Rapid clinical assessment of spatial contrast sensitivity changes in retinal disease and ageing

Evidence suggests best-corrected visual acuity is not sensitive to subtle vision losses in early disease stages, indicating the need for other tests. Here, we quantified contrast sensitivity in 99 people (20-88 years): 52 with eye diseases (10 with early AMD, 9 diabetics without retinopathy, 22 glaucoma suspects, 11 high myopes) and 47 age-matched healthy controls using a new spatial vision chart (0.28-100% Weber contrasts; 3-60 c/degrees frequencies). In retinal diseases and healthy ageing, the chart detected frequency-dependent losses; sensitivity was reduced at 3 and 8 c/degrees in AMD, at 6 and 8 c/degrees in diabetes, and at all frequencies in myopia and with ageing. Intrasession repeatability was excellent and spatial contrast changes were in accordance with deficits identified previously using complex and time-consuming psychophysical tests. The chart offers a simple, rapid and readily available tool for clinical use to document early visual deficits.