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Comment & Response
May 14, 2020

Questions on a Study on the Effects of Flavanol-Rich Dark Chocolate on Visual Function and Retinal Perfusion

Author Affiliations
  • 1Rosenberg School of Optometry, University of the Incarnate Word, San Antonio, Texas
  • 2Feik School of Pharmacy, University of the Incarnate Word, San Antonio, Texas
JAMA Ophthalmol. Published online May 14, 2020. doi:10.1001/jamaophthalmol.2020.1487

To the Editor Siedlecki et al1 compared dark (DC) and milk chocolate (MC) consumption on optical coherence tomography angiography (OCT-A), visual acuity (VA), and large-letter contrast sensitivity.1 Their study was based on Rabin et al,2 comparing DC with MC on VA, large-letter CS, and small-letter CS (SLCS). While both studies reported minimal VA and large-letter CS effects, Rabin et al2 reported improved SLCS possibly because of flavanol-associated increased blood flow, suggesting that SLCS can identify visual acuity changes despite normal VA.3 The well-executed Siedlecki et al1 study included double masking, baseline measures, and OCT-A. However, we raise questions and offer comments.

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