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Geographic Atrophy Size Progression Correlates Better with Longitudinal Changes in Quantitative Contrast Sensitivity
Filippos Vingopoulos1,2, Marta Stevanovic2, Peyman Razavi1
1Harvard Retinal Imaging Lab, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts.
Ophthalmology Science
|August 1, 2026
Summary
Geographic atrophy (GA) size correlates with reduced contrast sensitivity (CS) over time, but not visual acuity. Quantitative CS measures may be superior for tracking GA treatment effects.
Area of Science:
- Ophthalmology
- Medical Imaging
- Vision Science
Background:
- Geographic atrophy (GA) is an advanced form of age-related macular degeneration causing irreversible vision loss.
- Current methods for assessing GA progression and treatment efficacy, such as visual acuity (VA), may not fully capture functional decline.
Purpose of the Study:
- To investigate the cross-sectional and longitudinal correlations between total geographic atrophy (GA) size and quantitative contrast sensitivity function (qCSF).
Main Methods:
- A prospective, observational study involving 83 eyes with GA cross-sectionally and 30 eyes longitudinally.
- Contrast sensitivity (CS) was measured using the qCSF device, alongside spectral-domain OCT and fundus autofluorescence (FAF).
- Mixed-effects multivariate regression models analyzed relationships between GA size, qCSF metrics, and VA.
Main Results:
- Cross-sectionally, GA size was associated with multiple qCSF outcomes (AULCSF, CS thresholds), but not VA.
- Longitudinally, an increase in GA size correlated with significant decreases in CS metrics (AULCSF, LCVA, CS thresholds), but not VA.
- The impact of GA size increase on CS was substantially greater than its non-significant impact on VA.
Conclusions:
- Total GA size and its longitudinal changes are significantly associated with declines in qCSF.
- qCSF metrics demonstrate a stronger correlation with GA progression than VA.
- Contrast sensitivity emerges as a more sensitive functional endpoint for evaluating treatment effects in GA.
