Introducing a new method to assess vision: Computer-adaptive contrast-sensitivity testing predicts visual functioning...

Area of Science:

• Ophthalmology
• Neuroscience
• Medical Imaging

Background:

• Impaired low-contrast visual acuity (LCVA) is a common issue in multiple sclerosis (MS) and other neurological conditions.
• Current assessments of LCVA often use limited contrast levels (e.g., 2.5%, 1.25%).
• Computerized adaptive testing, such as the quick contrast-sensitivity function (qCSF), enables evaluation across a wider range of contrasts and spatial frequencies.

Purpose of the Study:

• To compare the qCSF method with traditional high-contrast visual acuity (HCVA) and low-contrast charts.
• To evaluate the association between qCSF and patient-reported visual function using the National Eye Institute Visual Functioning Questionnaire (NEIVFQ).

Main Methods:

• 131 consecutive MS patients were enrolled.
• Assessments included HCVA (at 30cm and 5m), low-contrast vision (Sloan charts at 2.5% and 1.25%), qCSF, and the NEIVFQ.
• Linear regression models, corrected for age, gender, and multiple testing, were used to analyze associations.

Main Results:

• qCSF demonstrated a higher association with Sloan charts (R²=0.68) compared to HCVA (5m: R²=0.5; 30cm: R²=0.41).
• qCSF showed the strongest association with NEIVFQ subscales (R²=0.20-0.57).
• Sloan charts lacked significant association with NEIVFQ subscales after multiple testing correction.

Conclusions:

• The qCSF method is a valuable and promising outcome measure for assessing low-contrast vision in MS and other neurological disorders.
• qCSF exhibits a stronger correlation with patient-reported visual function compared to standard low- and high-contrast charts.