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/° frequencies). In retinal diseases and healthy ageing, the chart detected frequency-dependent losses; sensitivity was reduced at 3 and 8 c/° in AMD, at 6 and 8 c/° 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.