Central Serous Chorioretinopathy Reduces Contrast Sensitivity, Creates Perceived Visual Impairment

Contrast sensitivity function (CSF) is reduced in patients with central serous chorioretinopathy (CSCR) and correlates strongly with perceived visual impairment, according to research published in the British Journal of Ophthalmology. 

Researchers conducted a 2-center, prospective observational study of 129 eyes of 120 participants consisting of individuals with CSCR (40 eyes, median age 48 years, 66.7% men) and a healthy control group (89 eyes, median age 59 years, 57.14% men). They performed biomicroscopic evaluation, fundus imaging, best corrected visual acuity (BCVA) measurements, and contrast sensitivity testing on all participants. Median baseline BCVA was 0.10 and 0.00 logMAR for the CSCR and control groups, respectively. Main outcomes measures were outputs of the quantitative CSF (qCSF) method including area under the log CSF (AULCSF), contrast acuity (CA), and contrast sensitivity (CS) thresholds at six spatial frequencies (1, 1.5, 3, 6, 12, and 18 cycles per degree [cpd]).

After adjusting for age, researchers noted a correlation between CSCR and significant reductions in median AULCSF (P =.02, ꞵ=-0.14). It was also associated with reduced CS thresholds at 6, 12, and 18 cpd compared with controls (P =.009, ꞵ=-0.18; P <.001, ꞵ=-0.23; and P =.04, ꞵ=-0.09, respectively). CSCR was not associated with reduced CS at thresholds of 1, 1.5, and 3 cpd (P =.54, P =.25, and P =.24 respectively).

A total of 19 of the 36 patients in the CSCR cohort reported a subjective perception of visual impairment. Median BCVA was 0.097 logMAR in the symptomatic group compared with 0.00 logMAR in the asymptomatic group (P =.02). Investigators reported that subjective symptomatology was associated with reductions in AULCSF (P <.001, ꞵ=-0.48), CA (P <.001, ꞵ=-0.29), and decreased CS thresholds for all spatial frequencies (P ≤.01 for all).   

“CS was found to be significantly reduced in CSCR, and seems to strongly correlate with subjective visual impairment,” according to the researchers. They discuss the possibility that “the novel qCSF method may serve as a valuable adjunct visual function metric for patients with CSCR.” 

Study limitations include a broad range of patients with varying levels of CSCR and failure to perform subjective assessments using the vision-related quality of life (VRQOL) questionnaire.

Reference

Vingopoulos F, Garg I, Kim EL, et al. Quantitative contrast sensitivity test to assess visual function in central serous chorioretinopathy. Br J Ophthalmol. Published online March 15, 2022. doi:10.1136/bjophthalmol-2021-320415