The Contrast Acuity Assessment (CAA) test was developed to assess the minimum spatial vision requirements for commercial pilots. The goal of the CAA test was for it to be sensitive to retinal image degradation in subjects who had undergone excimer laser refractive surgery. Increased aberrations and scattered light or abnormal processing of visual information in the retina and/or the visual pathway are the main causes of retinal image degradation. The purpose of this study was to further investigate the effect of aberrations, scatter and other parameters on the CAA test under photopic and mesopic conditions. This could help to provide explanations for previous CAA test results. The effect of contrast, stimulus onset time, pupil size and crowding on the CAA test was examined. This was in order to try to provide explanations for the decline in Landolt ring gap acuity over the central 5 degrees, as observed in previous CAA test results, which had shown a foveal dip to occur under photopic and mesopic conditions. Contrast Sensitivity was measured on eight subjects using 6 and 3 mm artificial pupils using the City University Contrast Sensitivity Test. A significant trend of decreasing contrast sensitivity with increased pupil size occurred for the middle and lower spatial frequencies (1.2 and 6.1 cpd), but not for the highest 19.1 cpd spatial frequency. The effects of using high contrast (125%) rather than low contrast (24%) CAA test targets were investigated, in combination with the use of artificial pupils of 6 mm and 3 mm. We concluded that low contrast could play a role in producing a foveal dip under photopic and mesopic conditions. The effect of crowding and stimulus onset time on the CAA Test was examined on 3 subjects, by reducing the contrast of the fixation guides under mesopic and photopic conditions and increasing stimulus onset time. This gave inconclusive results. No significant conclusions were drawn concerning the effect of crowding or stimulus onset time on the CAA foveal dip. The effect of aberrations on normal subjects on the photopic and mesopic CAA test was examined, to determine whether they may have influenced the foveal dip. 14 subjects were tested with natural pupils, under photopic conditions and 10 subjects, were tested under mesopic conditions. A Shack Hartmann aberrometer was used to take wavefront aberration measurements. No significant regressions were found between aberrations and foveal dip. We concluded that aberrations were probably not the cause of the foveal dip. Q value lenses consisting of Q = -2, Q = -1, Q = 0, Q = +1 and Q = +1.5 contact lenses were tested on subjects with natural pupils, to determine whether the CAA test could pick up larger non-physiological changes in aberrations. Large changes in visual performance were observed. Z (4,0) spherical aberration versus central CAA gap acuity was found to produce a significant quadratic regression under mesopic conditions. Seidel coma and Seidel astigmatism were also found to produce significant linear regressions. under photopic conditions. Scatter was measured in 4 subjects, using 6 mm and 3 mm artificial pupils, to determine whether scatter would increase with the larger pupil size. Linear regressions of scatter k’ versus foveal dip gave results which were not statistically significant. Scatter was measured for 3 subjects using the 5 different Q value contact lenses, to see if the Q values affected the scatter. The results were not statistically significant. The differences in scatter produced were found to be far less than the increase of scatter found in two subjects with pathological conditions. We concluded that scatter played an insignificant role in producing the foveal dip or changing visual performance with the use of Q value contact lenses. The project produced a systematic investigation of the parameters affecting the CAA test. A statistically significant association, described by a quadratic regression curve, exists between CAA mesopic gap acuity and Z (4,0) spherical aberration.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:575725 |
| Date | January 2013 |
| Creators | Tsang, Yik Chong |
| Publisher | City University London |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://openaccess.city.ac.uk/2476/ |
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