Visual contrast sensitivity (CS) impairment in patients with post treatment Lyme disease (PTLD) is linked to signs of cognitive and neurologic impairment and may be a marker of illness severity.
Why was this study done?
Post treatment Lyme disease (PTLD) is marked by neurologic symptoms, cognitive impairment, and significant symptom burden, including fatigue and vision complaints. The purpose of this study was to determine whether visual contrast sensitivity (CS) is altered in patients with PTLD compared with healthy controls and, second, whether CS is associated with cognitive and/or neurologic problems.
How was this study done?
213 participants with PTLD were tested and results compared with controls. Visual CS was measured using a Pelli–Robson chart with forced-choice procedures, in which participants had to identify two of the three letters in each triplet to proceed with testing. The total number of letters read was recorded for each eye. CS impairment was defined for age <60 years as logCS of 1.80 (36 letters or fewer) and for those age ≥60 years as logCS of 1.65 (33 letters or fewer). Visual acuity testing was done using the Early Treatment for Diabetic Retinopathy Study charts and protocols. Participants self-administered a questionnaire to assess presence of eye and vision symptoms and also underwent a neurologic exam and battery of neurocognitive tests
What were the major findings?
Data in this study supports statistically significant increased odds of CS impairment in patients with PTLD compared to controls (2.6 times higher odds). Neither cases nor controls had significant distance acuity impairment. CS impairment was not associated with any of the ocular complaints in cases but was associated with neurologic abnormalities and specific cognitive test impairments with borderline statistical significance.
What is the impact of this work?
Visual contrast sensitivity is altered in patients with PTLD. CS impairment is associated with signs of cognitive and neurologic impairment and may be a useful marker of Lyme disease illness severity. Further investigation into the value of testing CS impairment in PTLD cases is warranted, especially if it is an indicator of cognitive or neurologic abnormalities.
Alison W. Rebman, Ting Yang, John N. Aucott, Erica A. Mihm, Sheila K. West; Contrast Sensitivity Loss in Patients With Posttreatment Lyme Disease. Trans. Vis. Sci. Tech. 2021;10(3):27. doi: https://doi.org/10.1167/tvst.10.3.27.
This research was funded by:
The Steven and Alexandra Cohen Foundation.