Comparing Three Different Contrast Sensitivity Tests in Adults and in Children with and without Amblyopia

Abstract

Background Tests of contrast sensitivity (CS) are not routinely performed in the clinic, although CS is reduced in many conditions, such as amblyopia or glaucoma. This may be due to perceived time constraints or unaffordability of equipment.

Patients and Methods Monocular CS functions obtained with the FACT, CSV 1000E, and Lea Symbols were compared in 19 healthy subjects aged 24 – 78 years and 24 subjects aged 5 – 16 years, 9 of whom had amblyopia.

Results CS functions could be obtained with all three tests. The tests were equally comfortable for young and adult patients, and took less than 5 minutes to perform (one eye). All measured CSs at 3, 6, 12, and 18 cycles per degree (cpd), but the FACT included 1.5 cpd.

Linear mixed effect models were performed. While there was no significant difference at low spatial frequencies, the Lea CS test showed a ceiling effect in that range, while the FACT showed a floor effect at high spatial frequencies. CS in amblyopic children did not differ between the contralateral and the amblyopic eye. Overall, amblyopic eyes had lower CS values than the control eyes and CS did not correlate significantly to visual acuity at distance.

Conclusion All three CS tests could be usefully applied in the clinic in adults as well as children over the age of 4 years. Only the CSV 1000E exhibited neither a ceiling nor a floor effect. This was also the fastest test. In children with amblyopia, CS testing offers additional information on visual function. In contrast to previous reports, we did not find that the CSV and FACT are interchangeable.

Zusammenfassung

Hintergrund Obwohl Kontrastempfindlichkeit bei vielen Augenkrankheiten wie Amblyopie oder Glaukom vermindert ist, werden Kontrastempfindlichkeitstest nicht routinemäßig durchgeführt. Der Grund dafür liegt womöglich in der Zeitknappheit oder an mangelnder Ausrüstung.

Patienten und Methoden Kontrastempfindlichkeitsfunktionen wurden mit 3 verschiedenen Tests: FACT, CSV-1000E und Lea Symbolen monokular bei 19 gesunden Erwachsenen (24 – 78 J) und 15 gesunden und 9 amblyopen Kindern (5 – 16 J) gemessen und miteinander verglichen.

Resultate Mit allen 3 Tests konnten Kontrastempfindlichkeitsfunktionen erhalten werden. Die Tests waren vergleichbar angenehm für Jung und Alt und dauerten alle weniger als 5 Minuten (1 Auge). Während alle Tests Kontrastempfindlichkeiten bei 3, 6, 12 und 8 Zyklen pro Grad messen, werden mit dem FACT auch Werte bei 1,5 Zyklen pro Grad gemessen. Lineare Mixed-Effect-Modelle wurden erstellt. In tiefen Ortsfrequenzen ergab sich keine signifikante Differenz. Lea zeigte einen Ceiling-Effekt in den tiefen und FACT ein Floor-Effekt in den hohen Ortsfrequenzen. Bei den amblyopen Kindern bestand kein signifikanter Unterschied zwischen dem amblyopen und dem Partnerauge. Insgesamt hatten die amblyopen Augen tiefere Kontrastempfindlichkeiten als die Kontrollen und korrelierten nicht signifikant mit dem Fernvisus.

Schlussfolgerung Alle Tests können sowohl bei Erwachsenen als auch bei Kindern über 4 Jahren sinnvoll in der Praxis eingesetzt werden. Für Kinder mit Amblyopie liefert die Kontrastempfindlichkeit zusätzliche Informationen über die visuelle Funktion. Im Gegensatz zur Literatur waren FACT und CSV nicht austauschbar. Der CSV ließ sich am schnellsten durchführen und zeigte als einziger Test weder einen Floor- noch einen Ceiling-Effekt.

Key words

CSV-1000E - 10M LEA SYMBOLS - Functional Acuity Contrast Test (FACT) - contrast sensitivity

Schlüsselwörter

CSV-1000E - 10M LEA SYMBOLS - Functional Acuity Contrast Test (FACT) - Kontrastempfindlichkeit

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