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Higher contrast thresholds for vanishing optotype recognition in macular visual fields among glaucoma patients: a structure–function analysis
  1. Yun Wen1,
  2. Zidong Chen1,
  3. Shuo Chen2,
  4. Kaixin Tan1,
  5. Yang Kong3,
  6. Hui Cheng2,
  7. Minbin Yu1
  1. 1State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
  2. 2School of Computer Science and Engineering, Sun Yat-Sen University, Guangzhou, China
  3. 3School of Electronics and Communication Engineering, Sun Yat-Sen University, Shenzhen, China
  1. Correspondence to Professor Minbin Yu, State Key Laboratory of Ophthalmology, Guangdong Provincial Key Lab of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-sen University, 510000, Guangzhou, Guangdong, China; yuminbin{at}


Background/aims We aimed to explore the impact of glaucomatous macular damage, specifically retinal ganglion cell (RGC) loss, on macular pattern vision measured by the vanishing optotype (VO) recognition contrast threshold.

Methods Seventy-two patients (mean age, 33.51±7.05 years) with primary open-angle glaucoma and 36 healthy controls (mean age, 30.25±6.70 years) were enrolled. VO recognition contrast thresholds of each participant were measured at the 16 preset test locations covering the central 5° visual field (VF). Macular sensitivity (MS) was tested by macular threshold test of Humphrey Field Analyzer. Macular RGC plus inner plexiform layer (GCIPL) thickness was also measured by spectral domain optical coherence tomography.

Results The VO contrast threshold demonstrated weak-to-moderate correlations (rho=−0.275 to −0.653) with MS (p<0.001). There was a significantly higher VO contrast threshold in glaucoma group (p<0.0001). At similar levels of MS, patients with glaucoma with GCIPL damage showed remarkably higher VO contrast thresholds than those with preserved GCIPL (p=0.0079). The structure–function relationships between VO contrast threshold and GCIPL thickness (rho=−0.725 to −0.802) were remarkably stronger than those between MS and GCIPL thickness (rho=0.210 to 0.448). VO contrast threshold showed stronger correlation with average GCIPL thickness (rho=−0.362 to −0.778) than MS (rho=0.238 to 0.398) at multiple test locations in glaucoma group.

Conclusions Glaucomatous eyes have higher contrast thresholds for VO recognition in fovea-around VF. Stronger structure–function relationships indicate that VO contrast threshold is more vulnerable to RGC damage.

  • glaucoma

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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  • Contributors YW, ZC and MY conceived and designed the study; SC, YK and HC conducted the coding and programming; YW, ZC, KT and MY performed the study; YW, ZC and MY analysed and interpreted the data; YW wrote the initial draft; YW, ZC and MY revised the manuscript.

  • Funding This study was supported by the Space Medical Experiment Project of China Manned Space Program (HYZHXM01015) and the Natural Science Foundation Team Project of Guangdong Province Grant (2015A030312016) to MY, and National Natural Science Foundation for Young Scientists to ZC (81600761).

  • Competing interests None declared.

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

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