Central contrast sensitivity as an outcome measure in randomized controlled trials in glaucoma ‐ a systematic review

• Published in: Acta ophthalmologica (Oxford, England) Vol. 102; no. S279
• Main Authors: Møller, Jens Riis, Sverstad, Alexander, Virgili, Gianni, Azuara‐Blanco, Augusto, Freiberg, Josefine Clement, Ahrensberg, Simone, Kristianslund, Olav, Petrovski, Goran, Kolko, Miriam
• Format: Journal Article
• Language: English
• Published: Malden Wiley Subscription Services, Inc 01.01.2024
• Subjects: Acuity; Clinical trials; Geographical distribution; Glaucoma; Retinal ganglion cells; Sensitivity analysis; Systematic review; Visual field
• ISSN: 1755-375X; 1755-3768
• DOI: 10.1111/aos.16188

Aims/Purpose: Standard automated perimetry (SAP) is currently the gold standard for diagnosing and assessing glaucoma progression. However, contrast sensitivity (CS) has shown promise as a valuable diagnostic tool in the early stages of glaucoma. This study aims to describe the evaluation of central CS as an outcome measure in randomized controlled trials on glaucoma. Methods: A descriptive systematic review was conducted, searching multiple databases for relevant literature and s. Two independent authors screened the records and collected data, with a third reviewer available for resolution in case of disagreements. Eligibility criteria included the use of central CS as an outcome measure, publication in English with no restrictions on the date, glaucoma of any type (including suspects and ocular hypertension), and no limitations on age, sex, ethnicity, or geographical location. Any type of intervention and comparator was included, while animal studies were excluded. Results: The initial search yielded 990 articles and s for title and screening, of which 29 met the eligibility criteria for full‐text data extraction. The review is currently in progress. Conclusions: Glaucoma affects not only peripheral visual functions but also central visual functions in the early stages. SAP detects visual field defects only after a significant loss of retinal ganglion cells. Visual acuity (VA) is routinely used in glaucoma evaluation but provides limited information on the disease stage, focusing mainly on foveal involvement. Currently, there are no widely accepted examinations of central visual functions routinely performed for suspected or established glaucoma patients. Studies have shown that CS declines in the early stages of glaucoma. This review aims to provide insight into the tests used to assess CS in glaucoma and their performance.