Remote Contrast Sensitivity Testing Seems to Correlate With the Degree of Glaucomatous Macular Damage

Abstract

Précis: Remote contrast sensitivity (CS) testing through a free downloadable home test correlates with glaucomatous macular damage measured by 10-2 visual field (VF) testing. Purpose: To assess the feasibility and validity of home CS monitoring as a measure of glaucomatous damage using a free downloadable smartphone application. Methods: Twenty-six participants were asked to remotely use the Berkeley Contrast Squares (BCS) application, a free downloadable tool that records the user’s CS for varying degrees of visual acuity. An instructional video detailing how to download and use the application was sent to the participants. Subjects were asked to send logarithmic CS results with a minimum 8-week test-retest window, and test-retest reliability was measured. Results were validated against office-based CS testing that was collected within the previous 6 months. Validity analysis was also carried out to determine whether CS as measured by BCS is a good predictor of 10-2 and 24-2 VF mean deviation (MD). Results: There was a high BCS test-retest reliability with an intraclass correlation coefficient score of 0.91 and a significant correlation between repeat test results and baseline test scores (Pearson, 0.86, P < 0.0001). There was significant agreement between unilateral CS scores as measured by BCS and office-based CS testing (b = 0.94, P < 0.0001, 95% CI: 0.61 to 1.27). Unilateral CS as measured by BCS was significantly associated with 10-2 VF MD (r 2 = 0.27, P = 0.006, 95% CI: 3.7 to 20.6), but not with 24-2 VF MD (P = 0.151). Conclusion: This study suggests that a free, rapid home CS test correlates with glaucomatous macular damage as measured by 10-2 VF.