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      Factors Affecting Contrast Sensitivity in Healthy Individuals: A Pilot Study

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          Abstract

          Objectives:

          To determine the demographic and ocular features affecting contrast sensitivity levels in healthy individuals.

          Materials and Methods:

          Seventy-four eyes of 37 subjects (7-65 years old) with refractive errors less than 1.0 diopter, no history of ocular surgery, and 20/20 visual acuity were included in the study. The participants were divided by age into three groups: group 1, 7-19 years, n=11; group 2, 20-49 years, n=15; and group 3, 50-65 years, n=11. All subjects underwent anterior and posterior segment evaluation, intraocular pressure measurements, refraction measurements, and clinical evaluation for strabismus. Contrast static test was performed using Metrovision MonPack 3 vision monitor system after measuring pupil diameter. Photopic and mesopic measurements were taken sequentially from right eyes, left eyes, and both eyes together.

          Results:

          Contrast sensitivity at intermediate and high spatial frequencies was lower with increasing age. Binocular measurements were better than monocular, and mesopic measurements were better than photopic measurements at all spatial frequencies. Contrast sensitivity at higher spatial frequency was lower with hyperopic refraction values.

          Conclusion:

          Increasing age, small pupil diameter, hyperopia, and photopic conditions were associated with lower contrast sensitivity in healthy individuals. Binocular contrast sensitivity measurements were better than monocular contrast sensitivity measurements in all conditions and spatial frequencies.

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          Most cited references19

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          Photoreceptor loss in age-related macular degeneration.

          The authors showed previously that parafoveal rods, but not cones, decrease during the course of adulthood in donor eyes that were screened to exclude the grossly visible macular drusen and pigmentary disturbances typical of age-related macular degeneration (AMD). Because AMD begins in the parafovea, this selective loss of rods actually may be subclinical AMD not yet visible in the fundus. If so, AMD must have a predilection for rods over cones. The authors tested this hypothesis by determining the relative numbers of cones and rods in donor eyes with mid-to late-stage AMD and in age-matched controls. Thirteen eyes (from seven donors) with grossly visible macular drusen and pigmentary disturbances were either wholemounted for photoreceptor counts or sectioned through the fovea for histopathology and carbonic anhydrase histochemistry to label red-green cones. Eyes were assigned to AMD or control groups on the basis of histopathology and clinical history. Five nonexudative AMD (NE-AMD) eyes from three donors showed sparing of foveal cones and loss of rods and cones in the parafovea. In two donors, rod loss exceeded cone loss at most parafoveal locations, and in one donor, rod density was normal and cone density was reduced. In eight exudative AMD (EX-AMD) eyes from five donors, photoreceptors surviving along the margins of and overlying disciform scars were largely cones. Photoreceptors are lost in NE-AMD as well as in the more severe exudative form, consistent with functional and clinical studies. The authors propose that rods die in older eyes without evidence of overt retinal pigment epithelial disease. In persons susceptible to AMD, the retinal pigment epithelium becomes dysfunctional. Secondarily, rod loss continues and cones begin to degenerate. Eventually, only degenerate cones remain; ultimately, all photoreceptors may disappear.
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            Contrast sensitivity throughout adulthood.

            Previous studies of spatial contrast sensitivity in adulthood have produced conflicting results. To clarify the situation, we measured contrast sensitivity functions on a large sample of adults (n = 91), ranging in age from 19 to 87. All observers were free from significant ocular pathology and were individually refracted for the test distance. Sensitivity for stationary gratings of low spatial frequency remained the same throughout adulthood. At higher spatial frequencies, sensitivity decreased with age beginning around 40 to 50 years. When a low spatial frequency grating was drifted, young adults' sensitivity improved by a factor of 4-5 over sensitivity to a static grating; this motion enhancement was markedly diminished in adults over 60 years, implying an impairment of temporal processing in the elderly. Reduced retinal illuminance characteristic of the aged eye could account for a large part of older adults' deficit in spatial vision, but appeared to play little role in their deficit in temporal vision.
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              Contrast sensitivity testing: a more complete assessment of vision.

              Contrast sensitivity testing is a powerful tool for determining the capability of the visual system to process spatial and temporal information about the everyday objects we see. The current gold standard in the assessment of vision, visual acuity, provides only a limited amount of information, obtained under artificial conditions. Contrast sensitivity testing measures a range of visual performance under real-life conditions. It measures the least amount of contrast needed to detect a visual stimulus and gives us a more complete quantitization of patients' visual capabilities. Many instances in which losses in contrast sensitivity were detected when visual acuity (one point on the contrast sensitivity function) was normal have been reported. These include amblyopia, neuro-ophthalmology, retina, anterior segment disease, and glaucoma. Therefore, contrast sensitivity testing enables the clinician to diagnose selective deficits in visual processing at an earlier stage than is possible with conventional testing methods.
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                Author and article information

                Journal
                Turk J Ophthalmol
                Turk J Ophthalmol
                TJO
                Turkish Journal of Ophthalmology
                Galenos Publishing
                2149-8695
                2149-8709
                April 2017
                1 April 2017
                : 47
                : 2
                : 80-84
                Affiliations
                [1 ] Kayseri Training and Research Hospital, Ophthalmology Clinic, Kayseri, Turkey
                [2 ] Independent Practitioner, İzmir, Turkey
                [3 ] Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
                Author notes
                * Address for Correspondence: Kayseri Training and Research Hospital, Ophthalmology Clinic, Kayseri, Turkey GSM: +90 505 925 55 65 E-mail: arzuskaratepe@ 123456hotmail.com
                Article
                2004
                10.4274/tjo.93763
                5384124
                28405481
                c58f4f58-6efb-4181-9ae7-beb19e86fb0f
                ©Turkish Journal of Ophthalmology, Published by Galenos Publishing.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 16 November 2015
                : 11 June 2016
                Categories
                Original Article

                contrast sensitivity,age,visual function,photopic
                contrast sensitivity, age, visual function, photopic

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