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Color vision defects in ocular hypertension and glaucoma. Quantification with a computer-driven color television system.

In order to detect early defects of color vision caused by increased intraocular pressure, a computer graphics device and color monitor system were used to measure color contrast sensitivity. The system determines the threshold chrominance of a colored grating in which there is no change in luminance. The study included 13 control subjects aged 10 to 57 years and 19 patients with ocular hypertension or glaucoma aged 20 to 58 years. In the 13 eyes with visual field loss, color contrast sensitivity was profoundly reduced when the grating colors fell on a tritan color confusion line. In the eyes without visual field loss, tritan color contrast sensitivity was reduced to an average level considerably below the extreme limits of the control group. These results were compared with those of other color vision tests and diagnostic criteria for glaucoma. The findings suggest that among the tests used, color contrast sensitivity testing was able to discriminate most effectively between patients who had retinal damage and the normal population.

Color Perception Tests↗

Reversible color vision loss in occupational exposure to metallic mercury.

Color vision was evaluated in twenty-one mercury exposed workers and referents matched for sex, age, tobacco smoking, and alcohol habits. The Lanthony 15 Hue desaturated panel (D-15 d) was applied. In the workers, mean urinary Hg (HgU) was 115+/-61.5 microg/g creatinine; in all but one the values exceeded the biological limit (BEI) proposed by the American Conference of Governmental Industrial Hygienists. A dose-related subclinical color vision impairment was observed in Hg-exposed workers compared to the referents. Just after the survey, working conditions were improved. Twelve months later the workers were reexamined. Mean HgU was 10.0 microg/g creatinine and in no subjects was the BEI exceeded. Color perception was significantly improved compared to the first examination and, furthermore, no differences were observed between exposed workers and referents. The results add evidence that the color vision loss observed during the first part of the study was related to Hg exposure and, moreover, show that this effect is reversible. These data indicate that metallic Hg can induce a reversible impairment in color perception. This suggests that color vision testing should be included in studies on the early effects of Hg. The possibility of applying the D-15 d as an early effect index in the biological monitoring of Hg exposed workers should also be entertained.

Adult↗

Color vision in albino subjects.

Color vision testing was performed on a group of ten black tyrosinase-positive albino patients and a group of normal subjects. Testing was accomplished by means of a Farnsworth-Munsell (F-M) 100-hue test and Nagel anomaloscope. As a group, the albino patients showed an increase in number of errors scored on the FM-100 hue test, without any specific axis in the majority of cases. Results on the Nagel anomaloscope showed a 'widening' into the red end of the Rayleigh equation. A possible explanation for this apparent widening is discussed, which emphasizes anticipated results of matching ranges obtained on extrafoveal cones.

Adolescent↗

Chronic carbon disulphide poisoning: a 4 year follow-up study of the ophthalmological signs.

Thirty workers of a viscose rayon industry had a complete eye examination in 1979 including visual acuity, perimetry, colour vision testing, fluorescein angiography, ERG and EOG, for possible signs of chronic carbon disulphide poisoning. They were divided into two groups, group A included workers exposed to relatively high CS2 levels (at least 50 mg/m3), group B working in the relatively safe bleaching division. In both groups fundus anomalies and abnormal EOG's en ERG's were found. Twenty-nine of these thirty workers were reexamined in 1983. A number of them were no longer exposed to CS2 for a period varying between 1 and 43 months. The fundus signs (pigmentary changes and vascular lesions) increased in frequency, even if the patient was no longer exposed. The light/dark ratio of the EOG after 4 years was decreased in comparison with the first EOG, although this was not statistically significant. The ERG improved on follow-up. This could be related either to a shift to supranormal amplitudes or to recovery from subnormal amplitudes after the patient was no longer exposed.

Carbon Disulfide↗

Color plates to help identify patients with blue cone monochromatism.

A new color vision test distinguishes patients with X-chromosome-linked blue cone monochromatism from those with autosomal recessive rod monochromatism. The test consists of two instructional and four test plates. Each test plate has three identical blue-green arrows and one purple-blue arrow; test plates differ from one another only with respect to the chroma of the purple-blue arrow. All five patients with blue cone monochromatism, aged 5 to 31 years, easily distinguished the purple-blue arrow on all four test plates, whereas none of the seven patients with rod monochromatism, aged 6 to 60 years, could distinguish the purple-blue arrow on all four plates. If a boy has a reduced visual acuity, normal rod electroretinograms, and 30-Hz cone electroretinograms reduced more than 97% below normal, this test can be used to determine whether his condition is an X-chromosome-linked one or an autosomal recessive one.

Adolescent↗

Autosomal dominantly inherited macular dystrophy with preferential short-wavelength sensitive cone involvement.

We found an apparently inherited tritan-like color vision defect in five members of a family, spanning three generations. The defect was associated with mild macular pigmentary changes, poor foveolar reflexes, or slightly reduced visual acuity in four of the affected individuals. The inheritance pattern appeared to be autosomal dominant. Results of various color vision tests indicated preferential involvement of the short-wavelength sensitive cone system, with relative preservation of the middle- and long-wavelength sensitive cone systems. Both anomaloscope testing with larger (8-degree) fields and short-wavelength sensitive electroretinography indicated some short-wavelength sensitive cone system involvement beyond the central macula in the three affected individuals on whom testing was performed. The condition appeared to be a familial macular dystrophy with preferential short-wavelength sensitive cone involvement. The abnormal macular findings and mild reduction in visual acuity distinguish this condition from congenital tritanopia; the normal optic disks distinguish it from autosomal dominant optic atrophy.

Adolescent↗

A time induced tritan defect.

It is hypothesized that if blue is signalled more slowly than red in the visual system, and if integration time is longer for blue than for red, then a tritan defect should be apparent for normal observers. Data from short-exposure viewing of the City University Colour Vision Test indicate that, at 3.75 msec. a significant tritan error occurs.

Adult↗

Acquired colour deficiency in patients with Parkinson's disease.

The blue cone pathway is reported to be affected early in Parkinson's disease (PD) and acquired type three (tritan) defects may occur. Sixty-one patients attending a treatment and rehabilitation centre for PD were examined with clinical colour vision tests. Seven of 13 patients, for whom the diagnosis of PD was equivocal or who had other medical conditions, were identified as having tritan colour deficiency. Results for the remaining 44 PD patients were compared with 40 age matched controls. Ten PD patients (22.7%) had tritan defects. Tritan defects were not found in the control group but performance on some tests was age related. We conclude that clinical tests for tritan colour deficiency are unlikely to be helpful in identifying PD.

Aged↗

ERGs, cone-isolating VEPs and analytical techniques in children with cone dysfunction syndromes.

Photoreceptor and post-receptoral function in children with congenital and acquired cone disorders was measured by full-field electroretinogram (ERG) and transient visual evoked potentials (VEPs). Subjects were five rod monochromats (RM), five with cone dystrophy (CD), and 30 controls. Patients were diagnosed by clinical findings, ERGs, and standard color vision tests. VEP stimuli were check reversals and color grating onsets that stimulated each photoreceptor type (L-, M-, or S-cones) or post-receptoral pathways (L-M, white/black). VEP signal-to-noise ratios (S/N) were calculated by Fourier analysis of VEP epochs. All RM patients showed extinguished cone ERGs. A near normal S-cone VEP was recorded from a blue-cone rod monochromat without any signal from the L- or M-cone stimuli. Two other RM patients were classified as incomplete RM based on a low-level VEP signal from either L- or M-cone stimuli. CD patients had mildly to severely reduced ERGs and VEPs were abnormal to all cone-isolating stimuli. The VEP S/N ratio was not significantly correlated with the amount of rod contrast in the color stimuli. Color VEPs provide an objective assessment of macular cone function in children with cone dysfunction syndromes that is more sensitive to residual central cone function than standard full-field ERGs. VEP techniques may be useful in the early detection of cone loss in children, especially in children who do not tolerate ERG testing.

Adolescent↗

Colour vision and spectral sensitivity in children with visual handicaps.

In children with a visual handicap, colour vision testing may provide additional cues to diagnosis. Some information is given by pseudo-isochromatic plates. More informative are the arrangement tests, especially the Panel D-15. These tests can be used also in cases with severely reduced visual acuity. In suspected achromatopsia, the scotopic spectral sensitivity can be revealed by the D-15 test, the anomaloscope, or measuring the spectral sensitivity.

Age Factors↗

Comparison of colour discrimination and electroretinography in evaluation of visual pathway dysfunction in aretinopathic IDDM patients.

The slow progression of diabetic retinopathy makes it difficult to assess the effects of intervention therapy. There is thus a need for surrogate markers of visual change in diabetes. Colour vision tests and electroretinography (ERG) may be useful in this regard; yet little is known of their relative performance in the assessment of visual dysfunction in diabetes. The aim of the present study was to compare colour discrimination (100 hue test) and ERG indices (oscillatory potentials (OP) and pattern ERG (PERG)) in the evaluation of aretinopathic IDDM patients. Colour discrimination was abnormal in 10 aretinopathic IDDM patients when compared with nine age matched controls; mean square root 100 hue error scores were 10.38 (SD 2.89) versus 4.77 (1.87) respectively, p < 0.01. OP implicit times of the ERG were also abnormal; for example, for right eye, mean OP1 implicit time for diabetics versus OP1 implicit time for controls was 20.1 (2.0) versus 18.6 (1.4) ms, p = 0.03. Comparison of the two techniques suggested that the 100 hue test was more sensitive and more specific than ERG OP implicit times in the detection of diabetic visual dysfunction in these patients.

Adult↗

Selective color constancy deficits after circumscribed unilateral brain lesions.

The color of an object, when part of a complex scene, is determined not only by its spectral reflectance but also by the colors of all other objects in the scene (von Helmholtz, 1886; Ives, 1912; Land, 1959). By taking global color information into account, the visual system is able to maintain constancy of the color appearance of the object, despite large variations in the light incident on the retina arising from changes in the spectral content of the illuminating light (Hurlbert, 1998; Maloney, 1999). The neural basis of this color constancy is, however, poorly understood. Although there seems to be a prominent role for retinal, cone-specific adaptation mechanisms (von Kries, 1902; Pöppel, 1986; Foster and Nascimento, 1994), the contribution of cortical mechanisms to color constancy is still unclear (Land et al., 1983; D'Zmura and Lennie, 1986). We examined the color perception of 27 patients with defined unilateral lesions mainly located in the parieto-temporo-occipital and fronto-parieto-temporal cortex. With a battery of clinical and specially designed color vision tests we tried to detect and differentiate between possible deficits in central color processing. Our results show that color constancy can be selectively impaired after circumscribed unilateral lesions in parieto-temporal cortex of the left or right hemisphere. Five of 27 patients exhibited significant deficits in a color constancy task, but all of the 5 performed well in color discrimination or higher-level visual tasks, such as the association of colors with familiar objects. These results indicate that the computations underlying color constancy are mediated by specialized cortical circuitry, which is independent of the neural substrate for color discrimination and for assigning colors to objects.

Adaptation, Physiological↗