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The relationship between contrast sensitivity and retinal nerve fiber layer thickness in patients with glaucoma

  • Glaucoma
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the correlation between contrast sensitivity (CS) and retinal nerve fiber layer (RNFL) in different areas of vision.

Methods

This report is a sub-analysis of a prospective, observational cohort study investigating changes in performance-based assessment, vision-related quality of life, and clinical measures in patients with moderate to advanced glaucoma. The study included 161 participants with at least a 2-year history of glaucoma who underwent annual testing for 4 years. Contrast sensitivity was measured using the Spaeth/Richman contrast sensitivity (SPARCS) test, while RNFL thickness (RNFLT) was measured using Cirrus optical coherence tomography (OCT). Statistical analyses were performed to determine correlations between CS and RNFLT; the correlations were calculated for each annual visit, totaling four correlation coefficients for each patient over the course of 4 years.

Results

The SPARCS score in the left upper area of vision correlated the most strongly with the RNFLT of the inferior quadrant for both eyes at each annual visit, specifically in the seven o’clock sector for the left eye and the six o’clock sector for the right eye (p < 0.05). There were no discernible trends for the correlations between the other areas of CS and RNFL quadrants or clock hours over the 4 years of the study. Linear regression between the SPARCS total score and average RNFLT showed a significant direct correlation at each visit (p < 0.01).

Conclusions

Contrast sensitivity in the left upper area of vision for both eyes correlated most strongly with the thickness of the inferior quadrant of the RNFL. These fibers project to the temporal portion of the right occipital lobe, implying a potential center for contrast perception in this area. The longitudinal nature of the study suggests that CS may be a predictive tool for changes in RNFL in patients with glaucoma. Despite this finding, retinal damage and its relationship to CS was diffuse. In addition, SPARCS was shown to predict RNFLT. Further research is warranted to understand how CS can be used as a tool in the clinical setting.

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Acknowledgements

We are grateful to both David Garway-Heath, MD (Moorsfields Eye Hospital, London, UK), who served as a scientific adviser and created the image we used for Fig. 3, and Michael Waisbourd, MD (Tel Aviv Sourasky Medical Center, Tel Aviv, Israel), who also served as a scientific advisor.

Funding

Merck Sharp & Dohme provided financial support in the form of a grant (IISP # 39138). The sponsor had no role in the design or conduct of this research.

Author information

Authors and Affiliations

  1. Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA

    Sarah Amanullah, Joseph Okudolo & Lisa A. Hark

  2. Department of Research and Glaucoma Research Center, Wills Eye Hospital, 840 Walnut Street, Suite 1140, Philadelphia, PA, 19107, USA

    Kamran Rahmatnejad, Shuai-Chun Lin, Sheryl S. Wizov, Remy S. Manzi Muhire, Lisa A. Hark, Cindy X. Zheng & George L. Spaeth

  3. Department of Biostatistics, Thomas Jefferson University, Philadelphia, PA, USA

    Tingting Zhan

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  1. Sarah Amanullah
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Corresponding author

Correspondence to Sheryl S. Wizov.

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Conflict of interest

The primary investigator, George L. Spaeth, has developed and patented the Spaeth/Richman Contrast Sensitivity test. The remaining authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants in the study.

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Amanullah, S., Okudolo, J., Rahmatnejad, K. et al. The relationship between contrast sensitivity and retinal nerve fiber layer thickness in patients with glaucoma. Graefes Arch Clin Exp Ophthalmol 255, 2415–2422 (2017). https://doi.org/10.1007/s00417-017-3789-4

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  • DOI: https://doi.org/10.1007/s00417-017-3789-4

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