Problems measuring contrast sensitivity in children

Evaluating Contrast Sensitivity in Asian Indian Pre-Term Infants With and Without Retinopathy of Prematurity

Purpose

The purpose of this study was to evaluate the contrast threshold in Asian Indian preterm infants with and without retinopathy of prematurity (ROP) using Newborn Contrast Cards measured during the first ROP screening and to correlate with final outcome and visual acuity at 3 months of corrected age.

Methods

Preterm infants born ≤ 2000 grams birth weight (BW) and/or ≤ 34 weeks gestational age (GA) undergoing ROP screening were enrolled prospectively. Visual acuity was recorded using Teller Acuity Cards. Contrast threshold was measured with Newborn Contrast Cards at first screening visit and at the end of ROP screening at 40 weeks of postmenstrual age or older.

Results

Of the 173 study infants, 134 (77.5%) did not have any stage of ROP. Of the remaining 39 (22.5%), 34 (87%) had type 2 ROP and 5 (13%) had type 1 ROP requiring treatment. The mean contrast threshold at the first visit of the no ROP type 1 and type 2 groups was 0.36 ± 0.07, 0.65 ± 0.19, and 0.46 ± 0.09, respectively (P < 0.001). Contrast threshold had a significant correlation with BW (R = −0.291, P = < 0.001) and gestational age (R = −0.47, P = < 0.001). The contrast threshold at the first visit correlated with visual acuity measured at 3 months of corrected age in logMAR (R = 0.36, P = 0.01). Other than BW and GA, no other systemic risk factors correlated with contrast threshold measured at the first screening visit.

Conclusions

Newborn Contrast Cards are a viable tool to test contrast threshold in preterm infants. The association between contrast threshold and ROP, and its correlation with visual acuity, suggest that contrast threshold measurement may help predict the clinical vision outcome among prematurely born infants.

Translational Relevance

Contrast threshold measurement may prove to be a useful tool in the estimation of visual potential in preterm infants.

Development of the spatial contrast sensitivity function (CSF) during childhood: Analysis of previous findings and new psychophysical data

Although the contrast sensitivity function (CSF) changes markedly during infancy, there is no consensus regarding whether, how, and why it continues to develop in later childhood. Here, we analyzed previously published data (N = 1928 CSFs), and present new psychophysical findings from 98 children (4.7–14.8 years) and 50 adults (18.1–29.7 years), in order to answer the following questions: (1) Does the CSF change during childhood? (2) How large is the developmental effect size? (3) Are any changes uniform across the CSF, or frequency-specific? and (4) Can some or all of the changes be explained by “non-visual” (i.e. procedural/cognitive) factors, such as boredom or inattentiveness? The new data were collected using a four-alternative forced-choice (4AFC) Gabor-detection task, with two different psychophysical procedures (Weighted Staircase; QUEST+), and suprathreshold (false-negative) catch trials to quantify lapse rates. It is shown that from ages 4 to 18 years, the CSF improves (at an exponentially decaying rate) by approximately 0.3 log₁₀ units (a doubling of contrast sensitivity [CS]), with 90% of this change complete by 12 years of age. The size of the effect was small relative to individual variability, with age alone explaining less than one sixth of variability (16%), and most children performing as well as some adults (i.e. falling within the 90% population limits for adults). Development was frequency-specific, with changes occurring primarily around or below the CSF peak (≤ 4 cpd). At least half — and potentially all — of the changes observed could be explained by non-visual factors (e.g. lapses in concentration), although possible biological mechanisms are discussed.

New paediatric contrast test: Hiding Heidi low-contrast 'face' test

BACKGROUND

The Hiding Heidi low-contrast 'face' test is a new paediatric contrast test to evaluate the ability to detect objects with low contrast. The purpose of the present study was to compare the Hiding Heidi low-contrast 'face' test (HH) with the Pelli-Robson contrast sensitivity test (PR) and the functional acuity contrast test (FACT) in the low-contrast assessment.

METHODS

Thirty university students participated in the present study. The contrast ability was evaluated by using three different methods: HH, PR and FACT. The HH was repeated on two separate occasions to test the repeatability.

RESULTS

There was a significant positive correlation between HH and PR (r = 0.65, P < 0.01); between HH and FACT at 6 cycles per degree (c.p.d.; r = 0.64, P < 0.01); between HH and FACT at 3 c.p.d. (r = 0.91, P < 0.01); and between HH and FACT at 1.5 c.p.d. (r = 0.56, P < 0.01). The paired t-test showed a significant difference between HH and PR (t = -6.05, P < 0.01); between HH and FACT at 6 c.p.d. (t = -11.16, P < 0.01); between HH and FACT at 3 c.p.d. (t = -8.35, P < 0.01); and between HH and FACT at 1.5 c.p.d. (t = -5.64, P < 0.01). They had good agreement. The HH had a high repeatability.

CONCLUSIONS

The HH had a positive correlation but produced significantly different readings when compared with FACT and PR. The features and role of HH in clinical contrast sensitivity assessment are discussed.