The relationship between perifoveal achromatic, L- and M-cone acuity and retinal structure as assessed with multimodal high resolution imaging

•Cone density correlates with L-cone logMAR at 5deg eccentricity.•L-cone acuity is a useful indicator of the perifoveal structure-function relationship.•Cone density cannot be characterized by a scalar factor across eccentricity. The relationships between perifoveal measures of achromatic-, L- and M-cone acuity and retinal structure were investigated in healthy young males. Thirty-two males, aged 20–39years, with normal foveal logMAR letter acuity and no observed ocular abnormalities participated in the study. Achromatic and isolated L- and M-cone spatial acuity was measured in the dominant eye with a Sloan E letter of 90% achromatic decrement contrast or 23% increment cone contrast, respectively. Separately, the central part of the same eye was imaged with high-resolution spectral-domain optical coherence tomography (SD-OCT) and adaptive optics ophthalmoscopy (AOO). Thickness measures and cone density in the fovea and parafoveal region were not correlated with perifoveal structural measures. A significant correlation was observed between thicker retinal pigment epithelium (RPE) complex, higher cone density and better L-cone logMAR at 5deg eccentricity, but not for achromatic or M-cone logMAR. The results imply that single letter perifoveal L-cone acuity, rather than achromatic acuity, may provide a useful measure for assessing the structure-function relationship and detecting early changes in the perifoveal cone mosaic.