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Intermediate spatial frequency letter contrast sensitivity: its relation to visual resolution before and during amblyopia treatment

We examined the loss of letter contrast sensitivity (LCS) measured using the Pelli‐Robson chart, and the extent to which any such loss was modulated by spectacle wear and occlusion therapy in children participating in an amblyopia treatment trial. Their initial mean interocular difference in logMAR acuity was approximately three times that of their LCS (0.45 vs 0.14 log units). Log LCS was weakly though significantly correlated with logMAR visual acuity (VA) for all VAs better than 0.90 (r = −0.19, 95% CI: −0.28 to −0.10) whereas for all VAs of 0.90 or poorer, log LCS was markedly and significantly correlated with VA (r = −0.72, 95% CI: −0.83 to −0.53). LCS in those children with a ≥0.1 log unit interocular difference on this test improved commensurately with VA during treatment. We conjecture that the spatial visual loss in all but the most severe amblyopes occurs in an area of resolution and contrast space that lies beyond that sampled by the Pelli‐Robson chart.