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Introducing a new method to assess vision: Computer-adaptive contrast-sensitivity testing predicts visual functioning
J P Stellmann1, K L Young1, J Pöttgen1
1Institute of Neuroimmunology and MS (INIMS), University Medical Centre Hamburg-Eppendorf, Germany.
Background:
Impaired low-contrast visual acuity (LCVA) is common in multiple sclerosis (MS) and other neurological diseases. Its assessment is often limited to selected contrasts, for example, 2.5% or 1.25%. Computerized adaptive testing with the quick contrast-sensitivity function (qCSF) method allows assessment across expanded contrast and spatial frequency ranges.
Objective:
The objective of this article is to compare qCSF with high- and low-contrast charts and patient-reported visual function.
Methods:
We enrolled 131 consecutive MS patients (mean age 39.6 years) to assess high-contrast visual acuity (HCVA) at 30 cm and 5 m, low-contrast vision with Sloan charts at 2.5% and 1.25%, qCSF and the National Eye Institute Visual Functioning Questionnaire (NEIVFQ). Associations between the different measures were estimated with linear regression models corrected for age, gender and multiple testing.
Results:
The association between qCSF and Sloan charts (R2 = 0.68) was higher than with HCVA (5 m: R2 = 0.5; 30 cm: R2 = 0.41). The highest association with NEIVFQ subscales was observed for qCSF (R2 0.20-0.57), while Sloan charts were not associated with any NEIVFQ subscale after correction for multiple testing.
Conclusion:
The qCSF is a promising new outcome for low-contrast vision in MS and other neurological diseases. Here we show a closer link to patient-reported visual function than standard low- and high-contrast charts.
