Age-related normal limits for spatial vision.

PURPOSE: To establish age-related, normal limits of monocular and binocular spatial vision under photopic and mesopic conditions. METHODS: Photopic and mesopic visual acuity (VA) and contrast thresholds (CTs) were measured with both positive and negative contrast optotypes under binocular and monocular viewing conditions using the Acuity-Plus (AP) test. The experiments were carried out on participants (age range from 10 to 86 years), who met pre-established, normal sight criteria. Mean and ± 2.5σ limits were calculated within each 5-year subgroup. A biologically meaningful model was then fitted to predict mean values and upper and lower threshold limits for VA and CT as a function of age. The best-fit model parameters describe normal aging of spatial vision for each of the 16 experimental conditions investigated. RESULTS: Out of the 382 participants recruited for this study, 285 participants passed the selection criteria for normal aging. Log transforms were applied to ensure approximate normal distributions. Outliers were also removed for each of the 16 stimulus conditions investigated based on the ±2.5σ limit criterion. VA, CTs and the overall variability were found to be age-invariant up to ~50 years in the photopic condition. A lower, age-invariant limit of ~30 years was more appropriate for the mesopic range with a gradual, but accelerating increase in both mean thresholds and intersubject variability above this age. Binocular thresholds were smaller and much less variable when compared to the thresholds measured in either eye. Results with negative contrast optotypes were significantly better than the corresponding results measured with positive contrast (p < 0.004). CONCLUSIONS: This project has established the expected age limits of spatial vision for monocular and binocular viewing under photopic and high mesopic lighting with both positive and negative contrast optotypes using a single test, which can be implemented either in the clinic or in an occupational setting.

Rod Photoreceptors Signal Fast Changes in Daylight Levels Using a Cx36-Independent Retinal Pathway in Mouse.

Temporal contrast detected by rod photoreceptors is channeled into multiple retinal rod pathways that ultimately connect to cone photoreceptor pathways via Cx36 gap junctions or via chemical synapses. However, we do not yet understand how the different rod pathways contribute to the perception of temporal contrast (changes in luminance with time) at mesopic light levels, where both rods and cones actively respond to light. Here, we use a forced-choice, operant behavior assay to investigate rod-driven, temporal contrast sensitivity (TCS) in mice of either sex. Transgenic mice with desensitized cones (GNAT2 cpfl3 line) were used to identify rod contributions to TCS in mesopic lights. We found that at low mesopic lights (400 photons/s/µm2 at the retina), control and GNAT2 cpfl3 mice had similar TCS. Surprisingly, at upper mesopic lights (8000 photons/s/µm2), GNAT2 cpfl3 mice exhibited a relative reduction in TCS to low (<12 Hz) while maintaining normal TCS to high (12-36 Hz) temporal frequencies. The rod-driven responses to high temporal frequencies developed gradually over time (>30 min). Furthermore, the TCS of GNAT2 cpfl3 and GNAT2 cpfl3 ::Cx36-/- mice matched closely, indicating that transmission of high-frequency signals (1) does not require the rod-cone Cx36 gap junctions as has been proposed in the past; and (2) a Cx36-independent rod pathway(s) (e.g., direct rod to OFF cone bipolar cell synapses and/or glycinergic synapses from AII amacrine cells to OFF ganglion cells) is sufficient for fast, mesopic rod-driven vision. These findings extend our understanding of the link between visual circuits and perception in mouse.SIGNIFICANCE STATEMENT The contributions of specific retinal pathways to visual perception are not well understood. We found that the temporal processing properties of rod-driven vision in mice change significantly with light level. In dim lights, rods relay relatively slow temporal variations. However, in daylight conditions, rod pathways exhibit high sensitivity to fast but not to slow temporal variations, whereas cone-driven responses supplement the loss in rod-driven sensitivity to slow temporal variations. Our findings highlight the dynamic interplay of rod- and cone-driven vision as light levels rise from night to daytime levels. Furthermore, the fast, rod-driven signals do not require the rod-to-cone Cx36 gap junctions as proposed in the past, but rather, can be relayed by alternative Cx36-independent rod pathways.

Motion perception at mesopic light levels: effects of physiological ageing and eccentricity.

PURPOSE: To explore the differential effects of age and eccentricity on the perception of motion at photopic and mesopic light levels. METHODS: Thirty-six visually normal participants (18 younger; mean age 25 years, range: 20-31) and (18 older; mean age 70 years, range: 60-79) underwent two testing sessions, one at photopic and one at mesopic light levels. In each session, motion perception was tested binocularly at two eccentricities (centrally, and peripherally at 15° rightwards and 5° superior to the horizontal) for four motion tasks: minimum contrast of a drifting Gabor to identify motion direction (motion contrast); translational global motion coherence; biological motion embedded in noise and the minimum duration of a high-contrast Gabor to determine the direction of motion, using two Gabor sizes to measure spatial surround suppression of motion. RESULTS: There was a significant main effect of light condition (higher thresholds in mesopic) for motion contrast (p < 0.001), translational global motion (p = 0.001) and biological motion (p < 0.001); a significant main effect of age (higher thresholds in older adults) for motion contrast (p < 0.001) and biological motion (p = 0.04) and a significant main effect of eccentricity (higher thresholds peripherally) for motion contrast (p < 0.001) and biological motion (p < 0.001). Additionally, we found a significant three-way interaction between light levels, age and eccentricity for translational global motion (similar increase in mesopic thresholds centrally for both groups, but a much larger deterioration in older adult's peripheral mesopic thresholds, p = 0.02). Finally, we found a two-way interaction between light condition and eccentricity for translational global motion (higher values in central mesopic relative to peripheral photopic, p = 0.001) and for biological motion (higher values in peripheral mesopic relative to central photopic, p < 0.001). CONCLUSIONS: For the majority of tasks assessed, motion perception was reduced in mesopic relative to photopic conditions, to a similar extent in both age groups. However, because some older adults exhibited elevated thresholds even under photopic conditions, particularly in the periphery, the ability to detect mesopic moving stimuli even at high contrast was markedly impaired in some individuals. Our results imply age-related differences in the detection of peripheral moving stimuli at night that might impact hazard avoidance and night driving ability.

Low luminance visual acuity as a clinical measure and clinical trial outcome measure: a scoping review.

PURPOSE: The measurement of standard visual acuity (VA) is the most well-known part of any ophthalmic examination to indicate visual function. Despite this, it is insensitive in detecting early disease changes. Therefore, other visual function tests have been developed including low luminance VA (LLVA) and low luminance deficit (LLD). This scoping literature review aims to summarise the current published applications of LLVA and LLD assessments to evaluate their utility as clinical markers and research outcome measures in a variety of ophthalmic conditions. RECENT FINDINGS: Sixty-five peer-reviewed publications were included. LLVA was pioneered for use in geographic atrophy, a subtype of age-related macular degeneration, which remains the mainstay of its clinical application. However, other studies have reported additional useful applications in inherited retinal diseases including rare maculopathies and rod-cone dystrophies. Although there are some variations in testing methodology, use of the standard Early Treatment Diabetic Retinopathy Study (ETDRS) chart with a 2.0 log unit neutral density filter is the most popular approach. The optimal testing luminance is still to be defined. SUMMARY: Overall, LLVA is an earlier clinical marker of change in central retinal function than standard VA. It has been shown to be a risk factor for disease progression and a better indicator of a patient's level of everyday visual function. It is inexpensive and simple to implement using readily available standard ophthalmic equipment.

Rod Photoresponse Kinetics Limit Temporal Contrast Sensitivity in Mesopic Vision.

The mammalian visual system operates over an extended range of ambient light levels by switching between rod and cone photoreceptors. Rod-driven vision is sluggish, highly sensitive, and operates in dim or scotopic lights, whereas cone-driven vision is brisk, less sensitive, and operates in bright or photopic lights. At intermediate or mesopic lights, vision transitions seamlessly from rod-driven to cone-driven, despite the profound differences in rod and cone response dynamics. The neural mechanisms underlying such a smooth handoff are not understood. Using an operant behavior assay, electrophysiological recordings, and mathematical modeling we examined the neural underpinnings of the mesopic visual transition in mice of either sex. We found that rods, but not cones, drive visual sensitivity to temporal light variations over much of the mesopic range. Surprisingly, speeding up rod photoresponse recovery kinetics in transgenic mice improved visual sensitivity to slow temporal variations, in the range where perceptual sensitivity is governed by Weber's law of sensation. In contrast, physiological processes acting downstream from phototransduction limit sensitivity to high frequencies and temporal resolution. We traced the paradoxical control of visual temporal sensitivity to rod photoresponses themselves. A scenario emerges where perceptual sensitivity is limited by: (1) the kinetics of neural processes acting downstream from phototransduction in scotopic lights, (2) rod response kinetics in mesopic lights, and (3) cone response kinetics as light levels rise into the photopic range.SIGNIFICANCE STATEMENT Our ability to detect flickering lights is constrained by the dynamics of the slowest step in the visual pathway. Cone photoresponse kinetics limit visual temporal sensitivity in bright (photopic) lights, whereas mechanisms in the inner retina limit sensitivity in dim (scotopic) lights. The neural mechanisms underlying the transition between scotopic and photopic vision in mesopic lights, when both rods are cones are active, are unknown. This study provides a missing link in this mechanism by establishing that rod photoresponse kinetics limit temporal sensitivity during the mesopic transition. Surprisingly, this range is where Weber's Law of Sensation governs temporal contrast sensitivity in mouse. Our results will help guide future studies of complex and dynamic interactions between rod-cone signals in the mesopic retina.

The "speed" of acuity in scotopic vs. photopic vision.

PURPOSE: The effect of duration of optotype presentation on visual acuity measures has been extensively studied under photopic conditions. However, systematic data on duration dependence of acuity values under mesopic and scotopic conditions is scarce, despite being highly relevant for many visual tasks including night driving, and for clinical diagnostic applications. The present study aims to address this void. METHODS: We measured Landolt C acuity under photopic (90 cd/m2), mesopic (0.7 cd/m2), and scotopic (0.009 cd/m2) conditions for several optotype presentation durations ranging from 0.1 to 10 s using the Freiburg Acuity and Contrast Test. Two age groups were tested (young, 18-29 years, and older, 61-74 years). RESULTS: As expected, under all luminance conditions, better acuity values were found for longer presentation durations. Photopic acuity in young participants decreased by about 0.25 log units from 0.1 to 10 s; mesopic vision mimicked the photopic visual behavior. Scotopic acuities depended more strongly on presentation duration (difference > 0.78 log units) than photopic values. There was no consistent pattern of correlation between luminance conditions across participants. We found a qualitative similarity between younger and older participants, despite higher variability among the latter and differences in absolute acuity: Photopic acuity difference (0.1 vs. 10 s) for the older participants was 0.19 log units, and scotopic difference was > 0.62 log units. CONCLUSION: Scotopic acuity is more susceptible to changes in stimulus duration than photopic vision, with considerable interindividual variability. The latter may reflect differences in aging and sub-clinical pathophysiological processes and might have consequences for visual performance during nocturnal activities such as driving at night. Acuity testing with briefly presented scotopic stimuli might increase the usefulness of acuity assessment for tracking of the health state of the visual system.

The impact of uncorrected astigmatism on night driving performance.

PURPOSE: To investigate the effect of uncorrected astigmatism on night driving performance on a closed-road circuit. METHODS: Participants included 10 drivers (mean age 24.4 ± 7.0 years), with low to moderate bilateral astigmatism (0.75-1.50 DC), who were regular contact lens (CL) wearers. Vision and night driving performance were assessed in a cross-over design with a toric CL and a best-sphere spherical CL. Binocular visual function measures included photopic and mesopic visual acuity (VA), contrast sensitivity (CS), mesopic motion sensitivity and glare tests (Mesotest® II and Halometer). Night-time driving performance was assessed on a closed-road circuit, which included measures of sign recognition, hazard detection and avoidance, pedestrian recognition distances, lane keeping, speed and overall driving score. RESULTS: Correction of astigmatism with toric CL significantly improved mesopic VA, photopic and mesopic CS, mesopic motion sensitivity, and reduced glare (p < 0.05), compared to the spherical CL; there were no significant effects of visual correction type on photopic VA. Correction of astigmatism using toric CL resulted in significant improvements in night driving performance, compared to driving with spherical CL, particularly for sign recognition, avoidance of low contrast hazards, increased pedestrian recognition distances and overall driving score (p < 0.05). CONCLUSIONS: Correction of low to moderate levels of astigmatism had significant positive effects on night-time driving performance and related tests of visual performance. This has important implications for optical corrections to improve night road safety of drivers with astigmatism.

Marked dissociation of photopic and mesopic contrast sensitivity even in normal observers.

AIM: Although contrast vision is not routinely tested, it is important: for instance, it predicts traffic incidents better than visual acuity. Mesopic contrast sensitivity (CS) testing approximates low-lighting conditions but entails dark adaptation, which can disrupt clinical routine. In receptor-specific diseases, a dissociation of photopic and mesopic sensitivity would be expected, but can photopic CS act as a surrogate measure for mesopic CS, at least for screening purposes? METHODS: Photopic and mesopic contrast sensitivities were studied in three groups: 47 normal subjects, 23 subjects with glaucoma, and three subjects with cataract. Twenty-eight of the normal subjects were additionally tested with artificial blur. Photopic contrast sensitivity was assessed with both the Freiburg Acuity and Contrast Test (FrACT) and the Mars Letter Contrast Sensitivity Charts. Mesopic contrast sensitivity, without and with glare, was measured with the Mesoptometer IIb. Coefficients of repeatability and limits of agreement were calculated for all tests. RESULTS: Test-retest limits of agreement were ± 0.17 logCS for Mars, ± 0.21 logCS for FrACT, and ±0.20 logCS / ± 0.14 logCS for Mesoptometer IIb without and with glare, respectively. In terms of inter-test comparison, Mars and FrACT largely agreed, except for ceiling effects in the Mars test. While mesopic and photopic contrast sensitivities correlate significantly (r  = 0.51, p < 0.01), only 27 % of the variance is in common. In particular, subjects with high photopic results may be nearly as likely to have low as well as high mesopic results. CONCLUSIONS: The photopic contrast sensitivity tests assessed here cannot serve as surrogate measures for current mesopic contrast sensitivity tests. Low photopic CS predicts low mesopic CS, but with normal photopic CS, mesopic CS can be normal or pathologic.

Why hearts flutter: Distorted dim motions.

When a display of red spots or hearts on a blue surround is moved around under dim light, the spots appear to wobble or flutter relative to the surround (the "fluttering hearts" effect). We explain this as follows: Rods and cones both respond to the hearts. Rods are more sluggish than cones, with a latency of ∼50 ms, and they are also much more sensitive to blue than to red (the Purkinje shift; Purkinje, 1825). Thus a red spot oscillating on a blue ground produces a double image: a light spot seen by the cones, followed by a trailing dark spot seen by the rods. These interacting spots of opposite luminance polarity move like "reverse phi" (Anstis, 1970) and this generates the fluttering hearts effect. We find that hearts flutter most markedly at or near mesopic equiluminance, when the red is lighter than the blue as seen by the cones, but darker than the blue as seen by the rods. These same red/blue luminance ratios give rise to two new illusions: the ghostly twin illusion, and the reversal of red/blue grating movement.

Effect of light level on the reference frames of visual motion processing.

It is empirically known that some action-related visual tasks, which may rely on the construction of spatiotopic coordinates, are not well conducted under mesopic vision. The aim of this study was to clarify the effect of light level on the reference frame, such as retinotopic and spatiotopic coordinate bases, associated with visual motion processing. For this purpose, we used a phenomenon called visual motion priming in which the perceived direction of a directionally ambiguous test stimulus is influenced by the moving direction of a priming stimulus. Previous studies have shown that negative and positive motion priming are conspicuously observed in retinotopic and spatiotopic coordinates, respectively. In the experiments, participants made a saccade after the termination of the priming stimulus and judged the perceived direction of the test stimulus presented subsequently in retinotopic or spatiotopic coordinates at different light levels. We found that in retinotopic coordinates, negative motion priming was observed at all light levels. In spatiotopic coordinates, positive motion priming was observed at photopic and scotopic light levels, whereas the strength of motion priming was greatly reduced at mesopic light levels. These results were robust to the change in the luminance contrast or the saccadic eye movement per se. Different spatiotemporal properties of cones and rods at mesopic light levels may disturb the construction of a spatiotopic representation of motion, which leads to the disappearance of visual motion priming in spatiotopic coordinates during mesopic vision.

Visual function correlates of self-reported vision-related nighttime driving difficulties.

PURPOSE: To investigate the visual function correlates of self-reported vision-related night driving difficulties among drivers. METHODS: One hundred and seven drivers (age: 46.06 ± 8.24, visual acuity [VA] of 0.2logMAR or better) were included in the study. A standard vision and night driving questionnaire (VND-Q) was administered. VA and contrast sensitivity were measured under photopic and mesopic conditions. Mesopic VA was remeasured after introducing a peripheral glare source into the participants' field of view to enable computation of disability glare index. Regression analyses were used to assess the associations between VND-Q scores, and visual function measures. RESULTS: The mean VND-Q score was -3.96±1.95 logit (interval scale score: 2.46±1.28). Simple linear regression models for photopic contrast sensitivity, mesopic VA, mesopic contrast sensitivity, and disability index significantly predicted VND-Q score (P<0.05), with mesopic VA and disability glare index accounting for the greatest variation (21 %) in VND-Q scores followed by photopic contrast sensitivity (19 %), and mesopic contrast sensitivity (15 %). A multiple regression model to determine the association between the predictors (photopic contrast sensitivity, mesopic VA, mesopic contrast sensitivity, and disability index) and VND-Q score yielded significant results, F (4, 102) = 8.58, P < 0.001, adj. R2 = 0.2224. Seeing dark-colored cars was the most challenging vision task. CONCLUSION: Changes in mesopic visual acuity, photopic and mesopic contrast sensitivity, as well as disability glare index are associated with and explain night driving-related visual difficulties. It is recommended to incorporate measurement of these visual functions into assessments related to driving performance.

Visual motion priming reveals why motion perception deteriorates during mesopic vision.

We know empirically that the perception of moving objects deteriorates under mesopic vision, in which both rods and cones operate. The purpose of this study was to examine the cause of this degradation. We utilized a phenomenon called visual motion priming, in which the perceived direction of a directionally ambiguous test stimulus is influenced by the moving direction of a preceding stimulus. The spatial distances between the priming and the test stimuli were varied. At mesopic light levels, a stimulus that is presented at the central retina is presumably processed by the cone system, while a stimulus that is presented at the peripheral retina is processed by the rod system (Raphael & MacLeod, 2011). Subjects judged the perceived direction of 180° phase-shifted sine-wave grating that was followed by a smoothly drifting priming stimulus under different retinal illuminances. We found that, under mesopic conditions, the strength of motion priming was greatly reduced when the priming and test stimuli were presented separately at the center and the periphery, respectively. In contrast, motion priming was perceived in most of the trials under photopic and scotopic conditions or when both the priming and test stimuli were presented at the central retina under mesopic conditions. When the priming and test stimuli temporally overlapped, motion priming was conspicuous irrespective of the retinal illuminance. These results suggest that the incompleteness in the integration of signals that was induced by the temporal delay of rod pathways caused the degradation of motion perception under mesopic vision.

Rod-cone signal interference in the retina shapes perception in primates.

Linking the activity of neurons, circuits and synapses to human behavior is a fundamental goal of neuroscience. Meeting this goal is challenging, in part because behavior, particularly perception, often masks the complexity of the underlying neural circuits, and in part because of the significant behavioral differences between primates and animals like mice and flies in which genetic manipulations are relatively common. Here we relate circuit-level processing of rod and cone signals in the non-human primate retina to a known break in the normal seamlessness of human vision - a surprising inability to see high contrast flickering lights under specific conditions. We use electrophysiological recordings and perceptual experiments to identify key mechanisms that shape the retinal integration of rod- and cone-generated retinal signals. We then incorporate these mechanistic insights into a predicti\ve model that accurately captures the cancellation of rod- and cone-mediated responses and can explain the perceptual insensitivity to flicker.

Incongruence in Lighting Impairs Face Identification.

The effect of uniform lighting on face identity processing is little understood, despite its potential influence on our ability to recognize faces. Here, we investigated how changes in uniform lighting level affected face identification performance during face memory tests. Observers were tasked with learning a series of faces, followed by a memory test where observers judged whether the faces presented were studied before or novel. Face stimuli were presented under uniform bright or dim illuminations, and lighting across the face learning and the memory test sessions could be the same ("congruent") or different ("incongruent"). This led to four experimental conditions: (1) Bright/Dim (learning bright faces, testing on dim faces); (2) Bright/Bright; (3) Dim/Bright; and (4) Dim/Dim. Our results revealed that incongruent lighting levels across sessions (Bright/Dim and Dim/Bright) significantly reduced sensitivity (d') to faces and introduced conservative biases compared to congruent lighting levels (Bright/Bright and Dim/Dim). No significant differences in performance were detected between the congruent lighting conditions (Bright/Bright vs. Dim/Dim) and between the incongruent lighting conditions (Bright/Dim vs. Dim/Bright). Thus, incongruent lighting deteriorated performance in face identification. These findings implied that the level of uniform lighting should be considered in an illumination-specific face representation and potential applications such as eyewitness testimony.

Association between central retinal thickness and low luminance visual acuity in early age-related macular degeneration.

PURPOSE/AIM: To examine whether central retinal thickness (CRT) is related to mesopic visual acuity (VA) and low luminance deficit (LLD, difference between photopic and mesopic VA) in eyes with early and intermediate age-related macular degeneration (AMD). MATERIALS AND METHODS: In a cross-sectional study, 50 pseudophakic subjects older than 63 years were divided into three groups (no AMD, early AMD and intermediate AMD). Spectral domain optical coherence tomography (SD-OCT) was used to measure CRT in the 1 mm-central-area. Best-corrected distance VA was measured under photopic or mesopic luminance conditions and LLD calculated. Subjects were stratified by VA impairment to compare CRTs across these groups. Relationships were examined by stepwise multiple linear regression. RESULTS: No significant differences in mean CRT, photopic and mesopic VA or LLD were detected between the groups no AMD, early AMD and intermediate AMD. However, mean CRTs were 20 microns and 18 microns thicker in the eyes with impaired mesopic VA (> 0.3 logMAR) and impaired LLD (⩾ 0.3 logMAR) compared to the eyes with non-impaired VA or LLD respectively (both p < 0.01). CRT and mesopic pupil size were independent predictors of mesopic VA (p = 0.001). CRT emerged as the only independent predictor of LLD (p = 0.004). CONCLUSIONS: Increased CRT was linked to worse retinal function when measured under mesopic conditions in eyes without AMD and eyes with early to intermediate AMD. SD-OCT imaging combined with VA measurements under low luminance conditions could be a useful tool to detect early AMD.

Influences of luminance contrast and ambient lighting on visual context learning and retrieval.

Invariant spatial context can guide attention and facilitate visual search, an effect referred to as "contextual cueing." Most previous studies on contextual cueing were conducted under conditions of photopic vision and high search item to background luminance contrast, leaving open the question whether the learning and/or retrieval of context cues depends on luminance contrast and ambient lighting. Given this, we conducted three experiments (each contains two subexperiments) to compare contextual cueing under different combinations of luminance contrast (high/low) and ambient lighting (photopic/mesopic). With high-contrast displays, we found robust contextual cueing in both photopic and mesopic environments, but the acquired contextual cueing could not be transferred when the display contrast changed from high to low in the photopic environment. By contrast, with low-contrast displays, contextual facilitation manifested only in mesopic vision, and the acquired cues remained effective following a switch to high-contrast displays. This pattern suggests that, with low display contrast, contextual cueing benefited from a more global search mode, aided by the activation of the peripheral rod system in mesopic vision, but was impeded by a more local, fovea-centered search mode in photopic vision.

Rapid Adaptation of Night Vision.

Apart from the well-known loss of color vision and of foveal acuity that characterizes human rod-mediated vision, it has also been thought that night vision is very slow (taking up to 40 min) to adapt to changes in light levels. Even cone-mediated, daylight, vision has been thought to take 2 min to recover from light adaptation. Here, we show that most, though not all adaptation is rapid, taking less than 0.6 s. Thus, monochrome (black-white-gray) images can be presented at mesopic light levels and be visible within a few 10th of a second, even if the overall light level, or level of glare (as with passing headlamps while driving), changes abruptly.

Effect of Varying Levels of Glare on Contrast Sensitivity Measurements of Young Healthy Individuals Under Photopic and Mesopic Vision.

Contrast sensitivity (CS), the ability to detect small spatial changes of luminance, is a fundamental aspect of vision. However, while visual acuity is commonly measured in eye clinics, CS is often not assessed. At issue is that tests of CS are not highly standardized in the field and that, in many cases, optotypes used are not sensitive enough to measure graduations of performance and visual abilities within the normal range. Here, in order to develop more sensitive measures of CS, we examined how CS is affected by different combinations of glare and ambient lighting in young healthy participants. We found that low levels of glare have a relatively small impact on vision under both photopic and mesopic conditions, while higher levels had significantly greater consequences on CS under mesopic conditions. Importantly, we found that the amount of glare induced by a standard built-in system (69 lux) was insufficient to induce CS reduction, but increasing to 125 lux with a custom system did cause a significant reduction and shift of CS in healthy individuals. This research provides important data that can help guide the use of CS measures that yield more sensitivity to characterize visual processing abilities in a variety of populations with ecological validity for non-ideal viewing conditions such as night time driving.

[Measurement of contrast vision: mesopic or photopic vision? : Comparison of different methods for measuring contrast sensitivity within the framework of driving licence regulations]. / Kontrastsehen messen: mesopisch oder photopisch? : Ein Vergleich verschiedener Verfahren zur Messung der Kontrastempfindlichkeit im Rahmen der Fahrerlaubnisverordnung.

BACKGROUND: Since 2011 the regulations for occupational driving licences make the examination of contrast vision sensitivity obligatory; however, apart from mesopic procedures no uniform regulations are available for methods and minimum requirements. OBJECTIVE: By comparing different mesopic and photopic contrast sensitivity tests this study analyzed whether these could be equivalently used and lead to the same results. MATERIAL AND METHODS: Contrast vision sensitivity was determined in 150 subjects with emmetropia using five different methods, i.e. the mesopic test device Mesotest II as the reference method, Rodatest 302 and Optovist as photopic test devices and two photopic test charts (Vistech chart and Mars charts). The results of passing the tests were compared and Cohens κ was determined to quantify the conformity between the tests. RESULTS: Poor agreement was found between Mesotest II and Optovist as well as between Mesotest II and the Vistech chart. There was no agreement between Rodatest 302 or Mars charts and Mesotest II; nevertheless, the contrast vision sensitivity measured with Optovist, Rodatest 302 and the Vistech chart showed good correlation (0.46 ≤ r ≤ 0.69). CONCLUSION: Apart from a few limitations, the reference method Mesotest II as well as Optovist and the Vistech chart are suitable for testing contrast vision sensitivity, whereas Rodatest 302 and Mars charts cannot be recommended based on the current criteria for minimum requirements. The minimum requirements must be urgently adapted and strict regulations for measurement must be formulated. In addition, due to the poor agreement between the methods an amendment of the driving licence regulations should be considered, which requires examination of both mesopic and photopic contrast vision or alternatively mesopic contrast vision alone.

Psychophysical Vision Simulation of Diffractive Bifocal and Trifocal Intraocular Lenses.

PURPOSE: The visual performance of monofocal, bifocal, and trifocal intraocular lenses was evaluated by human individuals using a vision simulator device. This allowed investigation of the visual impression after cataract surgery, without the need actually to implant the lenses. METHODS: The randomized, double-masked, three-way cross-over study was conducted on 60 healthy male and female subjects aged between 18 and 35 years. Visual acuity (Early Treatment Diabetic Retinopathy Study; ETDRS) and contrast sensitivity tests (Pelli-Robson) under different lighting conditions (luminosities from 0.14-55 cd/m2, mesopic to photopic) were performed at different distances. RESULTS: Visual acuity tests showed no difference for corrected distance visual acuity data of bi- and trifocal lens prototypes (P = 0.851), but better results for the trifocal than for the bifocal lenses at distance corrected intermediate (P = 0.021) and distance corrected near visual acuity (P = 0.044). Contrast sensitivity showed no differences between bifocal and trifocal lenses at the distant (P = 0.984) and at the near position (P = 0.925), but better results for the trifocal lens at the intermediate position (P = 0.043). Visual acuity and contrast sensitivity showed a strong dependence on luminosity (P < 0.001). CONCLUSIONS: At all investigated distances and all lighting conditions, the trifocal lens prototype often performed better, but never worse than the bifocal lens prototype. TRANSLATIONAL RELEVANCE: The vision simulator can fill the gap between preclinical lens development and implantation studies by providing information of the perceived vision quality after cataract surgery without implantation. This can reduce implantation risks and promotes the development of new lens concepts due to the cost effective test procedure.