30) were included. The qCSF method uses an intelligent algorithm to measure CSF across multiple spatial frequencies. All maculopathy eyes combined and individual macular disease groups were compared with healthy control eyes. Main outcomes included area under the log CSF (AULCSF) and six CS thresholds ranging from 1 cycle per degree (cpd) to 18 cpd.
Results 151 eyes with maculopathy and 93 control eyes with VA ≥20/30 were included. The presence of a maculopathy was associated with significant reduction in AULCSF (β: −0.174; p<0.001) and CS thresholds at all spatial frequencies except for 18 cpd (β: −0.094 to −0.200 log CS, all p<0.01) compared with controls. Reductions in CS thresholds were most notable at low and intermediate spatial frequencies (1.5 cpd, 3 cpd and 6 cpd).
Conclusion CSF measured with the qCSF active learning method was found to be significantly reduced in eyes affected by macular disease despite good VA compared with healthy control eyes. The qCSF method is a promising clinical tool to quantify subtle visual deficits that may otherwise go unrecognised by current testing methods.
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Twitter @FVingopoulos, @itikagarg
Contributors KW was involved in conception, planning, conducting and reporting of the work. FV, IG, MK, RS, RK and IL was involved in conduct of the work. JWM, DH, DV and LK were involved in conception and planning of the work. JBM was involved in conception, planning, conducting and reporting of the work. All authors reviewed and edited the manuscript and approved the final version of the manuscript.
Funding Lions International Equipment Fund and Massachusetts Lions Club (grant: #530125).
Competing interests Dr JWM is a consultant for Genentech, Kalvista Pharmaceuticals, Sunovion and Valeant Pharmaceuticals. Dr JBM is a consultant for Alcon, Allergan, Zeiss, Heidelberg and Genentech. The remaining authors report no relevant financial disclosures.
Patient consent for publication Not required.
Ethics approval Institutional review board approval was obtained for this study (protocol: P001311, 2019).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request.