Neural contrast sensitivity is not affected by myopic blur

Purpose The prevalence of myopia is increasing worldwide, accompanied by an increase of potentially under-corrected myopes. Because the neural pathways processing the retinal image are prone to adaptation in relation to the retinal image quality, we wondered to what extent neural contrast sensitivity (NCS) is altered in the presence of myopic blur. Additionally, the impact of retinal abnormalities like foveal hypoplasia with albinism on NCS was tested. Methods NCS was psychophysically determined for 11 emmetropic, 23 myopic well-corrected and 15 myopic under-corrected otherwise healthy young (27 ± 6 years) participants and 1 albinism patient. Aberration-free stimulation, independent of the eye’s refractive state, was achieved by using a unique spatial light modulator-based interferometric system to bypass the eye’s optics. Results No significant differences in NCS were observed between the three groups (Median area-under-curve: 61.9, 62.1, and 62.9 for emmetropes, well-corrected, and under-corrected myopes, respectively; all p > 0.1) but were significantly equivalent between emmetropes and myopes (all p < 0.001). However, the NCS function of the albinism patient differed significantly from the here defined “normal” NCS function. Conclusions NCS is unaffected by myopic blur and remains stable even for under-correction of up to 1.5 D. This means, that long-term under-corrected myopes still can achieve normal visual acuity as soon as their refractive errors are sufficiently corrected. Furthermore, NCS testing can relate visual deficits to an underlying neurological disorder.