Variability of Rayleigh and Moreland test results using anomaloscope in young adults without color vision disorders.

AIM: To validate the reference ranges proposed by the manufacturer of the Oculus HMC Anomaloscope MR for Rayleigh and Moreland tests in healthy young adults. METHOD: The manual Rayleigh (red-green) and the Moreland (blue-green) anomaloscope tests were performed on 90 healthy subjects (54 female, 36 male, 178 eyes) residing in Poland, aged between 18-45 years, and without color vision disorders (assessed with HRR test). The analyzed parameters for both the Rayleigh and the Moreland tests were as follows: the lower (R1/M1) and the upper (R2/M2) limits; the center (RC/MC) and the width (RW/MW) of the matching ranges. RESULTS: The results of the Rayleigh test were similar to the values proposed in the anomaloscope user's manual, however, with a small shift of RC and R2 towards the red color. The double-peak distribution of R2 with a small second peak (approximately at R2 = 52) was mainly due to the measurements in male subjects (nmale = 8, nfemale = 2), which suggests that this group might be diagnosed with subtle protanomaly. The results of the Moreland test showed a high MW which did not correspond to the reference range described in the anomaloscope user's manual. The observed significant correlations between R1 and M1 suggest that the M1 parameter seems to be the best indicator of blue vision quality. CONCLUSIONS: Oculus HMC Anomaloscope MR is a sensitive tool for detection of prot-deuteranomalies but the reference ranges for young adults require a certain adjustment towards the red color. The parameters obtained for the Moreland test varied significantly between the subjects and therefore the test should not be used as is to diagnose color vision deficits in the green-blue area (tritanomaly).

Predicting the CN Lantern Test for Railways with Clinical Color-vision Tests.

SIGNIFICANCE: This research will help clinicians in advising their color-vision-defective patients regarding their career options. PURPOSE: In Canadian railways, individuals with a color-vision-defect (CVD) may qualify for positions at shorter sighting distance from signal lights. The railway companies' medical units use the CN Lantern (CNLan) test, and there is little information available as to whether clinical color-vision tests (CCVTs) can predict the CNLan results. This study determines the ability of some CCVTs to predict the CNLan performance to assist clinicians in advising their CVD patients regarding career options. METHODS: The CNLan viewing distance was varied between 4.6 and 0.57 m using a geometric progression. The CCVTs were the Hardy, Rand, and Rittler; Ishihara; ColorDx pseudoisochromatic plate (PIP); the Rabin Cone Contrast Test; Color Assessment and Diagnosis; Cambridge Color Vision Test; U.S. Air Force Operational Based Vision Assessment Cone Contrast Test; Farnsworth Munsell D15; and ColorDx D15. Fifty-six normal-color-vision and 63 CVD subjects participated in this study. RESULTS: Failure of either the Farnsworth Munsell D15 or ColorDx D15 essentially guarantees failure on the CNLan at the 4.6-m distance. The agreement values decreased as the viewing distance decreased. CONCLUSIONS: To counsel patients regarding a career as a locomotive engineer, clinicians should have either the Hardy, Rand, and Rittler or ColorDx PIP and a D15 test. For patients applying for a position in the yard, a mild-to-moderate classification CVD on HRR or ColorDx PIP indicates a high probability of passing CNLan.

The effect of the ChromaGen contact lens system on visual performance.

BACKGROUND: To evaluate the effects of the ChromaGen contact lens (CCL) on best-corrected visual acuity, contrast sensitivity and pseudoisochromatic test plate performance in patients with congenital colour vision deficiency (CVD). METHODS: CCLs were inserted into 50 eyes of 25 patients with congenital red-green CVD. The patients were tested with the Ishihara and Hardy-Rand-Rittler test plates before and after the insertion of Magenta 2, Magenta 3, and Violet 3 CCLs. The patients' mean numbers of recognised symbols were calculated and the most appropriate CCL was determined for each eye. The best-corrected visual acuity for both far and near vision and contrast sensitivity were evaluated before and after the insertion of the appropriate CCLs, and the results were compared. RESULTS: The mean age of the patients was 26.56 ± 10.30 years. While all CCLs increased the mean numbers of recognised symbols on the Ishihara (p < 0.001 for all), Magenta 3 was observed to be the most useful CCL. On the other hand, while all CCLs increased the mean numbers of recognised symbols on Hardy-Rand-Rittler (p < 0.001 for all), Magenta 2 and Magenta 3 were detected as the most useful CCLs. After insertion of the most appropriate CCL for each eye, the mean best-corrected visual acuity for both far and near vision were decreased (p < 0.001 for both). Statistically significant alterations were also detected at some spatial frequencies of contrast sensitivity measurements. CONCLUSION: CCLs decrease the far and near best-corrected visual acuity, and static and dynamic contrast sensitivity at some spatial frequencies, and invalidate the pass criteria of pseudoisochromatic test plates by increasing the number of recognised symbols.

New iPAD-based test for the detection of color vision deficiencies.

PURPOSE: To develop and validate a new iPad-based color vision test (Optopad). METHODS: A total of 341 student eyes were enrolled in a first comparative study between Optopad and the Isihara tests. In a second comparative study, Optopad vs. the Farnworth-Munsell test (FM 100H), a total of 66 adult eyes were included. Besides the agreement between tests, the correlation between FM 100H and Optopad outcomes were investigated. Multiple regression analysis was used to predict the total error score (TES) from contrast thresholds measured with the Optopad test. RESULTS: The Ishihara and Optopad tests detected the same anomalous patients. Concerning FM 100H vs. Optopad, 10 subjects were diagnosed as anomalous with both tests, 3 mild anomalous cases based on TES were classified as normal with Optopad, and 2 anomalous subjects based on Optopad test showed normal TES values. Statistically significant correlations of TES and partial error red-green (PTESRG) with thresholds measured with the red-green Optopad stimuli were found. A multiple quadratic regression model was obtained relating TES and chromatic contrast values from Optopad (R2 = 0.855), with only 13 cases showing residuals of ≥ 25 units. CONCLUSIONS: The design and implementation of a chromatic contrast discrimination test has been carried out, with promising clinical results. This test seems to provide comparable outcomes to those obtained with Ishihara and FM 100H tests.

Validity and Acceptance of Color Vision Testing on Smartphones.

BACKGROUND: Ishihara color plates (ICP) are the most commonly used color vision test (CVT) worldwide. With the advent of new technologies, attempts have been made to streamline the process of CVT. As hardware and software evolve, smartphone-based testing modalities may aid ophthalmologists in performing more efficient ophthalmic examinations. We assess the validity of smartphone color vision testing (CVT) by comparing results using the Eye Handbook (EHB) CVT application with standard Ishihara color plates (ICP). METHODS: Prospective case-control study of subjects 18 years and older with visual acuity of 20/100 or better at 14 inches. The study group included patients with any ocular pathology. The color vision deficient (CVD) group was patients who failed more than 2 plates. The control group had no known ocular pathology. CVT was performed with both ICP and EHB under standardized background illuminance. Eleven plates were tested with each modality. Validity of EHB CVT and acceptance of EHB CVT were analyzed. Statistical analyses were performed using Bland-Altman plot with limits of agreement (LOA) at the 95th percentile of differences in score, independent samples t tests with 95% confidence interval (CI), and Pearson χ tests. RESULTS: The Bland-Altman plot showed agreement between correct number of plates in EHB and ICP for the study subjects (bias, -0.25; LOA, -1.92 to 1.42). Agreement was also observed between the correct number of plates in EHB and ICP for the controls (bias, -0.01; LOA, -0.61 to 0.59) and CVD (bias, -0.50; LOA, -4.64 to 3.64) subjects. The sensitivity of EHB was 0.92 (95% CI 0.76-1.07) and the specificity of EHB was 1.00 (95% CI 1.00-1.00). Fifty-nine percent preferred EHB, 12% preferred ICP, and 29% had no preference. CONCLUSIONS: In healthy controls and patients with ocular pathology, there was an agreement of CVT results comparing EHB with ICP. Overall, the majority preferred EHB to ICP. These findings demonstrate that further testing is required to understand and improve the validity of smartphone CVT in subjects with ocular pathology.

Validity of the Worth 4 Dot Test in Patients with Red-Green Color Vision Defect.

PURPOSE: The Worth four dot test uses red and green glasses for binocular dissociation, and although it has been believed that patients with red-green color vision defects cannot accurately perform the Worth four dot test, this has not been validated. Therefore, the purpose of this study was to demonstrate the validity of the Worth four dot test in patients with congenital red-green color vision defects who have normal or abnormal binocular vision. METHODS: A retrospective review of medical records was performed on 30 consecutive congenital red-green color vision defect patients who underwent the Worth four dot test. The type of color vision anomaly was determined by the Hardy Rand and Rittler (HRR) pseudoisochromatic plate test, Ishihara color test, anomaloscope, and/or the 100 hue test. All patients underwent a complete ophthalmologic examination. Binocular sensory status was evaluated with the Worth four dot test and Randot stereotest. The results were interpreted according to the presence of strabismus or amblyopia. RESULTS: Among the 30 patients, 24 had normal visual acuity without strabismus nor amblyopia and 6 patients had strabismus and/or amblyopia. The 24 patients without strabismus nor amblyopia all showed binocular fusional responses by seeing four dots of the Worth four dot test. Meanwhile, the six patients with strabismus or amblyopia showed various results of fusion, suppression, and diplopia. CONCLUSIONS: Congenital red-green color vision defect patients of different types and variable degree of binocularity could successfully perform the Worth four dot test. They showed reliable results that were in accordance with their estimated binocular sensory status.

[Quantitative Color Vision Defect Evaluation - Lanthony Test and its Modified Interpretation]. / Kvantitativní vyhodnocení defektu barvocitu - Lanthonyho test a jeho modifikovaná interpretace.

UNLABELLED: Our aim was to develop quick and exact instrument for examination of color vision defects (CVD). We used Lanthony saturated and desaturated test. Data were evaluated according the Vingrys and King-Smith study. We had together 123 eyes of 86 patients. From all subjects we received these average values: AA 44.32 (min -87.13, max 80.64), TES 13.36 (min 8.84, max 30.30), SI 1.97 (min 1.22, max 5.69) and CI 1.66 (min 1.0, max 3.94). At the base of counting algorithm and average values form saturated and desaturated test we revealed 25 (29 %) patients with CVD. Twelve patients (14 %) classified as CVD+ had dichromacy and all had inborn CVD. Eight patients (9 %) from this group had deutranopia and four patient (5 %) protanopia. Anomaly trichromacy we revealed in thirteen patients (15 %). Eight (9 %) of these patients had inborn CVD. Six (7 %) of these patients had protanomalia, one (1 %) had deuteranomalia and one tritanomalia. We established and specified TES, CI and SI critical values, which was used to dividing patients into specific groups. KEY WORDS: Lanthony test, color vision defect, index of selectivity, index of confusion, total error score.

[Investigation of Color Vision Using Pigment Color Plates and a Tablet PC]. / Untersuchung des Farbsehens mittels Pigmentfarbtafeln und Tablet-PC.

BACKGROUND: Many applications (apps) for ophthalmic solutions, including colour vision tests, are currently available. However, no colour vision test app has been evaluated through clinical trials on a tablet PC. METHOD: Using standard test conditions and a tablet pc (iPad2®), colour vision tests were performed with 19 Velhagen/Broschmann/Kuchenbecker colour plates and an HMC anomaloscope. The plates were alternately presented at first in a book (pigment colour plates) and then in a tablet PC (iPad®). A total of 77 volunteer subjects were examined. 62 subjects were colour normal and 15 male subjects had a colour vision deficiency. The coincidence and the 95 % confidence intervals were determined. RESULTS: The average age of all subjects (n = 77) was 42.8 ± 16.9 years. The mean near visual acuity of all subjects was 0.99 ± 0.15. The coincidence of the results of all subjects between books and tablet PC was 88.0 %. The 95 % confidence interval ranged from 81.6 to 89.6 %. In the group of subjects with colour vision deficiency (n = 15), the coincidence was 83.3 %. The 95 % confidence interval ranged from 78.4 to 87.3 %. In the group of subjects without colour vision deficiency (n = 62), the coincidence was 89.1 %. The 95 % confidence interval ranged from 87.1 to 90.8 %. The overlap of error numbers of colour normal subjects and colour vision deficiency subjects was 2 errors with the book and 5 errors with the tablet pc. CONCLUSIONS: Testing colour vision using book and tablet pc only gives roughly comparable results. However, separation with the book was better and the colour plates differed in validity. For this reason, only some of the colour plates could be used on a tablet PC.

Comparison of Ishihara Booklet with Color Vision Smartphone Applications.

PURPOSE: To compare the standard Ishihara booklet with color-vision-testing smartphone applications. METHODS: A prospective observational diagnostic study on 42 normal trichromats and 38 color-deficient subjects. Patients were presented with three color vision tests in random order: an Ishihara test booklet and two color-vision-testing smartphone applications: Eye2Phone and the Color Vision Test application (CVT app). Sensitivity and specificity of the electronic tests was compared with Ishihara results, and in each one of these applications every plate was individually analyzed for success/failure rate. RESULTS: Average age was 42.7 ± 12.9 years. There were 57 males (71.2%). Sensitivity and specificity of each test was 100% (38/38) and 95.2% (40/42) for the Eye2Phone, and 100% (38/38) and 54.8% (23/42) for the CVT app. There was no significant difference between the Ishihara booklet and the Eye2Phone (p = 0.500), with a high kappa measure of agreement (0.950, p < 0.001). The CVT app was significantly different than both other tests (p < 0.001) with a low kappa measure of agreement (0.535 with the Ishihara and 0.575 with the Eye2Phone). Of the 21 tested plates, color-deficient subjects failed 11.8 ± 3.1 plates in the Ishihara booklet and 14.1 ± 2.1 plates in the Eye2Phone (p < 0.001). Significant plate-specific differences for the color-deficient group were found in plate numbers 3, 6, 7, 8, 9, 15, and 16. Both tests were poorly able to give an indication of the specific dichromatism type. The Ishihara booklet was rated more comfortable and clearer than the Eye2Phone in color-deficient subjects. The CVT app was rated lowest for comfort and clarity in both groups. CONCLUSIONS: Smartphone applications testing for color vision deficiency are readily available; however, users of these apps should be aware that some may have different sensitivity for detection of color vision deficiency compared to Ishihara booklet, limiting their usefulness for clinical use. Therefore, further validation of these applications is required.

Test illuminant location with respect to the Planckian locus affects chromaticity shifts of real Munsell chips.

The asymmetric sequential color-matching technique was used to determine the shifts in chromaticity of real Munsell chips induced by four test illuminants. The reference illuminant was C. Illuminants green (G) and purple (P) induced shifts orthogonal to the Planckian locus, while illuminants S and A induced shifts along the Planckian locus. Vectors describing the shifts induced by A and S were quantitatively and qualitatively different from those due to G and P. The data suggest that physiological factors, influenced by the proximity of the Planckian locus, affect chromatic constancy under nonsimulated viewing conditions.

iPad colour vision apps for dyschromatopsia screening.

Optic neuritis (ON) is a common and important cause of vision loss or vision disturbances in the community, particularly amongst the young, and it is often associated with a persistent dyschromatopsia. Traditionally screening for dyschromatopsia has been carried out using pseudo-isochromatic Ishihara plates. These colour plates were originally developed for testing of colour blindness, and indeed have only more recently been applied to ON. As the Ishihara plate books used for testing are expensive, unwieldy, and are not commonly available in many clinics or wards, many neurologists and ophthalmologists have taken to using untested and unstudied downloadable software packages on portable electronic devices for testing. This study compared the efficacy of printed and iPad (Apple, Cupertino, CA, USA) versions of the Ishihara plates in screening for dyschromatopsia in patients who were suspected of having ON. The main finding was that dyschromatopsia testing using a commercially available application on an iPad was comparable to using the current pragmatic clinical benchmark, the pseudo-isochromatic plates of Ishihara. These findings provide support for the increasingly common practice of screening for dyschromatopsia using the iPad.

A Modified Protocol for Color Vision Screening Using Ishihara.

INTRODUCTION: The Ishihara plates are commonly used as an initial occupational screening test for color vision. While effective at detecting red-green deficiencies, the color deficient subject can learn the test using different techniques. Some medical standards such as the European Aviation Safety Agency (EASA) require plate randomization and apply a stricter pass/fail requirement than suggested by Ishihara. This has been reported to increase the false positive rate up to ∼50%. METHOD: Two modifications to the Ishihara protocol are investigated. These involved allowing subjects a second attempt where one or two reading errors were made and the presentation of rotated Ishihara plates. RESULTS: A reduction of false positive rate to 5.9% was found. Correct identification of certain rotated Ishihara plates was not affected. DISCUSSION: By using a modified Ishihara protocol, fewer color normal subjects would require unnecessary advanced color vision examination. Further, additional safeguards would be in place to ensure that no subject with a color vision deficiency could pass the Ishihara test.

Color Vision and the Railways: Part 1. The Railway LED Lantern Test.

PURPOSE: Lantern tests and practical tests are often used in the assessment of prospective railway employees. The lantern tests rarely embody the actual colors used in signaling on the railways. Practical tests have a number of problems, most notably consistency of application and practicability. This work was carried out to provide the Railway LED Lantern Test (RLLT) as a validated method of assessing the color vision of railway workers. METHODS: The RLLT, a simulated practical test using the same LEDs (light-emitting diodes) as are used in modern railway signals, was developed. It was tested on 46 color vision-normal (CVN) and 37 color vision-deficient (CVD) subjects. A modified prototype was then tested on 106 CVN subjects. RESULTS: All 106 CVN subjects and most mildly affected CVD subjects passed the modified lantern at 3 m. At 6 m, 1 of the 106 normal color vision subjects failed by missing a single red light. All the CVD subjects failed. The RLLT carried out at 3 m allowed mildly affected CVD subjects to pass and demonstrate adequate color vision for the less demanding railway tasks. Carried out at 6 m, it essentially reinforced normal color vision as the standard. CONCLUSIONS: The RLLT is a simply administered test that has a direct link to the actual visual task of the rail worker. The RLLT lantern has been adopted as an approved test in the Australian National Standard for Health Assessment of Rail Safety Workers in place of a practical test. It has the potential to be a valid part of any railway color vision standard.

Color Vision and the Railways: Part 2. Comparison of the CN Lantern Used on the Canadian Railways and Railway LED Lantern Tests.

PURPOSE: There are two currently available lantern tests that have their design based solely on the practices of the rail industry. These are the CN Lantern (CNLAN) used on the Canadian Railways and the Railway LED Lantern Tests (RLLT). In the same way that the signaling practices differ in the two jurisdictions, the design of the lanterns also differ. The CIE (Commission Internationale de l'Éclairage)-recommended color vision standards for transport predate both lanterns. The study was undertaken to assess the appropriateness of these lanterns in CIE Color Vision Standard 1. CIE Standard 1 is called "Normal color vision" but some very mild anomalous trichromats may pass the specified "lantern test that presents a high level of difficulty." METHODS: The lantern tests were undertaken by 46 color vision-normal and 37 color vision-deficient subjects. RESULTS: Subjects made more errors on the RLLT, and the pattern of errors is different, partly because there are blank presentations in the RLLT and "no light" is an acceptable response. The two lanterns showed agreement on the pass/fail categorization of 73 of the 83 subjects. The RLLT fails more color vision-normal subjects. CONCLUSIONS: Despite the different construction principles, the RLLT and CNLAN have pass/fail levels that are comparable with the Holmes-Wright Type B lantern, which is nominated in CIE Color Vision Standard 1 but is no longer commercially available. The higher failure rate of color vision-normal subjects on the RLLT has been addressed by changing the intensities of the two darkest red lights.

Color Vision and the Railways: Part 3. Comparison of FaLant, OPTEC 900, and Railway LED Lantern Tests.

PURPOSE: The Farnsworth Lantern (FaLant) and the OPTEC 900 are nominated in the Commission Internationale de l'Éclairage (CIE) Color Vision Standard 2. Neither test uses the railway signal color code of red, yellow, and green, and only the OPTEC 900 is commercially available. The Railway LED Lantern Test (RLLT) is based on railway signaling practices in New South Wales, Australia, and is nominated in the Australian railway medical standard. The objective of this study is to compare the performance of the three lantern tests. METHODS: The RLLT, FaLant, and OPTEC 900 were administered to 46 color vision-normal and 37 color vision-deficient (CVD) subjects. RESULTS: The pattern of errors on the RLLT was different from that of the FaLant and OPTEC 900. This may be accounted for, at least in part, by the different colors and the use of blank presentations in the RLLT. The three lanterns showed agreement in failing 21 and passing 6 of the CVD subjects (72.9%). The lanterns gave different results for 10 CVD subjects (27.9%): n = 5 passed only the RLLT and n = 3 passed only the FaLant; n = 1 failed only the FaLant and n = 1 failed only the RLLT. The overall failure rate by CVD for each lantern was 67.6% (RLLT), 73.0% (FaLant), and 78.4% (OPTEC 900). CONCLUSIONS: Despite the different construction principles, the pass/fail levels of the RLLT, FaLant, and OPTEC 900 are comparable and consistent with the performance of other lanterns listed by the CIE for Color Vision Standard 2. The RLLT may be a little easier to pass and is based on the signal color code used and actual signaling practice. We propose that the RLLT is also an appropriate lantern for CIE Color Vision Standard 2.

[Web-based analysis of Stilling's color plates]. / Webbasierte Analyse von Stilling-Farbtafeln.

BACKGROUND: Color vision tests with pseudoisochromatic plates currently represent the most common procedure for the screening of congenital color vision deficiencies. By means of a web-based color vision test, new and old color plates can be tested for diagnostic quality without major effort. METHODS: A total of 16 digitized Stilling's color plates of the 11th edition from 1907 were included in a web-based color vision test (http://www.farbsehtest.de). The χ(2)-test was used to check whether the Stilling color plates showed similar results to the nine previously evaluated Ishihara color plates. RESULTS: A total of 518 subjects including101 (19.5 %) female subjects with a mean age of 34.6 ± 17 years, took the web-based test with the 25 plates. For all participants the range for the correctly recognized plates was between 5.2 % (n = 27) and 97.7 % (n = 506) for the Stilling color plates and between 64.9 % (n = 336) and 100 % (n = 518) for the Ishihara color plates. For participants with more than 5 errors (n = 247), the range for correctly recognized plates was between 2.0 % (n = 5) and 98.0 % (n = 242) for the Stilling plates and between 42.5 % (n = 105) and 100 % (n = 247) for the Ishihara plates. Taking all color plates and all participants into account there was a significantly higher incidence of erroneous recognition of the Stilling color plates (3038 false and 5250 true answers) compared to the Ishihara color plates (1511 false and 3151 true answers) (p < 0.001, χ(2)-test). CONCLUSION: The diagnostic quality of the tested Stilling color pates was very variable. Some of the plates could be used for the test edition of the Velhagen/Broschmann/Kuchenbecker color plates from 2014. Overall, the Stilling color plates were recognized with a higher incidence of error by all participants in the web-based test compared to the utilized Ishihara color plates, which in most cases was attributable to ambiguity of some symbols.

Reproducibility of a new colour test.

PURPOSE: To evaluate the reproducibility of a new colour test, using the Chromatometer CM3. METHODS: Twenty healthy subjects were recruited at the Department of Ophthalmology, at the Medical University of Vienna. A total of 40 eyes were tested. Both eyes were tested separately with the Chromatometer CM3. The colour test was repeated after several days. Each time, best-corrected visual acuity was tested using Snellen charts, and colour perception was tested using the Chromatometer CM3. RESULTS: The Chromatometer CM3 showed reproducible results between the two tests at almost every luminosity level. All 4 green-red measurements and 2 blue-yellow brightness measurements showed reproducible results between the first and second tests. CONCLUSION: The Chromatometer CM3 seems to be an appropriate method to detect changes in colour perception, although the red-green comparison appeared to be more precise than the blue-yellow comparison.

The effect of colour and size on attentional bias to alcohol-related pictures

Attentional bias plays an important role in the development and maintenance of alcohol addiction, and has often been measured with a visual probe task, where reaction times are compared for probes replacing either a substancerelated cue or a neutral cue. Systematic low-level differences between image classes are a potential cause of low internal reliability of the probe task (Ataya et al., 2012). Moreover, it is unclear whether automatic attentional capture by low-level properties such as size and colour in the non-substance related image could reduce attentional bias to the alcohol-related cue. Here, alcohol-related attentional bias was assessed in moderate social drinkers by measuring reaction times to targets that replaced either an alcohol-related or a non-alcohol related (i.e., neutral) picture. All alcohol-related images were greyscale, and the neutral stimulus could be either greyscale (‘control’), in colour (‘colour’), or greyscale and 25% larger in size (‘25% larger size’). We found attentional bias towards the alcohol-related stimuli in the control and 25% larger size conditions, but not in the colour condition. The magnitude of attentional bias was significantly reduced in the colour condition compared to the control and 25% larger size conditions. These findings indicate that salient low-level features in the non-substance related cue, in particular colour, can reduce the effect of alcohol-related content on the allocation of alcohol drinkers’ attention. Further, the results highlight the need for image pairs in visual probe tasks to be closely matched on basic perceptual dimensions (AU)

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Accuracy of four commonly used color vision tests in the identification of cone disorders.

PURPOSE: To determine which color vision test is most appropriate for the identification of cone disorders. METHODS: In a clinic-based study, four commonly used color vision tests were compared between patients with cone dystrophy (n = 37), controls with normal visual acuity (n = 35), and controls with low vision (n = 39) and legal blindness (n = 11). Mean outcome measures were specificity, sensitivity, positive predictive value and discriminative accuracy of the Ishihara test, Hardy-Rand-Rittler (HRR) test, and the Lanthony and Farnsworth Panel D-15 tests. RESULTS: In the comparison between cone dystrophy and all controls, sensitivity, specificity and predictive value were highest for the HRR and Ishihara tests. When patients were compared to controls with normal vision, discriminative accuracy was highest for the HRR test (c-statistic for PD-axes 1, for T-axis 0.851). When compared to controls with poor vision, discriminative accuracy was again highest for the HRR test (c-statistic for PD-axes 0.900, for T-axis 0.766), followed by the Lanthony Panel D-15 test (c-statistic for PD-axes 0.880, for T-axis 0.500) and Ishihara test (c-statistic 0.886). Discriminative accuracies of all tests did not further decrease when patients were compared to controls who were legally blind. CONCLUSIONS: The HRR, Lanthony Panel D-15 and Ishihara all have a high discriminative accuracy to identify cone disorders, but the highest scores were for the HRR test. Poor visual acuity slightly decreased the accuracy of all tests. Our advice is to use the HRR test since this test also allows for evaluation of all three color axes and quantification of color defects.

Comparison between Hardy-Rand-Rittler 4th edition and Ishihara color plate tests for detection of dyschromatopsia in optic neuropathy.

BACKGROUND: The aim of this work was to compare the specificity-sensitivity balance of the Hardy-Rand-Rittler (HRR) 4th edition with the Ishihara color plate tests for color-vision defects in patients with optic neuropathy. METHODS: This is a prospective case-control study. The study group included 43 patients (48 eyes) with newly diagnosed optic neuropathy, and the control group included 33 patients (33 right eyes) who were referred to the eye clinic for conditions other than optic nerve or retinal macular disorders. Individuals with visual acuity of less than 20/70 (0.54 Log MAR) were excluded. All patients underwent comprehensive eye examination and color-vision evaluation with both tests in a random order under standardized lighting conditions. The scores of the Ishihara and HRR tests were set as the number of plates identified out of 12 and six respectively. RESULTS: The receiver operating characteristics (ROC) curve was statistically significantly better when using the HRR test (area under curve [AUC] = 0.93 ± 0.03) than for the Ishihara test (AUC = 0.77 ± 0.05) (P = 0.0006). The best specificity-sensitivity balance for the HRR was 100 % and 79 % respectively, and for the Ishihara test 100 % and 48 % respectively. CONCLUSIONS: The HRR 4th edition test proved to be superior to the Ishihara test in detecting acquired dyschromatopsia due to optic neuropathy. We recommend using the HRR 4th edition test as a screening method for detection of color-vision defects in patients with optic neuropathy.