An evaluation of the Mars Letter Contrast Sensitivity Test.

PURPOSE: The Mars Letter Contrast Sensitivity Test (initially known as the Lighthouse Letter Contrast Sensitivity Test) is similar in design to the Pelli-Robson Test but may offer several advantages. This study evaluates the repeatability of the Mars test and its agreement with the Pelli-Robson test in normal and low-vision subjects. METHODS: Fifty-four subjects were tested (age 22-86 years), including 20 normally sighted young adults, 17 normally sighted older adults, and 17 adults with low vision (20/16 to 20/250). Subjects were tested with both contrast sensitivity tests and with the ETDRS visual acuity chart. After a short break, subjects were retested with an alternate form of each contrast sensitivity test. The chart forms used (two Pelli-Robson and three Mars) and the order of testing were varied systematically. Testing was monocular with habitual correction and, for subjects over 40 years of age, included appropriate near add. Letter-by-letter scoring was used for both tests. Repeatability and agreement were assessed by determining the 95% limits of agreement (LoA): +/- 1.96 standard deviations of the differences between administrations or tests. RESULTS: The Mars test showed excellent agreement with the Pelli-Robson test, with 95% LoA of +/- 0.21 log units for all subjects. The Mars test was similarly repeatable (95% LoA = +/-0.20 log units) to the Pelli-Robson test (95% LoA = +/-0.20 log units) among all subjects. CONCLUSION: The new Mars Letter Contrast Sensitivity Test shows excellent agreement with the Pelli-Robson test and has similar repeatability. There are subtle differences in the actual contrast levels on different forms of the Mars test, and adjusting for these differences leads to superior repeatability of the Mars test. Thus, the Mars test may be a useful alternative to the Pelli-Robson test offering several advantages, including smaller size, improved durability, and ease of use.     

Reliability and validity of the Melbourne Edge Test and High/Low Contrast Visual Acuity chart.

PURPOSE: The purposes of the study were to investigate the test-retest reliability and the validity of new versions of the Melbourne Edge Test (MET) and the High/Low Contrast Visual Acuity (H/LCVA) chart and to investigate the agreement between the original and new versions. METHODS: The MET original photographic version, MET new light box version, H/LCVA Chart original photographic version, H/LCVA Chart new printed version, and the Pelli-Robson chart were administered twice to one eye of 22 subjects with low vision and 20 soft contact lenses wearers. RESULTS: For the low vision group, the test-retest 95% limits of agreement were +/- 5.2 dB for the MET new light box version and +/- 0.39 logarithm of the minimum angle of resolution (logMAR) for the LCVA component of the H/LCVA new printed version. For the soft contact lens group, the test-retest 95% limits of agreement were +/- 2.1 dB for the MET new light box version and +/- 0.26 logMAR for the LCVA component of the H/LCVA new printed version. Moderate to high correlations were obtained between contrast sensitivity tests, thus providing evidence of validity. Scores obtained for the new test versions were significantly higher than the original versions (p < 0.01). CONCLUSIONS: Of all the tests administered, the MET original photographic version and the Pelli-Robson Chart had the highest test-retest reliability for the low vision group. For the soft contact lens group, the H/LCVA original version (low contrast letters, 18% Weber) and the Pelli-Robson Chart had the highest reliability.     

Improving the design of the letter contrast sensitivity test

PURPOSE: To develop a small-format letter contrast sensitivity test with improved accuracy, suitable for portable use and near testing, and having a simple and unambiguous scoring system that can be used with reference to existing norms. METHODS: A near test, printed on resin-coated paper and mounted on plastic was developed by using Sloan letters, with 0.04 log unit contrast decrements between each letter and a simple scoring procedure. Monte Carlo methods and a Weibull function model of visual performance were used to assess test accuracy. RESULTS: The new test has 28% lower score standard deviations than the Pelli-Robson Contrast Sensitivity Chart, over a wide range of low misreporting rates, while maintaining test scores that differ from the Pelli-Robson by 0.01 log unit, permitting use of norms collected with the Pelli-Robson test. CONCLUSIONS: While maintaining comparability with Pelli-Robson norms, the new test has improved accuracy in comparison with the Pelli-Robson chart and several other advantages that result from its smaller size.     

The letter contrast sensitivity test: clinical evaluation of a new design

PURPOSE: To compare the reliability, validity, and responsiveness of the Mars Letter Contrast Sensitivity (CS) Test to the Pelli-Robson CS Chart. METHODS: One eye of 47 normal control subjects, 27 patients with open-angle glaucoma, and 17 with age-related macular degeneration (AMD) was tested twice with the Mars test and twice with the Pelli-Robson test, in random order on separate days. In addition, 17 patients undergoing cataract surgery were tested, once before and once after surgery. RESULTS: The mean Mars CS was 1.62 log CS (0.06 SD) for normal subjects aged 22 to 77 years, with significantly lower values in patients with glaucoma or AMD (P<0.001). Mars test-retest 95% limits of agreement (LOA) were +/-0.13, +/-0.19, and +/-0.24 log CS for normal, glaucoma, and AMD, respectively. In comparison, Pelli-Robson test-retest 95% LOA were +/-0.18, +/-0.19, and +/-0.33 log CS. The Spearman correlation between the Mars and Pelli-Robson tests was 0.83 (P<0.001). However, systematic differences were observed, particularly at the upper-normal end of the range, where Mars CS was lower than Pelli-Robson CS. After cataract surgery, Mars and Pelli-Robson effect size statistics were 0.92 and 0.88, respectively. CONCLUSIONS: The results indicate the Mars test has test-retest reliability equal to or better than the Pelli-Robson test and comparable responsiveness. The strong correlation between the tests provides evidence the Mars test is valid. However, systematic differences indicate normative values are likely to be different for each test. The Mars Letter CS Test is a useful and practical alternative to the Pelli-Robson CS Chart.     

Repeatability of the Waterloo Four-Contrast LogMAR Visual Acuity chart and Near Vision Test card on a group of normal young adults

PURPOSES: To investigate the repeatability of logMAR visual acuity (VA) with the Waterloo Four-Contrast LogMAR Visual Acuity (FCLVA) chart and the Near Vision Test (NVT) card. The differences and agreements between near logMAR VA using horizontally- and vertically-presented letters were also determined. METHODS: Visual acuity of one eye (55 subjects) was first assessed by using the FCLVA chart, comprising four charts of varying contrast, and then with the NVT card (comprising four charts of two contrasts and two presentations). Measurements were repeated after 3 or 4 weeks. RESULTS: No significant between-visit differences were observed for any of the charts used. The repeatability coefficient for the distance 90, 60, 30 and 10% charts were 0.07, 0.11, 0.15 and 0.16 log units, respectively. The repeatability coefficients of the near vision charts were 0.06, 0.04 (high contrast), 0.11 and 0.10 (low contrast) log units. The agreements between horizontally- and vertically-presented letters were good. The differences were similar to the repeatability coefficient of each chart. CONCLUSIONS: The repeatability coefficient of the high contrast distance and near chart was about half a line. Repeatability coefficients increase with decreasing contrasts for both distance and near charts, with coefficients of one line or more for low contrast charts. Variabilities in both distance and near VA increase with decrease in contrast. The presentation of the letters does not affect near VA and the agreement between horizontally- and vertically-presented letters (both high and low contrast) was within the repeatability coefficient of each chart.     

数字式Mars对比敏感度检查表在国人低视力患者中的应用

目的评估数字式Mars对比敏感度检查表的精确性和准确性,探索其能否应用于中国低视力患者的对比敏感度检查。方法前瞻性对照研究。正常视力者40例,双眼习惯矫正视力≥1.0,排除明显眼部疾病;低视力患者43例,双眼中好眼最佳矫正视力≤0.3。所有被检者在视力矫正的前提下采取单眼测试,检查程序如下：①由第一名检查者从3张数字式Mars对比敏感度检查表中采取抽签法随机抽取一张表格,对被检者进行测试,并记录结果。②由第一名检查者随机用数字式Mars对比敏感度检查表和字母式Mars对比敏感度检查表分别再次测试被检者,分别记录每次的测试结果。③第二名检查者用步骤1中使用的那张数字式Mars对比敏感度检查表对被检者进行测试并记录结果。重复性和再现性通过统计组内标准差（Sw）、精确度（1.96Sw）、组内变异系数（CVw）和组内相关系数（ICC）进行评估;一致性比较采用Pearson线性相关分析、ICC及Bland-Altman分析法综合分析。结果数字式Mars对比敏感度检查表的重复性参数和再现性参数1.96Sw、CVw较小,而ICC值较高,大于0.75。数字式Mars对比敏感度检查表和字母式Mars对比敏感度检查表之间的一致性示两者之间呈高度正相关（r=0.995,P＜0.01）。ICC为0.997,Bland-Altman分析结果为95%LoA的范围非常窄,为（-0.053,0.092）logCS,表明2个表之间具有高度的一致性。结论数字式Mars对比敏感度检查表具有较高的准确性和精确性,能够应用于中国低视力患者的对比敏感度检查。     

Normal values for photopic and mesopic letter contrast sensitivity

PURPOSE: The exponential increase of patients having refractive surgery has increased the number of patients with night vision disturbances, such as decreased contrast sensitivity. However, there are no standard contrast sensitivity scales in normal persons in the mesopic range. We describe Pelli-Robson contrast sensitivity under photopic and mesopic luminance conditions in a large Spanish population over a wide range of age groups to provide normal values. A further aim was to evaluate the effect of photopic visual acuity on photopic and mesopic contrast sensitivity. METHODS: A cross-sectional study was performed on 292 participants stratified by age into six groups. Binocular contrast sensitivity was determined with best spectacle correction using the Pelli-Robson letter chart at 1 m under photopic (85 cd/m2) and mesopic (0.15 cd/m2) luminance conditions. RESULTS: Phototopic letter contrast sensitivity began to decrease gradually from the 61 to 70-year-old age group onward, and for mesopic conditions, from the 51 to 60-year-old age group onward. The reduction in mean contrast sensitivity between the oldest and the youngest age groups was 0.20 log units (photopic) and 0.33 log units (mesopic). Loss in contrast sensitivity due to luminance (two successive triplets) increased slightly with age. Both photopic and mesopic letter contrast sensitivity significantly improved as photopic visual acuity increased. CONCLUSIONS: Under mesopic conditions, Pelli-Robson contrast sensitivity began to decline 1 decade earlier than under photopic conditions and was affected by visual acuity. Normal values for mesopic contrast sensitivity could be of help in deciding whether mesopic function is normal or a decrease in contrast sensitivity is pathologic in nature.     

Differences in the legibility of letters at contrast threshold using the Pelli-Robson chart

One disadvantage of using high-contrast letters as test objects when measuring visual acuity is the fact that they are not of equal legibility. A number of charts are now commercially available that assess contrast sensitivity using letter targets. This study attempted to assess the legibility of letters at contrast threshold on the Pelli-Robson letter contrast sensitivity chart by determining the percentage of correct responses for each of the ten Sloan letters at contrast threshold. Results of 493 contrast sensitivity measurements taken in optometric practice indicated that there is a definite difference in legibility between letters at contrast threshold as for letters at acuity threshold. The data suggest that the probability of correctly identifying two out of a group of three letters at threshold on the Pelli-Robson chart varies between 67% and 97% due to letter type alone. Because of the very regular and pronounced miscalling of the letter C as an O, we suggest that this should be accepted as a correct call during threshold measurements on the Pelli-Robson chart. This helps to balance the legibility of different groups of letters.     

Intermediate spatial frequency letter contrast sensitivity: its relation to visual resolution before and during amblyopia treatment

We examined the loss of letter contrast sensitivity (LCS) measured using the Pelli-Robson chart, and the extent to which any such loss was modulated by spectacle wear and occlusion therapy in children participating in an amblyopia treatment trial. Their initial mean interocular difference in logMAR acuity was approximately three times that of their LCS (0.45 vs 0.14 log units). Log LCS was weakly though significantly correlated with logMAR visual acuity (VA) for all VAs better than 0.90 (r = -0.19, 95% CI: -0.28 to -0.10) whereas for all VAs of 0.90 or poorer, log LCS was markedly and significantly correlated with VA (r = -0.72, 95% CI: -0.83 to -0.53). LCS in those children with a > or =0.1 log unit interocular difference on this test improved commensurately with VA during treatment. We conjecture that the spatial visual loss in all but the most severe amblyopes occurs in an area of resolution and contrast space that lies beyond that sampled by the Pelli-Robson chart.     

Contrast sensitivity and glare in cataract using the Pelli-Robson chart.

There is a need for a convenient, clinically applicable test of glare disability which can be used in the preoperative evaluation of patients with cataract. In this study, contrast sensitivity (using the Pelli-Robson letter chart), near vision, and visual acuity were compared, with and without the introduction of a glare source in 70 patients with cataract, 15 with intraocular lenses, and 19 controls. A disposable pen torch was shone at the pupillary margin to induce glare. Contrast sensitivity demonstrated the most marked reduction during glare testing. Cortical cataracts were most affected followed by posterior subcapsular opacities. The glare disability was significantly less in pseudophakic patients and was absent from patients with non-cataractous phakic eyes. Glare testing with a disposable pen torch and a Pelli-Robson contrast sensitivity letter chart provides a rapid test of glare disability which can be easily incorporated into the clinical appraisal of patients with cataract.     

The usefulness of Vistech and FACT contrast sensitivity charts for cataract and refractive surgery outcomes research

AIM: To investigate the repeatability and sensitivity of two commonly used sine wave patch charts for contrast sensitivity (CS) measurement in cataract and refractive surgery outcomes. METHODS: The Vistech CS chart and its descendant, the Functional Acuity Contrast Test (FACT), were administered in three experiments: (1) Post-LASIK and age matched normal subjects; (2) Preoperative cataract surgery and age matched normal subjects; (3) Test-retest repeatability data in normal subjects. RESULTS: Contrast sensitivity was similar between post-LASIK and control groups and between the Vistech and FACT charts. The percentage of subjects one month post-LASIK achieving the maximum score across spatial frequencies (1.5, 3, 6, 12, 18 cycles per degree) were (50, 33, 13, 13, 0 respectively) for FACT, but only (0, 0, 13, 4, 0 respectively) for Vistech. A small number of cataract patients also registered the maximum score on the FACT, but up to 60% did not achieve the minimum score. Test-retest intraclass correlation coefficients varied from 0.28 to 0.64 for Vistech and 0.18 to 0.45 for FACT. Bland-Altman limits of agreement across spatial frequencies were between +/-0.30 and +/-0.85 logCS for Vistech, and +/-0.30 to +/-0.75 logCS for FACT. DISCUSSION: The Vistech was confirmed as providing poorly repeatable data. The FACT chart, likely because of a smaller step size, showed slightly better retest agreement. However, the reduced range of scores on the chart due to the smaller step size led to ceiling (post-LASIK) and floor (cataract) effects. These problems could mask subtle differences between groups of patients with near normal visual function as found post-refractive or cataract surgery. The Vistech and FACT CS charts are ill suited for refractive or cataract surgery outcomes research.     

The reliability of the Pelli-Robson contrast sensitivity chart

Normative contrast sensitivity (CS) data were obtained using the commercially available Pelli-Robson chart from the dominant eye of 30 young (mean (+/- SD) age 22.5 +/- 4.3 years) and 42 older (mean (+/- SD) age 70.2+/- 6.7 years) subjects with normal healthy eyes. The majority of young subjects were found to have a CS of 1.80 log units or above. The majority of the older subjects were found to have a CS of 1.65 log units or above. CS results were obtained using both sides (A and B) of the Pelli-Robson chart from 30 (15 young and 15 older) of these subjects. These measurements were repeated under identical conditions, 2 weeks later. There was no significant difference between the results from sides A and B of the chart. The CS scores were shown to be repeatable to within +/- 0.15 log units or +/- 1 step. Therefore a significant change in CS score is +/- 2 steps or 0.30 log units. Slight improvements in reliability could be obtained by more careful permutation of letters on each step and a smaller step size. The restriction against these changes is the ensuing increased chart size.     

A comparison of clinical acuity and contrast sensitivity charts: effect of uncorrected myopia

We have examined the effect of corrected and uncorrected myopia on visual acuity and contrast sensitivity using a standard acuity chart and two commercially available printed contrast sensitivity charts (Vistech and Pelli-Robson). We tested 140 eyes of 70 young adults. Most subjects were myopic and were tested with and without their optimum spectacle or contact lens correction. We found no effect of myopia, if well corrected, on acuity or contrast sensitivity. All three test scores were sensitive to uncorrected myopia. The Pelli-Robson contrast sensitivity chart, which was designed to be insensitive to defocus, required more than three diopters of refractive error to elicit a two line change in performance, and it was generally very insensitive to uncorrected myopia. Although the Vistech chart was sensitive to uncorrected myopia, the large step sizes used in the chart, and the higher inter- and intra-subject variability in scores reduces its potential value for refraction. The Snellen letter chart gave the most sensitive and reliable changes in performance with uncorrected myopia.     

Contrast and glare sensitivity. Association with the type and severity of the cataract.

PURPOSE: Contrast and glare sensitivity tests are now being used as adjuncts to visual acuity in the assessment of visual function. Limited data are available on the associations of the former tests with cataract type and severity. The aim of the study is to assess these associations using standardized techniques. METHODS: Contrast sensitivity tests (using the Pelli-Robson chart) and glare sensitivity tests (using the Vistech MCT 8000) were done on 128 patients with cataracts and no other ocular disease and on 29 control volunteers. The cataracts were graded using the Lens Opacities Classification System II (LOCS II). Data from the left eyes were analyzed using logistic regression models. RESULTS: Contrast sensitivity loss was associated with cataract severity for cortical (P less than 0.0001) and posterior subcapsular (P = 0.0001) cataracts and with decreased visual acuity (P = 0.0001). Night and day glare sensitivity were each associated only with increased severity of posterior subcapsular cataracts (P less than or equal to 0.003) and with decreased visual acuity (P less than 0.001). Additional analyses showed that contrast and glare sensitivity were similar in eyes with no cataracts and early cataracts. CONCLUSION: These results suggest that the Pelli-Robson Chart and the Vistech MCT 8000 are good techniques for evaluating visual function in moderate to advanced cataracts. However, for early cataracts, other techniques need to be explored to assess visual function loss.     

Contrast and glare sensitivity in epilepsy patients treated with vigabatrin or carbamazepine monotherapy compared with healthy volunteers

BACKGROUND/AIM: Many antiepileptic drugs have influence on visual functions. The aim of this study was to investigate possible changes in contrast sensitivity, macular photostress, and brightness acuity (glare) tests in patients with epilepsy undergoing vigabatrin (VGB) or carbamazepine (CBZ) monotherapy compared with healthy volunteers. METHODS: 32 patients undergoing VGB therapy, 18 patients undergoing CBZ therapy, and 35 healthy volunteers were asked to participate in an ophthalmological examination. In the previous study, visual field constrictions were reported in 40% of the patients treated with VGB monotherapy. In the present study, these VGB and CBZ monotherapy patients were examined for photopic contrast sensitivity with the Pelli-Robson letter chart and brightness acuity and macular photostress with the Mentor BAT brightness acuity tester. RESULTS: Contrast sensitivity with the Pelli-Robson letter chart showed no difference between these groups and normal subjects (ANOVA: p= 0.534 in the right eye, p= 0.692 in the left eye) but the VGB therapy patients showed a positive correlation between the contrast sensitivity values and the extents of the visual fields in linear regression (R = 0.498, p = 0.05 in the right eye, R = 0.476, p = 0. 06 in the left eye). Macular photostress and glare tests were equal in both groups and did not differ from normal values. CONCLUSION: The results of this study indicate that carbamazepine therapy has no effect on contrast sensitivity. Vigabatrin seems to impair contrast sensitivity in those patients who have concentrically constricted in their visual fields. Neither GBZ nor VGB affect glare sensitivity.     

Measuring contrast sensitivity under different lighting conditions: comparison of three tests.

PURPOSE: The purpose of this study was to evaluate three psychophysical tests for the measurement of contrast sensitivity (CS) and disability glare (DG) at different luminance levels. METHODS: In 60 eyes of 60 individuals (group 1: 20 healthy eyes of young individuals; group 2: 20 healthy eyes of elderly subjects; group 3: 20 eyes with nuclear cataract), CS with best correction was measured twice with the Frankfurt-Freiburg Contrast and Acuity Test System (FF-CATS) and the Functional Acuity Contrast Test (FACT, 1.5 cycles per degree [cpd]) at 167 cd/m2 and 0.167 cd/m2, and with the Pelli-Robson Chart (PRC) at 100 cd/m2 with and without glare. Repeatability of test and retest, and discriminative ability between the different subgroups, were assessed for CS values. RESULTS: Maximum CS values varied across tests. In all groups, highest CS values were obtained with the photopic FF-CATS. For FACT scores at 1.5 cpd, there was a ceiling effect for young subjects. CS scores obtained with the PRC were the lowest. The PRC had the best test-retest repeatability of all tests. Under mesopic conditions with glare, reliability was generally lower; the FF-CATS had the highest repeatability of the mesopic tests. The FF-CATS discriminated best between the different groups for all conditions. CONCLUSIONS: There are large discrepancies in the test results between CS testing methods, especially under different lighting conditions. Results from different CS tests are not interchangeable.     

Effects of spherical and astigmatic defocus on acuity and contrast sensitivity: a comparison of three clinical charts

Two contrast sensitivity charts (Vistech and Pelli-Robson) have become available to the eye care practitioner. Their value as clinical tools for the assessment of visual function may be enhanced because of either an insensitivity to the effects of optical focus or a hypersensitivity to defocus. We compared the sensitivity to defocus of these charts to the traditional Snellen chart by examining the effect of up to +/- 5.00 D of spherical and astigmatic defocus on performance with each chart. In order to simulate the two types of clinical examination scenarios, tests were performed both with and without mydriatic/cycloplegic agents. The Pelli-Robson contrast sensitivity chart was very resistant to the effects of all types of optical defocus. As predicted, the high spatial frequencies on the Vistech chart were sensitive to defocus. However, although contrast sensitivities for the low frequencies were affected less, optical defocus produced significant decreases in low frequency Vistech contrast sensitivity. In addition, the Vistech chart was very insensitive to axis 180 blurring lenses. There was no indication that either contrast sensitivity chart was more sensitive to defocus than the standard Snellen chart.     

Comparison of contrast sensitivity,visual acuity,and Humphrey visual field testing in patients with glaucoma

BACKGROUND: Despite their normal or near-normal Snellen visual acuity, patients with glaucoma often complain of "poor" vision. OBJECTIVE: To investigate the relationship between large-letter contrast sensitivity, high-contrast visual acuity, and visual field defects in patients with glaucoma who have 20/40 or better visual acuity. DESIGN :Prospective, cross-sectional case series. PATIENTS AND METHODS: We evaluated 250 eyes of 144 subjects from the Glaucoma Service at the University of Illinois at Chicago College of Medicine. Subjects with a diagnosis of glaucoma, suspected glaucoma, or ocular hypertension who met the 20/40 or better vision requirement were recruited. Visual acuity was measured using the rear-illuminated Lighthouse Visual Acuity Chart at 4 m. Contrast sensitivity was measured using the Pelli-Robson Chart in a front-illuminated box with even luminance across the chart. Visual fields of the patients were measured using the 24-2 full-threshold program on the Humphrey Visual Field Analyzer. RESULTS: A significant correlation (r = 0.57, P < 0.001, n = 127) was found between the visual field mean deviations and the contrast sensitivity scores. The correlation (r = -0.322, P < 0.001, n = 127) was less between the visual field mean deviation and the log MAR visual acuity values, as was the correlation between the contrast sensitivity scores and log MAR visual acuity values (r = -0.370, P < 0.001, n = 127). In the subgroup of patients with chronic open-angle glaucoma, the correlation between the mean visual field deviation and the contrast sensitivity score was higher at 0.689 (P < or = 0.001, n = 62). CONCLUSIONS: Reduced contrast sensitivity is significantly correlated with visual field losses in patients with glaucoma and a visual acuity of 20/40 or better. The study data support the conclusion that, compared with visual acuity, the disease process preferentially affects contrast sensitivity. In our previous work, contrast sensitivity was shown to be more related than visual acuity to real-world function in patients with early glaucomatous changes.     

Simple clinical techniques to evaluate visual function in patients with early cataract

Among the 80 subjects who were recruited with normal retinal and neural function, 54 had cataract and a visual acuity (VA) better than 6/24. The 26 age-matched subjects had clear media. Contrast sensitivity (CS) at low and intermediate spatial frequencies was measured using the Pelli-Robson letter chart. Two measures of glare disability (GD) were obtained using the Mentor Brightness Acuity Tester (BAT) in conjunction with a logMAR VA chart and the Pelli-Robson chart. Although CS is predominantly affected at high spatial frequencies in early cataract, we found that some subjects had reduced scores on the Pelli-Robson chart. This CS loss could not be predicted from VA measurements and was particularly found in subjects with posterior subcapsular cataract. High GD scores were found in a number of subjects with relatively good VA and could not be predicted from results of VA or CS. We suggest that CS and GD measurements using the Pelli-Robson chart and the BAT provide valuable information regarding the management of patients with early cataract.     

Evaluation of the efficacy of contrast sensitivity measures for the detection of early primary open-angle glaucoma.

We investigated the relative efficacy of contrast sensitivity (CS) measures for the identification of early primary open-angle glaucoma (POAG) patients. The contrast sensitivity function (CSF) was sampled at five spatial frequencies using a standard oscilloscope technique and measures of CS were also obtained using the Cambridge Gratings, Pelli-Robson CS Charts, Melbourne Edge Test (MET), and the High and Low Contrast Bailey-Lovie Letter Charts. Of the techniques evaluated, the High and Low Contrast Bailey-Lovie Letter Charts and the oscilloscope technique at the peak of the CSF exhibited the highest levels of sensitivity and specificity for differentiating between the POAG patients and normals. However, the relatively low levels of sensitivity and specificity obtained for the oscilloscope and chart tests overall indicate that, regardless of the pass/fail criterion selected, CS is unsuitable for screening for early POAG.