Intersession repeatability of contrast sensitivity scores in age-related macular degeneration

To describe the intersession repeatability of contrast sensitivity (CS) measurement using Pelli-Robson charts in patients with age-related macular degeneration.

Repeatability was calculated from three measurements of CS over a 12-week period using a standardized protocol in 107 nontreated eyes of 107 patients with age-related macular degeneration who were enrolled in an ongoing clinical trial.

Data from 91 patients were included in the analysis, with a 95% coefficient of repeatability of 7 letters (0.35 log CS), ranging from 6 letters for 32 eyes with drusen only to 8 letters for patients with late AMD (macular scars or geographic atrophy). Three (3%) of these stable patients had an apparent six or more letter reduction in contrast sensitivity at the week 1 visit compared with baseline.

There is a high intersession test-retest variability of Pelli-Robson CS scores in patients with AMD, with implications for AMD clinical trial design. Although a change criterion of six or more letters may be an adequate end point in clinical trials for patients with early AMD, a larger change criterion may be necessary for clinical trials of patients with late AMD.