Quantitative cone contrast threshold testing in patients with differing pathophysiological mechanisms causing retinal diseases

Kayla M White; Itamar Livnat; Caroline R Frambach; John Doan; Urmi V Mehta; Clara Yuh; Anton M Palma; Kimberly A Jameson; M Cristina Kenney; Mitul C Mehta; Chantal J Boisvert; Wade R Crow; Andrew W Browne

doi:10.1186/s40942-023-00442-3

Quantitative cone contrast threshold testing in patients with differing pathophysiological mechanisms causing retinal diseases

Int J Retina Vitreous. 2023 Feb 2;9(1):9. doi: 10.1186/s40942-023-00442-3.

Authors

Kayla M White^{1

2}, Itamar Livnat³, Caroline R Frambach¹, John Doan^{4

5}, Urmi V Mehta^{6

7}, Clara Yuh^{8

7}, Anton M Palma⁹, Kimberly A Jameson¹⁰, M Cristina Kenney^{6

11}, Mitul C Mehta⁶, Chantal J Boisvert^{6

12}, Wade R Crow⁶, Andrew W Browne^{6

11

13

9}

Affiliations

¹ School of Medicine, University of California, Irvine, CA, 92617, USA.
² Case Western Reserve University Ophthalmology, 10900 Euclid Ave, Cleveland, OH, 44106, USA.
³ Department of Ophthalmology, Gavin Herbert Eye Institute, University of California, Irvine, CA, 92617, USA. ilivnat@hs.uci.edu.
⁴ Medical College of Wisconsin, Wauwatosa, WI, 53226, USA.
⁵ Kaiser Permanente Santa Clara Internal Medicine, Santa Clara, CA, 95051, USA.
⁶ Department of Ophthalmology, Gavin Herbert Eye Institute, University of California, Irvine, CA, 92617, USA.
⁷ Western University of Health Sciences, Pomona, CA, 91766, USA.
⁸ University of California, Irvine, CA, 92617, USA.
⁹ Institute for Clinical and Translational Sciences University, Department of Physical Medicine and Rehabilitation, University of California, Irvine, CA, 92617, USA.
¹⁰ Institute for Mathematical Behavioral Sciences, University of California, Irvine, CA, 92617, USA.
¹¹ Center for Translational Vision Research, University of California, Irvine, CA, 92617, USA.
¹² Duke Eye Center, Department of Ophthalmology, Duke University School of Medicine, Durham, NC, 27705, USA.
¹³ Department of Biomedical Engineering, University of California, Irvine, CA, 92617, USA.

Abstract

Background: Cone contrast threshold testing (CCT) provides quantitative measurements of color and contrast function to reveal changes in vision quality that are not standard endpoints in clinical trials. We utilize CCT to measure visual function in patients with multiple sclerosis (MS), age-related macular degeneration (AMD), epiretinal membrane (ERM), and retinal vein occlusion (RVO).

Methods: Retrospective data was gathered from 237 patients of the Gavin Herbert Eye Institute. Subjects included 17 patients with MS, 45 patients with AMD, 41 patients with ERM, 11 patients with RVO, and 123 healthy controls. Patients underwent the primary measurement outcome, CCT testing, as well as Sloan visual acuity test and spectral domain optical coherence tomography during normal care.

Results: Color and contrast deficits were present in MS patients regardless of history of optic neuritis. AMD with intermediate or worse disease demonstrated reduced CCT scores. All 3 stages of ERM demonstrated cone contrast deficits. Despite restoration of visual acuity, RVO-affected eyes demonstrated poorer CCT performance than unaffected fellow eyes.

Conclusions: CCT demonstrates color and contrast deficits for multiple retinal diseases with differing pathophysiology. Further prospective studies of CCT in other disease states and with larger samples sizes is warranted.

Keywords: Age-related macular degeneration; Color vision; Cone contrast threshold testing (CCT); Epiretinal membrane; Multiple sclerosis; Optic neuritis; Retinal vein occlusion.