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Parkinson's disease patients have reduced visual contrast acuity

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Patients with Parkinson's disease (PD) often have difficulties with visual acuity in low-contrast images. Because they may have normal high-contrast vision, this is often overlooked during routine eye exams. In the current issue of the Journal of Parkinson's Disease, researchers report that PD patients had significantly worse vision for low-contrast images at close (40 cm) and far (2 m) distances. Even for high-contrast images, PD patients' vision was deficient at far distances.

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In addition, the degree of low-contrast visual deficiency correlated with PD severity, suggesting that such visual testing may provide insights for the physician in the diagnosis and treatment of PD. To provide an easy-to-use screening tool for physicians, the investigators have developed an iPad®-based application that can replace the traditional paper charts used in normal eye testing.

Thirty-two patients with PD and 71 control subjects were studied. All subjects received a neurological examination, which included the Unified Parkinson's Disease Rating Scale (UPDRS), and vision testing using the Variable Contrast Acuity Chart displayed on an Apple® iPad 2. Usual corrective lenses were worn by subjects that required them.

"Visual impairments can have a significant impact on quality of life and day-to-day functions," explained lead investigator Charles H. Adler, MD, PhD, Department of Neurology, Mayo Clinic College of Medicine, Scottsdale, AZ. "However, impaired contrast sensitivity in PD patients is a topic that has received relatively little attention in clinical practice. The electronic form of low contrast acuity letter chart we used in this study combines contrast sensitivity with visual acuity testing and is quick and easy to administer.  It is portable, quantitative, and adjustable for testing distances and contrast levels.".


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