Remote Contrast Sensitivity Testing Appears to Correlate With Degree of Glaucomatous Macular Damage.

PRECIS: Remote contrast sensitivity testing via a free downloadable home test correlates with glaucomatous macular damage measured by 10-2 visual field testing.

PURPOSE: To assess the feasibility and validity of home contrast sensitivity monitoring as a measure of glaucomatous damage using a free downloadable smart phone application.

METHODS: 26 participants were asked to remotely use the Berkeley Contrast Squares application, a free downloadable tool that records users' contrast sensitivity 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 contrast sensitivity results with a minimum 8 week test-retest window, and test-retest reliability was measured. Results were validated against office-based contrast sensitivity testing that was collected within the previous 6 months. Validity analysis was also carried out to determine if contrast sensitivity as measured by Berkeley Contrast Squares is a good predictor of 10-2 and 24-2 visual field mean deviation.

RESULTS: There was a high Berkeley Contrast Squares test-retest reliability with an intraclass correlation coefficient score of 0.91 and significant correlation between repeat test results and baseline test scores (Pearson 0.86, P<0.0001). There was significant agreement between unilateral contrast sensitivity scores as measured by Berkeley Contrast Squares and office-based contrast sensitivity testing (b=0.94, P<0.0001, 95% CI [0.61 to 1.27]). Unilateral contrast sensitivity as measured by Berkeley Contrast Squares was significantly associated with 10-2 visual field mean deviation (r2=0.27, P= 0.006, 95% CI [3.7 to 20.6]), but not with 24-2 visual field mean deviation (P=0.151).

CONCLUSION: This study suggests that a free, rapid home contrast sensitivity test correlates with glaucomatous macular damage as measured by 10-2 visual field.