Improving the Effectiveness of the Infant Contrast Sensitivity Card Procedure

Drover, James R.; Earle, Avery; Courage, Mary L.; Adams, RD

doi:10.1097/00006324-200201000-00013

Cited by 43 publications

(9 citation statements)

References 42 publications

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“…Others have argued that the immature foveal cones directly cause the high spatial frequency loss28, but we think it more likely that the immature fovea forces infants to use their more mature extrafoveal vision for most visual tasks29. This issue can be examined by comparing the free-fixating infant CSF30 to the CSF of extrafoveally-tested adults31, 32. When the adult CSF is measured at approximately the eccentricity of the grating stimuli relative to the center of the preferential looking apparatus (about 7.5 deg), infant and adult CSFs are similar in shape, and can be more-or-less well superimposed by a vertical shift (relative to a logarithmic Y-axis) of about 0.75 log units (Fig.…”

Section: Infant Photopic Sensitivity To Contrastmentioning

confidence: 99%

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Contrast Insensitivity: The Critical Immaturity in Infant Visual Performance

Brown

Lindsey²

2009

Optometry and Vision Science

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This is a targeted review of the critical immaturities limiting psychophysical luminance contrast detection in human infants. Three-month-old infants are 50 times less sensitive to contrast than adults are. Rod experiments suggest that early-stage immaturities, like the short length of infant rod outer segments, have only a modest direct effect on infant visual performance. Infant contrast sensitivity may resemble adult extrafoveal sensitivity, because the foveal cones of the neonate are immature and may not generate strong enough responses to mediate visual performance. This use of the extrafoveal retina reduces the high-spatial-frequency end of the infant contrast sensitivity function, contributing to poor infant resolution acuity. The remaining difference between infant and adult contrast sensitivity functions may be a simple overall reduction in infant sensitivity. The maximum of the infant contrast sensitivity function increases proportionately with age, and may be numerically near the infant's age in weeks. Contrast discrimination experiments indicate that the critical immaturity that limits infant contrast sensitivity is a mid-level phenomenon, occurring before the site of the contrast gain control. For example, the infant ascending visual pathway might be limited by large amounts of intrinsic noise. These results suggest that there is little effect of inattentiveness to the psychophysical task by ostensibly alert infant patients or subjects. The clinician or researcher can interpret behavioral measurements of infant visual performance with confidence.

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Section: Infant Photopic Sensitivity To Contrastmentioning

confidence: 99%

“…Black diamonds, monocular data30, white diamonds, binocular data30. Black triangles, adult temporal monocular data (eccentricity=7.5 deg)31, white triangles, adult nasal data (eccentricity=10 deg)31.…”

Section: Figuresmentioning

confidence: 99%

Contrast Insensitivity: The Critical Immaturity in Infant Visual Performance

Brown

Lindsey²

2009

Optometry and Vision Science

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“…Behavioral tests developed to assess CS in infants and children are more straightforward to administer in the clinic because the examiner directly assesses the child's "looking" response. Pediatric CS test stimuli include sine-wave gratings (contrast sensitivity card test [CSCT]), [23][24][25][26] a large low frequency square wave grating (OCC), 9 schematic face stimuli (Hiding Heidi 27,28 [HH], www.good-lite.com; Mr. Happy 29 ), and picture outlines (Cardiff Contrast Test 30,31 [CCT], www.eyesfirst.eu).…”

Section: Introductionmentioning

confidence: 99%

A New Contrast Sensitivity Test for Pediatric Patients: Feasibility and Inter-Examiner Reliability in Ocular Disorders and Cerebral Visual Impairment

Mayer

Taylor

Kran

2020

Trans. Vis. Sci. Tech.

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Assess feasibility and interexaminer reliability of a new test of contrast sensitivity (CS) for pediatric populations. Methods: The Double Happy (DH) measures CS using a method similar to the Teller Acuity Cards. The schematic DH face is 16 degrees in diameter with features of 0.3 c/d and a channel frequency of 0.8 c/d. DH log 10 CS is in 0.15 log unit steps, 0.05 to 2.1. Participants were 43 unselected patients, ages 2 to 18 years: 23 were diagnosed with ocular disorders only; 20 were diagnosed with cerebral visual impairment (CVI). Two examiners measured DH log 10 CS. Visual acuity (VA) was also measured. Results: All 43 participants were tested for binocular DH log 10 CS. Cohen's kappa values for interexaminer reliability were fair. The between examiner ICC was +0.92 (P < 0.001). The mean difference between examiners was near zero, and the 95% CI was −0.44 to 0.45 log 10 CS. DH log 10 CS was near normal in the ocular disorder group and reduced in the CVI group. VA was reduced in both groups. DH log 10 CS and VA were correlated (r = −0.65). DH log 10 CS was a marginally better predictor of diagnosis than VA. Conclusions: DH log 10 CS test was successful in a diverse pediatric population diagnosed with ocular disorders or CVI. Interexaminer reliability was comparable to that of adults tested previously using the same stimuli and methods. Both CS and VA are reduced in CVI. Translational Relevance: CS and VA both should be tested in pediatric clinical populations, especially in those at risk of CVI. Recent studies report that functional visual abilities and vision-related quality of life (QoL) are reduced in children with congenital ocular disorders. 6,7 An extensive study of diverse pediatric vision disorders found impaired functional vision and eye-related QoL in children with moderate-severe visual impairment defined by their visual acuity deficit. 8 A study of adolescents with low vision tested with the Ohio Contrast Cards (OCC) found that CS correlated with vision-related QoL, whereas visual acuity did not. 9 This study provides some evidence that CS may be more sensitive than VA to aspects of vision-related QoL.

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“…17–22 Test results were classified as normal if they fell within 95% tolerance limits for age, borderline if they fell outside the 95% tolerance limit but within the 99% tolerance limit, and abnormal if they fell outside of the 99% tolerance limit 18,21,22 …”

Section: Methodsmentioning

confidence: 99%

“…For 12-month-olds and for 4-year-olds 95% tolerance ranges for normal contrast sensitivity 18,21 are shown as the pale gray areas.…”

Section: Figmentioning

confidence: 99%

Preoperative visual acuity and contrast sensitivity in children with small, partial, or non-central cataracts

Birch

Subramanian

Patel

2013

Journal of American Association for Pediatric Ophthalmology and

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Background While there is clear evidence that dense central cataracts >3 mm diameter warrant prompt intervention to prevent deprivation amblyopia, guidelines for management of small, partial and non-central cataracts are not evidence-based. Consensus guidelines advise managing affected infants and preschool children by monitoring for possible progression in size or density and pharmacologic pupillary dilation, if indicated. Extraction is deemed necessary if the cataract progresses sufficiently to obscure the visual axis or if strabismus or nystagmus develops. We evaluated the long-term visual acuity outcome of the consensus guidelines and whether sensory testing during infancy and early childhood may be helpful in guiding treatment. Methods A total of 40 consecutive children diagnosed with small, partial, or non-central cataracts at 1 week to 2.5 years of age were enrolled in a prospective study of forced-choice preferential looking visual acuity and contrast sensitivity development. Long-term visual acuity outcome was assessed by crowded HOTV or ETDRS at 4–11 years. Results Of the 40 children managed by consensus guidelines, 24 (60%) had abnormal visual acuity at 4–11 years of age, including 9 (23%) who had moderate to severe visual impairment (20/80 or worse) in one or both eyes. Abnormal visual acuity and contrast sensitivity during development were predictive of abnormal long-term visual acuity outcomes. Conclusions Visual acuity and contrast sensitivity tests were sensitive to the effects of visual deprivation on the developing visual system and may be useful in early identification of children with small, partial, or non-central cataracts who could benefit from cataract extraction.

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Improving the Effectiveness of the Infant Contrast Sensitivity Card Procedure

Cited by 43 publications

References 42 publications

Contrast Insensitivity: The Critical Immaturity in Infant Visual Performance

Contrast Insensitivity: The Critical Immaturity in Infant Visual Performance

A New Contrast Sensitivity Test for Pediatric Patients: Feasibility and Inter-Examiner Reliability in Ocular Disorders and Cerebral Visual Impairment

Preoperative visual acuity and contrast sensitivity in children with small, partial, or non-central cataracts

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