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1From the School of Psychology, University of Western Australia, Crawley, Western Australia, Australia; and the 2Lions Eye Institute, University of Western Australia, Perth, Western Australia, Australia.
PURPOSE. It is well established that contrast sensitivity is reduced in glaucoma. This study explored whether such contrast processing abnormalities consist of an absolute threshold level difference or a problem with contrast gain control.
METHODS. Seventeen patients with primary open-angle glaucoma and 17 approximately age-matched control subjects participated. Subjects were tested foveally and midperipherally (12.5°). Subjects with glaucoma were tested in a peripheral region of relatively normal visual field (neighboring locations required to be within the normal 95% confidence limit on the total deviation plot of their most recent SITA/full threshold Humphrey Field Analyzer assessment; Carl Zeiss Meditec, Dublin, CA). Control subjects were tested in matching locations. Contrast discrimination was assessed using the steady-pedestal (magnocellular [M] pathway) and pulsed-pedestal (parvocellular [P] pathway) stimuli of Pokorny and Smith for seven pedestal luminances between 15 and 75 cd/m2, presented on a background of 30 cd/m2.
RESULTS. Glaucoma group thresholds were significantly elevated compared with control subjects foveally and peripherally on both the pulsed-pedestal (P) and steady-pedestal (M) tasks (P < 0.01). Effect size statistics revealed slightly greater deficits on the P pathway task and greater deficits for pedestals that were decrements, rather than increments, from the surround luminance. Foveal deficits were of a magnitude to be explained by a reduction in contrast sensitivity; however, the peripheral deficits were greater than predicted by this factor alone.
CONCLUSIONS. Foveal and midperipheral dysfunction of both M and P pathways was identified in people with glaucoma, in areas of relatively normal visual field performance. These findings are supportive of nonselective neural adaptation abnormalities in early glaucoma.
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