Strongest Correlation Between Contrast Sensitivity and Morphological Characteristics in Bilateral nAMD

Area of Science:

• Ophthalmology
• Retinal Diseases
• Vision Science

Background:

• Neovascular age-related macular degeneration (nAMD) patients often report significant visual impairment despite preserved standard visual acuity.
• Existing visual acuity tests may not fully capture the functional deficits experienced by nAMD patients.
• Previous research indicated contrast sensitivity correlates well with quality of life in nAMD.

Purpose of the Study:

• To evaluate Pelli-Robson contrast sensitivity, ETDRS visual acuity, low luminance visual acuity, and reading speed in nAMD patients.
• To correlate these visual function parameters with morphologic features identified through fundus autofluorescence, OCT, and OCT angiography.
• To determine which visual function test best reflects the underlying structural damage in nAMD.

Main Methods:

• Fifty-four patients with bilateral nAMD were included in the study.
• Visual function was assessed using Pelli-Robson contrast sensitivity, ETDRS visual acuity, low luminance visual acuity, and Radner reading speed.
• Morphologic parameters were quantified using fundus autofluorescence, optical coherence tomography (OCT), and OCT angiography.

Main Results:

• Contrast sensitivity showed the strongest correlation with the total area of macular geographic atrophy and the percentage of atrophy within the central 1 mm.
• A regression model identified total macular geographic atrophy area, photoreceptor inner/outer segment junction disruption, central subretinal fibrosis, and central retinal thickness as key predictors of contrast sensitivity.
• These morphologic factors explained 71% of the variation in contrast sensitivity.

Conclusions:

• Contrast sensitivity is the most sensitive measure correlating with morphologic impairment in bilateral nAMD among the tested visual function parameters.
• Contrast sensitivity may serve as a valuable complement to ETDRS visual acuity in clinical trials for nAMD.
• Implementing contrast sensitivity testing in clinical practice could provide a more comprehensive diagnostic tool for nAMD patients.