scholarly journals Measuring the Contrast Sensitivity Function in Non-Neovascular and Neovascular Age-Related Macular Degeneration: The Quantitative Contrast Sensitivity Function Test

2021 ◽  
Vol 10 (13) ◽  
pp. 2768
Author(s):  
Filippos Vingopoulos ◽  
Karen M. Wai ◽  
Raviv Katz ◽  
Demetrios G. Vavvas ◽  
Leo A. Kim ◽  
...  

Age-related macular degeneration (AMD) affects various aspects of visual function compromising patients’ functional vision and quality of life. Compared to visual acuity, contrast sensitivity correlates better with vision-related quality of life and subjectively perceived visual impairment. It may also be affected earlier in the course of AMD than visual acuity. However, lengthy testing times, coarse sampling and resolution, and poor test–retest reliability of the existing contrast testing methods have limited its widespread adoption into routine clinical practice. Using active learning principles, the qCSF can efficiently measure contrast sensitivity across multiple spatial frequencies with both high sensitivity in detecting subtle changes in visual function and robust test–retest reliability, emerging as a promising visual function endpoint in AMD both in clinical practice and future clinical trials.

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Susanne G. Pondorfer ◽  
Jan. H. Terheyden ◽  
Manuel Heinemann ◽  
Maximilian W. M. Wintergerst ◽  
Frank G. Holz ◽  
...  

Abstract The purpose of this study was to assess which visual function measures are most strongly associated with vision-related quality of life (VRQoL) in age-related macular degeneration (AMD). A cross-sectional study of subjects with early AMD (n = 10), intermediate AMD (n = 42) and late AMD (n = 38) was conducted. Subjects were interviewed with the Impact of Vision Impairment (IVI) questionnaire. Functional tests performed included best-corrected visual acuity (BCVA), low luminance visual acuity (LLVA), visual acuity measured with the Moorfields Acuity Charts (MAC), contrast sensitivity, reading speed, mesopic and dark-adapted microperimetry. The relationship between VRQoL and visual function was assessed with multiple regressions controlling for confounders. Rasch analysis demonstrated the validity of the IVI to assess VRQoL through three subscales: reading and accessing information, mobility and independence, and emotional well-being. Subjects with late AMD had significant lower IVI scores on all subscales compared with intermediate and early AMD (p < 0.011). In the overall cohort, IVI subscales were associated with BCVA, LLVA, MAC-VA and contrast sensitivity (all p < 0.001). Among the subgroup of early and intermediate AMD subjects, reading and mobility subscales were significantly associated with MAC-VA (p < 0.013). These results suggest that MAC-VA is a useful, patient-relevant measure of visual impairment in AMD.


2021 ◽  
pp. bjophthalmol-2020-318494
Author(s):  
Karen M Wai ◽  
Filippos Vingopoulos ◽  
Itika Garg ◽  
Megan Kasetty ◽  
Rebecca F Silverman ◽  
...  

IntroductionContrast 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.MethodsPatients 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.Results151 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).ConclusionCSF 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.


Author(s):  
Daniel Caballe-Fontanet ◽  
Cristina Alvarez-Peregrina ◽  
Neus Busquet-Duran ◽  
Eduard Pedemonte-Sarrias ◽  
Miguel Angel Sanchez-Tena

Background: Age-related macular degeneration (AMD) is a disease with an increasing incidence due to the general aging of the population that decreases the patient’s quality of life. This work aims to study whether selective cut optical filters improve the AMD patient’s quality of life. Methods: Prospective and longitudinal study in 79 patients. Visual acuity, contrast sensitivity, and the line differences in the Colenbrander test were measured. Patients answered The National Eye Institute 25-Item Visual Function Questionnaire (NEI VFQ-25), which measures the quality of life related to vision before and after using cut optical filters. Results: There was an improvement of 5.99 points (3.7–8.3) in NEI VFQ-25 after wearing filters. This improvement was 4.0 points for 450-nm filters and 12.7 points for 511-nm filters. For patients with visual acuity (VA) < 0.25, results of NEI VFQ-25 increased by 10.11 points (1.19–19.02) and for patients with late AMDs, results increased by 5.33 points (1.31–9.35). Conclusions: Selective filters improve the quality of life of patients with AMD. The success rate in the fitting of filters is better for those with VA lower than 0.25 and those with late or advanced AMD.


2020 ◽  
pp. 112067212097262
Author(s):  
Theodoros P Marakis ◽  
Chrysanthi Koutsandrea ◽  
Maria S Poulou

Purpose: To investigate the validity and reliability of the Greek Impact of Vision Impairment Questionnaire (IVI) and to explore the predictors of vision-related quality of life (VRQoL) in individuals with neovascular age-related macular degeneration (nAMD). Methods: About 191 patients completed the IVI and the SF-12 Health Survey, and were assessed on visual exams. A random group of 20 participants completed the IVI twice with a 2 weeks interval, to assess test-retest reliability. About 102 patients completed the IVI 1 year later in a follow-up examination. Rasch analysis was used to evaluate response category functioning, scale precision, unidimensionality, scale targeting and differential item functioning. Stepwise multiple linear regression analyses identified predictors of VRQoL. Results: Test-retest reliability of IVI items was calculated from 0.86 to 0.98. The six response categories were merged into four to figure out disordered thresholds. Rasch analysis concluded in three scales: Mobility and Independence, Reading and Accessing Information, and Emotional Wellbeing. Regarding convergent validity, the IVI scores had significant associations with SF-12 components (ρ = 0.28–0.47) and measurements of visual acuity (ρ = 0.39–0.66). Worse VRQoL at 1 year follow-up was correlated with decline in distance and near VA. Distance VA and the SF-12 components were common predictors for all three subscales. The duration of disease was a significant predictor for the emotional subscale. Conclusion: The Greek IVI was found to assess AMD patients’ perceptions of VRQoL in a valid, reliable and responsive to eyesight manner. VRQoL was mainly established by patients’ distance VA and mental health.


2017 ◽  
Vol 102 (3) ◽  
pp. 377-382 ◽  
Author(s):  
Eva K Fenwick ◽  
Gemmy Chui Ming Cheung ◽  
Alfred TL Gan ◽  
Gavin Tan ◽  
Shu Yen Lee ◽  
...  

AimTo assess the change in vision-related quality of life (VRQoL) after treatment for neovascular age-related macular degeneration (nAMD) and factors influencing this change in an Asian population.MethodsIn this longitudinal study, 116 patients (mean age±SD=66.5±9.9 years; 59.5% male) who underwent treatment for nAMD were recruited from a tertiary eye centre in Singapore. Best-corrected visual acuity (BCVA) and the Impact of Vision Impairment (IVI) questionnaire were evaluated at baseline and month 12. We defined three categories of BCVA change in the treated eye: BCVA gain ≥2 lines; no change in BCVA; BCVA loss ≥2 lines. The main outcome measures were the Rasch-derived IVI Reading, Mobility, and Emotional Scores. Multivariable linear regression analyses assessed the influence of sociodemographic, clinical and treatment-related factors on change in VRQoL.ResultsFollowing treatment, mean treated-eye BCVA improved by almost 2 lines (−0.22±0.40 logMAR, p<0.001) and 43% (n=50) patients reported a gain in BCVA of ≥2 lines. Mean±SD scores for Reading, Mobility and Emotional demonstrated positive changes of 0.43±1.73, 0.45±1.54 and 0.66±1.6, respectively (p<0.001 for all). In multivariable models, a ≥2 line improvement in BCVA was independently associated with a 47% (β=0.20; CI 0.01 to 0.39) increase in Reading Scores, but was not independently associated with Mobility or Emotional Scores.ConclusionNearly half of patients undergoing treatment for nAMD reported a 2-line improvement in vision which was, in turn, associated with substantial positive increases in Reading Scores. Improvements in Mobility and Emotional Scores appear to be driven by factors other than visual acuity.


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