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PubMedDate not supplied

Critical issues in the use and analysis of the Lanthony Desaturate Color Vision test.

The Lanthony Desaturate Color Vision test (D-15d) has been used to demonstrate the incidence of acquired color vision defects resulting from toxic exposure. The D-15d is a sensitive test designed to grade color deficiencies, but results can be difficult to interpret beyond the qualitative level, and the high incidence of errors reported for controls in some toxicology studies raises questions about how to effectively use this test. This article reviews standard administration of the test, physical determinants of performance, classification of acquired color vision defects, and methods of analysis that have been used to quantify results. The basis for a new method of analysis is discussed, illustrating the source of some characteristic errors, and recommendations are made for test protocols to attempt to more closely identify the type of color vision loss with the goal of identifying the site of toxicological insult.

Color Perception↗
PubMed1993

X-linked adrenoleukodystrophy: adult cerebral variant.

We report a unique case of a 43-year-old architect with adult-onset adrenoleukodystrophy who presented primarily with intellectual decline and no evidence of adrenal insufficiency. Serial MRIs taken over a number of months demonstrated the evolution of demyelination starting in the frontal white matter then shifting to the occipital white matter and finally resolving without any therapeutic intervention. Clinically, over this same period of time, the patient's symptoms resolved and he was able to return to work. The proband, his brother, and his nephew were found to have a color-vision defect. Each of these individuals had a red/green gene array that contained a 5' green-red 3' hybrid known to be associated with deutan color-vision defects. The proband's brother and nephew were otherwise normal. The gene that causes adrenoleukodystrophy appears not to be as close to the red/green color vision gene array on the X chromosome as previously reported.

Adrenoleukodystrophy↗
PubMed1990

Normative data for the standard pseudoisochromatic plates--Part 2.

The Standard Pseudoisochromatic Plates--Part 2 are designed as a screening test for acquired color vision deficiencies. In order to control for age-related changes in color vision, it is necessary to establish norms for this test. Results from this study suggest that, disregarding one figure on the first test plate, one or more blue-yellow errors indicate a blue-yellow color vision defect for patients between 20 and 60 years, whereas two or more blue-yellow errors are indicative of a blue-yellow color vision defect for patients under 20 years and over 60 years. For modified red-green test figures, one or more errors are suggestive of a red-green defect for patients under 60 years, whereas two or more errors indicate red-green vision defect for patients over 60 years. Asking patients to judge which figure is more distinct on each test plate is not useful in comparing responses between patients.

Adolescent↗
PubMed2000

[The clinical application of different brightness and different saturation D-15 tests].

PURPOSE: To compare the clinical application of different brightness and different saturation D-15 tests. METHODS: Eighteen normal subjects (30 eyes), 19 cases (38 eyes) of congenital color vision defects and 36 cases (59 eyes) of eye diseases were tested with Panel D-15 test, Hann's double D-15 test, middle and low saturation CAS-PI (Psychological Institute, Chinese Academy of Sciences) D-15 tests. RESULTS: A few of the normal eyes made minor errors in the low saturation D-15 tests. All of the protanopes and deuteranopes could be detected correctly. Protanomalias and deuteranomalias showed normal arrange or some type of abnormal arranges in all of the 5 sets of D-15 tests. In sick eyes, the abnormal rates were the highest in the low saturation D-15 tests and the lowest in Panel D-15 test. CONCLUSION: The five sets of different brightness and different saturation D-15 tests had similar efficiencies of detecting congenital color vision defects. The abnormal rates of CAS-PI(4/5)D-15 tests and the CAS-PI(2/5)D-15 tests were similar to those of Panel D-15 test and Hann's Double D-15 test. Both tests can be used in the clinical setting.

Adolescent↗
PubMed1981

[Trial and evaluation of a new test to examine color vision (author's transl)].

With the new Rodenstock color test disk it is possible to distinguish with 99% accuracy between deuteranopia and protanopia. In addition, the diagnosis is quantitatively correct (anomaly or anopia) in 92% of deuteranopia and 98% of protanopia cases. A special scheme for evaluation is presented. Special emphasis was placed on describing exactly the function of this new method of examining inherited color vision deficiencies. Only persons who were already known to have defective color vision were tested. Therefore, no conclusions can be drawn regarding the efficiency of detection of color vision deficiencies.

Color Perception Tests↗
PubMed1988

[Evaluation of the central visual field by the Friedmann Mark I analyzer and color vision in 85 patients with multiple sclerosis. Correlation with visual evoked potentials in 50 cases].

Analysis of the visual field using Friedmann's analyser Mark I and color study in 85 multiple sclerosis patients. Static perimetry of the central visual field and test batteries (Ishihara plates, 15 Hue Standard, 15 Hue of Lanthony) for acquired color vision defects were performed in 85 multiple sclerosis patients (61 definite, 12 probable, 12 possible cases). Results in patients were compared to data obtained in 53 control subjects matched for age. 64% of the 85 patients and 52% of 48 patients with no history of optic nevritis showed visual field abnormalities and/or color vision defects. Comparison with VEP was available in 50 patients. While 10 patients had abnormal VEP and normal static perimetry and coloration tests, 5 patients had the reverse findings.

Adolescent↗
PubMed1985

Improved color test results with large-field viewing in dichromats.

Standard methods for screening color vision defects may be expected to underestimate a color defective's complete chromatic discrimination abilities because the viewing field is confined to the fovea (central 2 degrees). Large-field (8 degrees) Farnsworth-Munsell 100-hue and dichotomous (D-15) tests were constructed. The 100-hue test, along with its small-field counterpart, was administered to five deuteranopes (green defectives) and four protanopes (red defectives). The D-15 small- and large-field tests were given to these same subjects with the addition of two deuteranopes and one protanope. Both deuteranopes and protanopes showed marked improvement on the large-field D-15 and 100-hue tests. This improvement in performance for large-field over small-field viewing is consistent with color-matching data, which show large-field trichromacy in observers who have been demonstrated to be small-field red-green dichromats. These results suggest that tests confined to central fovea viewing provide an incomplete functional description of the color vision of an appreciable number of classic dichromats.

Color Perception↗
PubMed1991

[The Nagel anomaloscope in the diagnosis of eye diseases].

The Nagel anomaloscope can be incorporated in the diagnosis of eye diseases. Three parameters are relevant: 1. The measure of the absolute matching range (scale units) 2. The preferred direction of the widened matching range (to red or to green) 3. The luminance matches with the yellow (decreasing matches indicating a pathologic scotopisation). - Six pathologic anomaloscope findings can be differentiated: 1. Pseudoprotanomaly (retinal diseases; type III acquired blue-yellow defects) 2. Symmetrically widened absolute matching range (reduced hue discrimination without reference to its etiopathology) 3. Absolute matching range asymmetrically widened to red with scotopisation (retinal diseases; type III acquired blue-yellow defects or type I acquired red-green defects) or without scotopisation (retinal diseases or optic nerve diseases; type III acquired blue-yellow defects) 4. Absolute matching range asymmetrically widened to green (mostly optic nerve diseases; type II acquired red-green defects) 5. Acceptance of both end matches ("0" up to "73") with scotopisation (retinal diseases) or without scotopisation (optic nerve diseases) 6. Achromatic matches (selective cone diseases, such as Stargardt's dystrophy or progressive cone dystrophy). Indications for anomaloscope examinations and clinical application of the method are discussed in ten cases. The utility of the Rayleigh-equation consists in diagnosing pathologic scotopisation (differential diagnosis between retinal diseases and optic nerve diseases) and in making a quantitative evaluation of the acquired color vision defect (follow-up examination).

Color Perception Tests↗
PubMed2005

Color vision and contrast sensitivity in epilepsy patients treated with initial tiagabine monotherapy.

The purpose of the study was to determine whether the use of a GABAergic antiepileptic drug (AED), tiagabine, affects color vision and contrast sensitivity. Twenty newly diagnosed patients with partial epilepsy (aged 19-72 years), receiving tiagabine as their initial monotherapy for 5-41 months were examined. Color vision was examined with the Standard Pseudoisochromatic Plates 2 (SPP2), with the Farnsworth-Munsell 100 Hue Test (FM100) and with the Color Vision Meter 712 (CVM) anomaloscope. Contrast sensitivity was measured with the Pelli-Robson letter chart. Three patients excluded from the color vision evaluation for congenital red-green color vision defects. Seven out of 17 patients (41%) had acquired color vision deficit examined with the FM100. The CVM anomaloscope revealed minor defects in two patients. Contrast sensitivity function was within normal ranges. The present study suggests that AED therapy with tiagabine, like with other established and newer AEDs may interfere with color perception.

Adult↗
PubMed1998

[Individual variations in color vision and its molecular biology].

Individual variations in normal color vision and congenital red-green color vision defects in Japanese males were investigated using both psychophysics and molecular biology techniques. 1. Normal color vision. We studied 72 Japanese males who were diagnosed as having normal color vision using the Ishihara plates test and Nagel model I anomaloscope. The structure of the gene arrays of the X-linked L- and M-pigment genes was determined using quantitative PCR-SSCP (polymerase chain reaction-single strand conformation polymorphism). We found the following variations of the number of M-pigment genes: 27 (38%) of these men had only one M-pigment gene, 29 (40%) had two, 13 (18%) had three and 3 (4%) had four. Two common polymorphisms were found at amino acid residue 180 of both L- and M-opsin, of the total 56 (78%) were Ser and the other 16 (23%) were Ala in the L-pigment and of the total 65 (90%) were Ala and the other 7 (10%) were Ser in the M-pigment. The Rayleigh match midpoints fell within the normal range, however there were two fairly distinct groups with consistent differences in each group. The mean values of the proportion of red in a mixture of red and green were 0.564 +/- 0.026 (mean +/- standard deviation). Correlation was found only between the Rayleigh match midpoint and the polymorphism at residue 180 of L-pigment. In order to estimate the variations of L/M cone ratio in the retinae the spectral sensitivities using heterochromatic flicker method were measured. Using the hypothesis that the luminosity function is proportional to the sum of L- and M-cone spectral sensitivity (k L (lambda) + M (lambda)), the constant k values were obtained. The k values for the subjects with Ser180 and Ala180 L-pigment were 1.89 +/- 1.44 and 1.85 +/- 1.02 respectively. Furthermore, in order to study the variation of information processing system, the spectral sensitivities for 1 degree, 200-ms test flash on a white background were measured. Using the hypothesis that the spectral sensitivity is proportional to the difference of L- and M-cone spectral sensitivity (L (lambda) - k' M (lambda)), the k' values were obtained. The k' values for the subjects with Ser180 and Ala180 L-pigment were 1.38 +/- 0.06 and 1.49 +/- 0.07 respectively. As a result, it was suggested that there are individual variations in both the L/M cone ratio and the color opponent system. 2. Congenital red-green color vision deficiencies. We studied the structure of the gene arrays of the X-linked L- and M-pigment genes and investigated the relationship between genotype and phenotype in 21 Japanese males comprising 4 protanopia, 6 protanomaly, 7 deuteranopia and 4 deuteranomaly. All of the protan subjects had 5' L-M fusion gene with/without the M gene. All of the deutan subjects had a normal L gene with/without 5' M-L fusion gene. Genotype agreed with phenotype in 8 of 10 protan subjects and 10 of 11 deutan subjects. Two of them were diagnosed as abnormal trichromatism in spite of having only one gene. One of them was diagnosed as dichromatism in spite of having two genes that encoded spectrally different pigments. As a result, it was felt that the diagnosis of dichromacy and abnormal trichromacy with an anomaloscope has limitations.

Asian People↗
PubMed1995

Centrally tinted contact lenses. A useful visual aid for patients with achromatopsia.

Achromatopsia (rod monochromacy) is a congenital color-vision defect of autosomal recessive inheritance due to severely abnormal or totally absent cone function. The disease is characterized by markedly reduced visual acuity, nystagmus, and, often, ametropia. Even under normal daylight conditions, these patients are extremely handicapped by glare because of a lack of rod inhibition by the abnormal or deficient cones. Light-absorbing glasses (absorption > 90%) can ameliorate this visual impairment to a certain extent but are sometimes not accepted by the patient since they are felt to disfigure the face. Especially during the first few years of school, this can lead to psychological problems. A special contact lens (Hydroflex, Wöhlk Company, Kiel) with a centrally tinted area (absorption 80%) that is slightly greater in diameter than the pupil under daylight conditions can correct ametropia and reduce light exposure and dazzle in a cosmetically much better way. Our first experience with this kind of visual aid in a 9-year-old girl suffering from incomplete achromatopsia is presented.

Child↗
PubMedDate not supplied

Color vision screening of young children.

Early detection of congenital color vision defects is desirable, but school screening studies have been stymied by lack of a suitable test. We evaluated a new color vision test, the APT-5, for use by volunteer screeners in schools and preschools. The screeners tested 1794 children, ages 3 to 13 years, and found the APT-5 easy to use with young children ages 5 years and up. Children who failed the screening were recruited for diagnostic color vision testing; for the children ages 5 to 13 years, 56% of those who failed the screening were successfully recruited. Data analysis indicated that the false-positive rate in this age group was 1% to 2%, and that for boys in this age group the positive predictive value was 71% to 81%. Retest data indicated that most false-positives were not due to the test itself, but to other factors in the school screening situation. Two thirds of all children scored as abnormal by anomaloscopy were simple deuteranomalous, indicating that the APT-5 effectively identified even mild color defects. The results of this trial indicate that the APT-5 is suitable for school color vision screening of children ages 5 years and up.

Adolescent↗
PubMedDate not supplied

[The examination of color vision using a 2 metameric equation method].

Modern anomaloscopes with four independent light channels (i.e. Besançon-Anomalometer which was presented in 1979 at the SFO Congress) allow accurate examinations of color vision. In our routine clinical examination, we use two metameric equations: the red-green Rayleigh equation and the blue-green Moreland equation. This so called Two-Equation-Method enables the diagnosis of congenital and acquired color vision defects in a precise qualitative as well as quantitative way. For both equations the goal of the examination is to measure the absolute matching range. Abnormal color vision is diagnosed if the absolute matching range is shifted and/or enlarged in one or both of the two metameric equations. In congenital colour vision deficiencies, the results are similar to those obtained with the Nagel anomaloscop. The different types of acquired defects are compared with the types of Verriest's classification. A computer controlled clinical examination of color vision, which will make the procedure simplier and shorter for the patient is actually being developed.

Color Perception↗
PubMed1978

Autosomal recessive incomplete achromatopsia with protan luminosity function.

A unique form of dichromatic color vision is described in a family with incomplete achromatopsia. In 1966, incomplete achromatopsia was diagnosed in 4 of 14 children of a consanguineous marriage. The 4 affected had best visual acuities of 6/60 or 6/180, pendular nystagmus, and aversion to bright lights. The ERG showed minimal photopic responses. No abnormality of rod function was present. There was a severe color vision defect. In 1976, one of the patients returned for further color testing. Color tests included measurement of the luminous efficiency function using heterochromatic flicker photometry and colorimetric evaluation. The luminous efficiency function resembled that of the protanope. From the colorimetric measurements, we conclude that the patient has a unique form of dichromatic color vision mediated by two visual photopigments: the normal MWS cone photopigment and a photopigment with the spectral characteristics of rhodopsin.

Adolescent↗
PubMedDate not supplied

Variety of genotypes in males diagnosed as dichromatic on a conventional clinical anomaloscope.

The hypothesis that dichromatic behavior on a clinical anomaloscope can be explained by the complement and arrangement of the long- (L) and middle-wavelength (M) pigment genes was tested. It was predicted that dichromacy is associated with an X-chromosome pigment gene array capable of producing only a single functional pigment type. The simplest case of this is when deletion has left only a single X-chromosome pigment gene. The production of a single L or M pigment type can also result from rearrangements in which multiple genes remain. Often, only the two genes at the 5' end of the array are expressed; thus, dichromacy is also predicted to occur if one of these is defective or encodes a defective pigment, or if both of them encode pigments with identical spectral sensitivities. Subjects were 128 males who accepted the full range of admixtures of the two primary lights as matching the comparison light on a Neitz or Nagel anomaloscope. Strikingly, examination of the L and M pigment genes revealed a potential cause for a color-vision defect in all 128 dichromats. This indicates that the major component of color-vision deficiency could be attributed to alterations of the pigment genes or their regulatory regions in all cases, and the variety of gene arrangements associated with dichromacy is cataloged here. However, a fraction of the dichromats (17 out of 128; 13%) had genes predicted to encode pigments that would result in two populations of cones with different spectral sensitivities. Nine of the 17 were predicted to have two pigments with slightly different spectral peaks (usually < or = 2.5 nm) and eight had genes which specified pigments identical in peak absorption, but different in amino acid positions previously associated with optical density differences. In other subjects, reported previously, the same small spectral differences were associated with anomalous trichromacy rather than dichromacy. It appears that when the spectral difference specified by the genes is very small, the amount of residual red-green color vision measured varies; some individuals test as dichromats, others test as anomalous trichromats. The discrepancy is probably partly attributable to testing method differences and partly to a difference in performance not perception, but it seems there must also be cases in which other factors, for example, cone ratio, contribute to a person's ability to extract a color signal from a small spectral difference.

Amino Acid Sequence↗
PubMed1986

Eye disease and color defects.

The groundwork for understanding color defects in eye disease was established by the end of the nineteenth century. Thereafter the field was neglected as scientists concentrated on studies of normal color vision and congenital color vision defects. Spurred by the development of the Farnsworth 100 hue-test, interest was renewed in the 1950s. The past 25 years have seen an explosion of interest in color defects in eye disease. The International Research Group on Color Vision Deficiencies has played an important role in this activity. The development of new clinical tests and instruments as well as refinement of laboratory techniques are among the important developments.

Color Perception Tests↗
PubMed2002

Color vision in 42 Congolese patients with tuberculosis receiving ethambutol treatment.

PURPOSE: To study color vision in Congolese patients with tuberculosis receiving ethambutol therapy. METHODS: A prospective, descriptive study of color vision test in patients with systemic tuberculosis receiving ethambutol was performed between April 1995 and January 1998 at the Department of Ophthalmology, University of Kinshasa. Color vision tests were assessed with pseudoisochromatic plates (the Ishihara Pseudo-isochromatic Plates), the AO-HRR (American Optical Handy Rand Rittler), the Bölle and Kastel anomaloscope, Farnsworth-Munsell test (the D-15 and the FM-100). RESULTS: There were 42 patients with a mean age of 33 years (range, 14 to 75 years). The color vision of all the patients was found to be normal as measured by the Ishihara pseudoisochromatic plates. One (2%) patient showed color vision defect (anarchic axis] with the OA-HRR test. Three (7%) of 42 patients displayed blue-yellow color axis or anarchic axis color vision test on the D-15 test. Fifteen (36%) of 42 patients had high total error scores at the Farnsworth-Munsell 100 test. The color axis was as follows: anarchic axis (13.1%), red-green-color and blue-yellow-color combined axis (13.1%), blue-yellow color axis (7.5%). Results of the Bölle and Kastel anomaloscope were normal in all patients. CONCLUSION: Our results confirm the importance of color vision examinations in the detection of the complications of ethambutol treatment.

Adolescent↗
PubMed1992

Color vision and dentistry.

Color vision is a critical component of restorative and esthetic dentistry, but dentists, as a group, do not have their color vision tested at any time during their careers. A study was undertaken to ascertain the color-vision status of practicing dental personnel at the University of Tennessee, College of Dentistry. One hundred fifty individuals, 75 men and 75 women, were screened. The results corroborated the existing medical data for the general population. It was found that 9.3% of the men and none of the women exhibited color-vision defect. Since most dentists are male, this study demonstrates an area of potential weakness for some practitioners. Once a color-vision problem is found, it is simple to remedy by employing a team approach to shade matching or mechanical means of matching shades (by the practitioner). No ethnic or racial distinctions were detected, although these have been reported in other studies.

Adult↗