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At the molecular level, visual signals trigger transformations in photopigment molecules, resulting in changes in the photoreceptor cell's membrane potential. The photon's energy level is denoted by its wavelength, with each specific wavelength of visible light associated with a distinct color. The spectral range of visible light, classified as electromagnetic radiation, spans from 380 to 720 nm. Electromagnetic radiation wavelengths exceeding 720 nm fall under the infrared category,...
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Updated: Aug 11, 2025

Simultaneous ex vivo Functional Testing of Two Retinas by in vivo Electroretinogram System
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Quantitative cone contrast threshold testing in patients with differing pathophysiological mechanisms causing retinal

Kayla M White1,2, Itamar Livnat3, Caroline R Frambach1

  • 1School of Medicine, University of California, Irvine, CA, 92617, USA.

International Journal of Retina and Vitreous
|February 3, 2023
PubMed
Summary

Cone contrast threshold testing (CCT) reveals vision quality changes in multiple sclerosis, macular degeneration, epiretinal membrane, and retinal vein occlusion. CCT identifies subtle deficits missed by standard tests.

Keywords:
Age-related macular degenerationColor visionCone contrast threshold testing (CCT)Epiretinal membraneMultiple sclerosisOptic neuritisRetinal vein occlusion

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Area of Science:

  • Ophthalmology
  • Neuro-ophthalmology
  • Vision Science

Background:

  • Cone contrast threshold testing (CCT) quantifies color and contrast vision, offering insights beyond standard clinical trial endpoints.
  • CCT assesses visual function in diverse retinal conditions, including multiple sclerosis (MS), age-related macular degeneration (AMD), epiretinal membrane (ERM), and retinal vein occlusion (RVO).

Purpose of the Study:

  • To evaluate the utility of CCT in detecting visual function deficits in patients with MS, AMD, ERM, and RVO.
  • To compare CCT performance across different retinal disease states and with healthy controls.

Main Methods:

  • Retrospective analysis of data from 237 patients at the Gavin Herbert Eye Institute.
  • Included 17 MS, 45 AMD, 41 ERM, 11 RVO patients, and 123 healthy controls.
  • Primary outcome: CCT testing. Secondary measures: Sloan visual acuity and spectral domain optical coherence tomography.

Main Results:

  • MS patients showed color and contrast deficits irrespective of optic neuritis history.
  • Intermediate or worse AMD correlated with reduced CCT scores.
  • ERM at all stages and RVO eyes (even with restored acuity) exhibited cone contrast deficits.

Conclusions:

  • CCT effectively identifies color and contrast deficits in various retinal diseases with distinct pathologies.
  • Further prospective studies with larger cohorts are recommended to validate CCT's role in other conditions.