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[Computer method for evaluating disorders in sense of color].

A new method for evaluating disorders in the sense of color has been developed and offered for practice. A total of 340 patients with diseases of the retina and optic nerve and 80 normal subjects were examined. The results indicate that different conditions of examination, selection of combination by the color, brightness, and deepness of the stimulus and background allow detection of decreased sensitivity of one, two, or three color perceptors (disorders in sense of color--color blindness) and permit a quantitative evaluation of functional disorders in the color channels of visual system. The new method can be used in the diagnosis of the initial pathological processes of different origin, involving the cone system at any level of visual route and associated with acquired disorders in color vision.

Color Perception↗

Foveal color and luminance sensitivity losses in glaucoma.

BACKGROUND AND OBJECTIVE: Losses in color vision sensitivity are noted in patients with glaucoma and these losses can occur before the onset of visual field defects in ocular hypertensive patients. The authors incorporate a technique that measures foveal luminance and isoluminant-color thresholds. PATIENTS AND METHODS: This study included 31 patients with glaucoma, 10 patients suspected of having glaucoma, and 67 control subjects. The testing conditions measured thresholds under identical spatial and temporal conditions. Individual differences in luminosity between colors were controlled by presenting 16 different ratios of the three phosphors on a color monitor. RESULTS: Relative to the control subjects, the patients with glaucoma showed a nonselective defect in both color and luminance sensitivity for red-green stimuli (P < .05), but a selective color defect for yellow-blue stimuli (P < .01). There were no statistically significant differences between patients suspected of having glaucoma and control subjects (P > 0.3). CONCLUSION: If the isoluminant-color stimuli are detected by foveal P-ganglion cells, then these results suggest that glaucoma leads to a generalized decrease in P-ganglion cell sensitivity that is more pronounced for cells with an input from cones sensitive to short wavelengths.

Adult↗

Development of the spatio-chromatic visual evoked potential (VEP): a longitudinal study.

Most prior visual evoked potential (VEP) research on the development of color vision has employed pattern-reversing stimuli that are not optimal for producing chromatic responses. We measured infant VEPs using low spatial frequency, onset-offset stimuli, modulated along the three axes of a cone-based color space (Derrington et al. [J. Physiol 1984;357, 241-265.]). Three color-normal infants were tested in a longitudinal design over the first postnatal year. One red/green color-deficient infant was also tested at 197 days. We found that VEP responses to S-axis (tritan) stimuli have their initial onset later than responses to red/green (L-M) or achromatic stimuli, and that developmental changes in VEP waveforms are more complex and longer lasting for chromatic than for achromatic stimuli. Possible mechanisms underlying these changes are discussed.

Adult↗

Ocular safety of Viagra, (sildenafil citrate).

To date, sildenafil citrate (Viagra) gives every evidence of being a safe drug for the eye despite a series of expressed concerns. A review of how its ocular safety profile has been identified offers insights into the strengths and weaknesses of present systems and resources for judging the ocular safety of Viagra or, for that matter, of any new drug. Such insights include: The great value of careful, informed assessment of preclinical information gleaned from laboratory experiments. By and large, such assessments point the way toward appropriate clinical evaluation. For Viagra, early in its development it was noted that besides exerting a major inhibitory effect on the intended target, the vascular-associated enzyme phosphodiesterase 5 (PDE5), the drug also exerts a lesser but definite inhibitory effect on the closely related PDE6, located in the retina. For this reason, preclinical evaluation of the drug included electroretinography plus postmortem histology. In addition, an extended eye examination was incorporated into clinical protocols. The often chaotic but invaluable information stream that becomes available once marketing approval has been gained and large populations begin to use a drug. False alarms, misattribution, and erroneous information are the order of the day. Nevertheless, as information accumulates, patterns of response clarify and the true nature of special susceptibility for subpopulations, if any, becomes apparent. A role for the astute clinician remains: Subtle changes or unusual risks for subpopulations can be missed entirely for long periods of time. A manifest need for improvement in evaluation of postmarketing side-effects. This need has led to the establishment of a new discipline: pharmacoepidemiology. In ophthalmology, the National Registry of Drug Induced Ocular Side-Effects maintains a constant and invaluable surveillance. Examples are supplied to illustrate each of these major points: Our presentation will include data gleaned from clinical trials plus postmarketing information on the incidence, duration, and type of color vision defects observed at different doses of Viagra.

3',5'-Cyclic-GMP Phosphodiesterases↗

[Evaluation of color pattern VECP in deutan].

Using an Equi-Energy-Color Pattern Generator, color vision experiments were performed on nine normal subjects, six cases of deuteranomalies, and six cases of deuteranopias with the use of Visually-evoked cortical potentials (VECPs). Checkerboard patterns, consisting of the pairing of any chosen one of three colors with its complementary color in terms of equal energy, were used. The pairing of a neutral color with its complementary color of protan, deutan and tritan were displayed on a color TV monitor. We measured the amplitude and latency of P100 component of VECPs. Cases of deuteranopia showed significantly smaller amplitude and longer latency of P100 component in protan and deutan responses than did normal subjects. Cases of deuteramomaly showed significantly smaller amplitude and longer latency of P100 component in only protan response compared to those of normal subjects. It was possible to objectively detect the deutan in color pattern VECPs.

Adolescent↗

The Tehran Eye Study: research design and eye examination protocol.

BACKGROUND: Visual impairment has a profound impact on society. The majority of visually impaired people live in developing countries, and since most disorders leading to visual impairment are preventable or curable, their control is a priority in these countries. Considering the complicated epidemiology of visual impairment and the wide variety of factors involved, region specific intervention strategies are required for every community. Therefore, providing appropriate data is one of the first steps in these communities, as it is in Iran. The objectives of this study are to describe the prevalence and causes of visual impairment in the population of Tehran city; the prevalence of refractive errors, lens opacity, ocular hypertension, and color blindness in this population, and also the familial aggregation of refractive errors, lens opacity, ocular hypertension, and color blindness within the study sample. METHODS DESIGN: Through a population-based, cross-sectional study, a total of 5300 Tehran citizens will be selected from 160 clusters using a stratified cluster random sampling strategy. The eligible people will be enumerated through a door-to-door household survey in the selected clusters and will be invited. All participants will be transferred to a clinic for measurements of uncorrected, best corrected and presenting visual acuity; manifest, subjective and cycloplegic refraction; color vision test; Goldmann applanation tonometry; examination of the external eye, anterior segment, media, and fundus; and an interview about demographic characteristics and history of eye diseases, eye trauma, diabetes mellitus, high blood pressure, and ophthalmologic cares. The study design and eye examination protocol are described. CONCLUSION: We expect that findings from the TES will show the status of visual problems and their causes in the community. This study can highlight the people who should be targeted by visual impairment prevention programs.

Blindness↗

A note on the possibility of explaining why a color cannot be both red and green.

To provide a neurophysiological basis for the opponent nature of color vision it has been previously argued that a color cannot be both red and green because color-opponent neurons cannot respond to both red and green at the same time. The present analysis shows that such arguments hinge on the possibility of excluding statements of the kind "a color can be both red and green." For an empirical fact to exclude such statements, these statements would have to be meaningful. However, statements like "a color is both red and green" are not meaningful and are not allowed in our language. Thus, the properties of neurons are not in a position to exclude the possibility of "a color that is both red and green." This means that this attempt to establish a neurophysiological basis for opponent colors is flawed.

Color Perception↗

Advantages and disadvantages of human dichromacy.

We compared the visual detection thresholds for cone-isolating stimuli of trichromats (those with normal color vision) with those of X-linked dichromats, who lack either the long-wavelength-sensitive (L) cones (protanopes) or middle-wavelength-sensitive (M) cones (deuteranopes). At low (1 Hz) temporal frequencies, dichromats have significantly higher (twofold) thresholds for all colored stimuli than trichromats; whereas at high (16 Hz) temporal frequencies, they perform as well or better than trichromats. The advantages of dichromats in detecting high temporally modulated targets can be related to an increased number, through replacement, of the remaining L- or M-cone type. However, their disadvantages in detecting low temporally modulated targets, even in directions of color space where their increased number of cone photoreceptors might be expected to be beneficial, are best explained in terms of the loss of L-M cone opponency and the inability of the visual pathways to reorganize to allow the detection of low-frequency luminance modulation.

Case-Control Studies↗

Acetazolamide affects performance on the Nagel II anomaloscope.

BACKGROUND: Recent reports have indicated that acetazolamide alters human electroretinograms. We wished to determine the effects of administering acetazolamide on performance on the Nagel II anomaloscope. METHODS: We tested 15 subjects matches of blue-green light to a mixture of blue and green lights (luminance match) on a Nagel type II anomaloscope 2.5 h after ingesting 500 mg of acetazolamide or a placebo. RESULTS: The mean of the luminance settings for the subjects was 54.4 for the placebo condition and 58.5 for the acetazolamide condition. The mean difference of 4.1 was statistically significant, indicating that following ingestion of acetazolamide subjects were less sensitive to a blue-green light. In two supplementary experiments we tested (1) a second group of four normal subjects using the Nagel type II anomaloscope and (2) the previously untreated eyes of four patients with primary open-angle glaucoma before and after placing them on acetazolamide therapy. In both groups, more blue-green light was needed to make the match after ingestion of acetazolamide. CONCLUSIONS: Acetazolamide alters the sensitivity of one or more cone populations, probably the carbonic anhydrase-containing cones. The sensitivity loss is reversible and does not appear to be clinically significant. However, the results suggest that patients administered acetazolamide should be excluded from studies which compare the color vision of glaucomatous patients to that of normals.

Acetazolamide↗

Selective loss of S-cones in diabetic retinopathy.

OBJECTIVE: To determine whether selective cone loss could explain the acquired tritan-like color confusion found in diabetic retinopathy. METHODS: Terminal deoxynucleotidyl transferase-mediated biotin-deoxyuridine triphosphate nick end labeling (TUNEL) was employed on paraffin sections of retinas from 5 donors with diabetic retinopathy. For quantitative analysis, postmortem retinas were obtained from 13 human donors; 7 from patients with various durations and stages of diabetic retinopathy (4 background, 3 proliferative) and 6 controls. Enzyme histochemical analysis for carbonic anhydrase (CA) was used to distinguish L/M-cones (positive for CA) from S-cones (negative for CA). Cone topography was determined by sampling 360 degrees from 0.1 to 1.5 mm of foveal eccentricity and along the horizontal meridians from 1.5 to 15.0 mm. RESULTS: Rare cells in both the inner and outer nuclear layers of the diabetic eyes were positively labeled with the TUNEL method. The CA staining revealed incomplete and patchy losses of S-cones that were limited to the diabetic retinas. Statistically significant reduction in the density of S-cones was found at nearly all foveal eccentricities from 0.1 mm to 15.0 mm. This was not the case for the L/M-cones. On average, for all locations, the percentage of S-cones compared with L/M-cones was decreased by 21.0% +/- 3.4% with respect to the controls. CONCLUSION: The S-cones selectively die in diabetic retinopathy. CLINICAL RELEVANCE: Selective loss of S-cones may contribute to the tritan-like color vision deficit seen in patients with diabetic retinopathy.

Adult↗

Familial appraisal of colorblindness in school children of an Indian population.

A total 2000 unrelated school children were screened for colorblindness in Vishakhapatnam, India. Whether the protan and deutan defects are the result of mutations at one locus or at two loci has not been completely resolved, although the evidence favors two discrete loci. The investigation was extended to the families of the 40 color vision anomalous children to study the descendance patterns of these two loci. The importance of these observations are discussed.

Adolescent↗

Sahlgren's saturation test for detecting and grading acquired dyschromatopsia.

A new sorting test requires only two minutes for quantitative estimation of saturation thresholds for bluish pigment colors. The test is highly sensitive to and specific for differences between normal subjects and individuals with acquired color vision defects. When combined with Ishihara's pseudo-isochromatic plates, it discriminates between congenital and acquired dyschromatopsias and identifies subjects with combined defects.

Adolescent↗

Evaluation of visual acuity during laser photoradiation therapy of cancer.

Visual function for ten patients undergoing HPD-PRT was tested using 1) the Graham Field Eye Chart for distance vision, 2) pseudo-isochromatic plates for color vision, and 3) Amsler grid for changes in macular function. Whereas some increases and decreases in ocular function were observed, no clear patterns or changes of significance were observed.

Adult↗

Performance of air traffic control tasks by protanopic color defectives.

Air traffic controllers perform a number of tasks which involve color identification, color discrimination, and color naming. Normal color vision is required for air traffic controllers, although the requirement is currently under review. The most critical task involving color is the distinction of red and black on flight strips; the distinction must be made reliably, quickly, and routinely for flight safety. In this study of four protanopes and three normals, all the protanopes were unable to make this distinction reliably under the lighting levels encountered at air traffic control (ATC) centers, whereas none of the normals had any difficulty. Protanopes also made numerous errors with other ATC tasks involving color. The use of a red filter, often recommended to aid color defectives, actually made performance worse and additionally compounded the usual protanopic loss of brightness for red light. When Snellen visual acuity was tested using the red filters, protanopes needed up to four times larger letters than the color normals. It is concluded that protanopes have inadequate vision for safe performance of some current ATC tasks.

Aviation↗

Adrenoleukodystrophy: a complex chromosomal rearrangement in the Xq28 red/green-color-pigment gene region indicates two possible gene localizations.

We have characterized a complex chromosomal rearrangement in band Xq28, in an adrenoleukodystrophy patient who also has blue-cone monochromacy. A 130-kb region upstream from the color-vision pigment genes was isolated as yeast artificial chromosome or cosmid clones. Another Xq28 sequence, not included in the above region, was obtained by cloning a deletion breakpoint from the patient. Using probes derived from the cloned sequences, we have shown that the rearrangement affects the color-pigment genes and includes two deletions, most likely separated by a large (greater than 110-kb) inversion. One deletion encompasses part of the pigment gene cluster and 33 kb of upstream sequences and accounts for the patient's blue-cone monochromacy. If this rearrangement also caused ALD, the disease gene would be expected to lie within or close to one of the deletions. However, deletions were not detected in a 50-kb region upstream of the red-color-pigment gene in 81 other ALD patients. Two CpG islands were mapped, at 46 and 115 kb upstream from the pigment genes.

Adrenoleukodystrophy↗