Comparison of Spaeth/Richman Contrast Sensitivity and Pelli-Robson Tests for Assessing Contrast Sensitivity in Patients with Glaucoma.

Purpose: To determine the optimal cut-offs for Pelli-Robson (PR) and Spaeth/Richman contrast sensitivity (SPARCS) test scores for diagnosing glaucoma and to compare PR and SPARCS scores (total and individual quadrants) for assessing contrast sensitivity in patients with glaucoma. Methods: This study was a single-center, cross-sectional, two-group analysis of 87 glaucomatous eyes and 87 non-glaucomatous control eyes. We assessed visual acuity, refraction, intraocular pressure (IOP), cup disc ratio (CDR), and anterior chamber depth in these patients. The PR score for central contrast sensitivity was obtained, and the SPARCS scores were generated for four outer zones and the central region. Results: The mean IOP [SD] was significantly higher in the glaucoma group (19.3 [5.2] mm Hg) compared with the control group (17.5 [3.6] mm Hg; P = 0.008). The mean CDR [SD] was significantly higher in the glaucoma group compared with the control group (0.73 [0.14] vs. 0.46 [0.12]; P < 0.001). The mean [SD] PR score (1.48 [0.17] vs. 1.23 [0.19]; P < 0.001) and total SPARCS score (78.2 [5.1] vs. 62.4 [11.2]; P < 0.001) were significantly higher in the control group compared with the glaucoma group. The optimal cut-off for identifying glaucoma was 1.35 for the PR score and 70 for the total SPARCS score. At this value of SPARCS score, the sensitivity for identifying glaucoma was 83.9% (95% CI, 74.5 to 90.9), specificity was 96.6% (95% CI, 90.3 to 99.3), positive predictive value (PPV) was 96.1% (95% CI, 88.9 to 99.2), and negative predictive value (NPV) was 85.7% (95% CI, 77.2 to 92.0). The area under the curve (AUC) value was significantly higher for the total SPARCS score compared with the PR score (0.92 vs. 0.83; P = 0.001). All individual SPARCS scores (superior nasal, superior temporal, central, inferior nasal, and inferior temporal) had lower AUC, sensitivity, specificity, PPV, and NPV values compared with the total SPARCS score. Conclusion: At the optimal cut-offs, the total SPARCS score offers significantly better diagnostic test properties for identifying glaucoma compared with the PR score.