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The natural history of dry type of age-related macular degeneration.

To study the natural history of dry type of age-related macular degeneration (AMD) and search for a sensitive method for detecting the development of the disease, the fundus fluorescein angiography, visual acuity, electroretinogram and FM 100-hue test were used to examine 75 eyes, 147 eyes, 73 eyes, and 94 eyes respectively. These examinations were taken at least twice during the follow-up periods. The average age was 63.2 years (50-80 years). The average follow-up was 29.8 months with a range of 3-74 months. It was shown tht there were not any statistically significant difference in the macular lesions and electroretinogram between the initial examinations and after follow-up (P > 0.05). 91.14% of the eyes maintained good visual acuity during the follow-up. Subretinal neovascularization developed only in one of the eyes. The total error score of FM 100-hue test had a statistically significant difference between the initial test and the test taken two years afterwards (P < 0.01). It was suggested that most of the dry type of AMD had a favorable prognosis and that color visual test was a sensitive method for monitoring the development of dry type of AMD.

Age Factors↗

Early detection of glaucomatous damage. II. Changes in the appearance of the optic disk.

Once we understand that an increase in the size of the optic disk cup is due to loss of optic nerve fibers combined with some physical tissue rearrangements, it is quite clear that cupping begins as soon as nerve loss begins. Methods to detect cupping are more sensitive to the earliest glaucoma damage than are present field testing methods. This conclusion is supported by large clinical studies and histological demonstration of nerve fiber loss prior to field loss in eyes with abnormal cups, asymmetric cupping, or nerve fiber layer abnormalities. While automated perimetry is likely to increase the sensitivity of detection, better test methodologies are needed to combine with the objectivity of computer-assisted machines. Disk hemorrhages, nerve fiber layer defects, and color vision abnormalities are early signs of damage, supporting the conclusion that damage is present before field loss. A number of other methods await further testing to determine their effectiveness. The idea that the disease glaucoma is defined by a certain visual field finding on the Goldmann perimeter is not valid if we define glaucoma as an eye with a history of elevated IOP and optic nerve damage. While such field loss is a convenient means of defining a particular stage of damage in glaucoma, there are clearly earlier stages of damage, whether we can always detect them or not. No patient should be told that he or she does not have glaucoma, but rather has ocular hypertension, based on a particular visual field finding. As testing and examination methods improve, so, hopefully, will our ability to determine whether damage is present. As this occurs, we will be better enabled to select most rationally those patients who will benefit from therapy. The idea that field testing is relatively insensitive to the earliest glaucoma damage might lead the skeptic to conclude that perimetry is not worth the trouble. This review has indicated that none of our present methods, ophthalmoscopic, psychophysical or otherwise, is perfect. But to omit using any of them (especially field testing) does a great disservice to the glaucoma patient. The greatest usefulness of the new automated instruments is that adequate field testing is now available in a cost-effective form to every ophthalmic office. We need to strive for better detection and follow-up of glaucoma damage to prevent needless blindness.

Color Perception Tests↗

Colour vision abnormalities in multiple sclerosis.

A battery of colour vision tests was employed to evaluate visual function in patients with multiple sclerosis (M.S.). Colour deficits were found in 45% of patients tested with the Ishihara plates and 42.5% of patients tested with the FM 100-Hue test. 65% of M.S. patients failed at least one of the tests. The colour vision deficits were not restricted to patients with optic neuritis or with visual evoked potential (VEP) abnormalities and there was no significant correlation between an abnormal VEP latency and a colour vision deficit. Colour vision testing may be a useful option to consider in the investigation of M.S. patients, even if there is no other evidence of visual system involvement.

Adult↗

The clinical assessment of colour discrimination in senile macular degeneration.

The colour discrimination of 15 subjects manifesting senile macular degeneration was investigated, over a wide range of illuminances, using the Farnsworth-Munsell 100-Hue test and Panel D-15. Ten subjects of similar ages with normal colour vision were investigated concurrently to provide a control group. Colour discrimination was shown to deteriorate with decreasing illuminance this being more marked for the subjects with senile macular degeneration than for the normal subjects. It is demonstrated that the FM 100 is the preferred test for assessment of colour discrimination loss in senile macular degeneration with early visual acuity loss. The Panel D-15 is more useful as acuity loss becomes more marked.

Age Factors↗

The effect of decreased visual acuity on clinical color vision testing.

PURPOSE: Evaluate the effect of visual acuity on color vision testing. DESIGN: University based clinical experimental study. METHODS: Right eyes of 12 healthy subjects were fogged with plus lenses to logMAR 1.88 and assessed with D-15 panel, Ishihara, and Hardy-Rand-Rittler (HRR) plates. Subjects were tested at lesser degrees of fogging, 0.1 logMAR intervals. The acuity at which 5% of the population tests abnormally was estimated as follows. The average acuity at which a 10% reduction in correct responses occurred was determined. From this, two standard deviations were subtracted. Examination devices were compared using repeated measures analysis of variance. RESULTS: Color vision testing did not significantly differ from baseline up to logMAR 1.40 (D-15 panel), 1.10 (HRR plates), and 0.72 (Ishihara plates). Testing devices were significantly different (P < .005). CONCLUSIONS: Color vision testing is accurate up to logMAR 1.40 (20/501) with D-15 panel, 1.10 (20/252) with HRR plates, and 0.72 (20/106) with Ishihara plates.

Adult↗

Exposure times for colour discrimination in the parafoveal field: a new procedure to detect subtle visual dysfunction in multiple sclerosis patients.

A new procedure to test colour discrimination in the parafoveal field is described. This method was used on 25 healthy controls and 25 subjects having a definite clinical or laboratory-supported diagnosis of multiple sclerosis, with or without a previous history of optic neuritis. The test proved to be sensitive in detecting visual dysfunction even in some patients in whom the standard technique of pattern-reversal evoked potential recordings yielded a normal result.

Adult↗

Normative data for elderly African Americans for the Stroop Color and Word Test.

The Stroop Color and Word Test is a measure of executive function that is commonly used in neuropsychological evaluations, but for which there are currently no normative date for elderly African American individuals. The present investigation examined the influence of demographic characteristics on this measure in a community-dwelling sample of 236 elderly African American adults (60-84 years of age). Age, education, gender, and the education by gender interaction were found to affect performance on the Stroop Color and Word Test tasks. Based on these results, normative tables for Stroop Color and Word Test scores, stratified by age and with score adjustments for education and gender, are provided.

Black or African American↗

Evaluation of poor performance and asymmetry in the Farnsworth-Munsell 100-hue test.

A statistical method for the analysis of errors on the Farnsworth-Munsell 100-hue test is introduced. The extent of asymmetry of errors are summarized by two indices, I1 and I2, derived from Fourier analysis of the error scores for the individual caps. The second index, I2, describes the (bipolar) color axis; the first index, I1, describes (monopolar) asymmetry of performance. The present analysis differs from previous approaches based on Fourier analysis of the errors in two ways: (1) a procedure is introduced which corrects the indices I1 and I2 for the biases that result from the segmentation of the test into four boxes; (2) statistics for the significance of I1 and I2 are derived by a Monte Carlo procedure, which properly handles the complex interdependence of individual error scores for each cap.

Color Perception Tests↗

Color vision and contrast sensitivity tests in early diagnosis of primary open-angle glaucoma.

Color vision was examined by the Farnsworth 100 hue test in 48 eyes with ocular hypertension (OHT). Thirteen eyes had a general loss of color discrimination and 8 had a blue-yellow axis. Spatial contrast sensitivity was tested in 31 eyes with OHT by the Mentor B-VAT and was reduced in 8 of them. Temporal contrast sensitivity was explored in 40 eyes with OHT by the Flickersyst&m and showed abnormal responses in 11 eyes. According to the lack of specificity of the responses and the overlapping of the results of normal eyes and OHT eyes, those tests are not useful for classifying an individual patient. Such investigations however have the interest to show that macular mediated functions may be impaired early in glaucoma.

Adult↗

Effect of petroleum derivatives and solvents on colour perception.

BACKGROUND: Occupational exposure to various neurotoxic chemicals has been shown to be associated with colour vision impairment. It seems that this can occur at low exposure levels, sometimes well below the recommended occupational threshold limits. This study was undertaken to determine the effect of exposure to petroleum derivatives (polyethylene, polystyrene) and solvents (perchloroethylene) on colour perception. METHODS: Colour vision was assessed using the Ishihara plates, the D-15 test and the Farnsworth Munsell 100 Hue test. Two factories using petroleum derivatives and three dry cleaning premises were chosen at random. A total of 93 apparently healthy employees were recruited from the five workplaces. Two age-matched control groups comprising 56 people, who were support staff of the university with no exposure to petroleum, solvents or their derivatives, were also recruited. RESULTS: All subjects passed the Ishihara test, showing that none had a congenital red-green defect. Some of the exposed employees failed the D-15 and had abnormally high FM100 Hue scores. All control subjects passed all the colour vision tests. The D-15 test showed that 28 per cent (26 of 93) of exposed employees had a colour vision defect whereas the FM 100 Hue test found that 63 per cent (59 of 93) had a colour vision defect. Most defects were of the blue-yellow type (22.6 per cent) when using the D-15 test. However, with the FM 100 Hue test, most defects were of the non-polar type with no specific axis (50.5 per cent). Mean total error scores calculated from the FM100 Hue test for exposed employees were statistically significantly higher than those of the control subjects. CONCLUSION: Employees directly exposed to petroleum derivatives and solvents have a higher risk of acquiring colour vision defects compared to subjects who are not.

Adult↗

New clinical color threshold test for eye disease.

Selective loss of sensitivity to blue light, when it is detected by the short wavelength-sensitive cones (B cones), is a common early sign of many retinal and visual pathway disorders. A reliable clinical test is needed to allow detection of this defect. We describe a new, simple forced-choice clinical test of B cone function which is brief, reliable, and free of patient criteria for seeing. Test results are relatively unaltered by up to 2 D of uncorrected refractive error and the usual small fixation changes the patient makes during the test. A comparison of three different test results, all obtained within 5 min, allows measurement of R and/or G cone function free of age and individual differences caused by yellowing of the ocular media in the B cone test result. The test has been used to demonstrate B cone sensitivity losses related to the severity of retinopathy in 60 diabetics, as well as selective B cone loss in glaucoma and ocular hypertension.

Color Perception Tests↗

Red square test for visual field screening. A sensitive and simple bedside test.

A reliable bedside test for screening of visual field defects is a valuable tool in the examination of patients with a putative disease affecting the sensory visual pathways. Conventional methods such as Donders' confrontation method, counting fingers in the visual field periphery, of two-hand confrontation are not sufficiently sensitive to detect minor but nevertheless serious visual field defects. More sensitive methods requiring only simple tools are also described. In this study, a test card with four red squares surrounding a fixation target, a black dot, with a total test area of about 11 x 12.5 degrees at a distance of 30 cm, was designed for testing experience of red colour saturation in four quadrants, red square test. The Goldmann visual field was used as reference. 125 consecutive patients with pituitary adenoma (159 eyes), craniopharyngeoma (9 eyes), meningeoma (21 eyes), vascular hemisphere lesion (40 eyes), hemisphere tumour (10 eyes) and hemisphere abscess (2 eyes) were examined. The Goldmann visual field and red square test were pathological in pituitary adenomas in 35%, in craniopharyngeomas in 44%, in meningeomas in 52% and in hemisphere tumours or abscess in 100% of the eyes. Among these, no false-normal or false-pathological tests were found. However, in vascular hemisphere disease the corresponding figures were Goldmann visual field 90% and red square test 85%. The 5% difference (4 eyes) was due to Goldmann visual field defects strictly peripheral to the central 15 degrees. These defects were easily diagnosed with two-hand confrontation and

Adult↗

[A rapid method: the 100-hue test].

A new and fast method for scoring and assessing the 100-Hue test (Farnsworth-Munsell) is reported. This method allows to simultaneously transcribe graphically the responses of the patient. This method reduces drastically the duration of examination and calculation, without modification of the principle of the 100-Hue Test. The qualitative and graphic validity, the statistical validity are analysed from 103 pathological subjects and 53 normal subjects. The two methods (Farnsworth-Kinnear and fast method) are examined comparatively.

Color Perception Tests↗

Psychophysical tests in X-linked retinitis pigmentosa carrier status.

Psychophysical tests were performed in 22 normal women and 17 X-linked carriers of retinitis pigmentosa. The tests consisted of luminance contrast sensitivity, grating at the fovea and broken annulus at the periphery, color contrast sensitivity, letters for the fovea and broken annulus for the periphery, along the three known confusion axes of protan, deutan and tritan observers. Statistical analysis of the data shows that there were significant differences between the carriers and age-similar normal subjects with all the tests. The most significant differences (P < 0.001) were found with the color contrast sensitivity at the periphery along the protanopic and deutanopic axes and the luminance contrast sensitivity at the periphery. The influence of the age is discussed.

Adolescent↗

[Use of a new anomaloscope test in diagnosis of glaucoma].

BACKGROUND: The Color Vision Meter 712 (CVM) is a new automatic computerized anomaloscope relying on both the Rayleigh and the Moreland equation. In the present study the diagnostic value of Color Vision Meter was examined in glaucoma for the first time and was compared with the Farnsworth 100 hue test. PATIENTS AND METHODS: 33 normals, 15 patients with ocular hypertension (OHT) and a heterogenic group of 31 glaucoma patients were tested with the Nagel anomaloscope, the Color Vision Meter 712 and the Farnsworth 100 hue test. The following determinations were made in all subjects: 1. Anomalous quotient of the Rayleigh equation of the Nagel anomaloscope and of the Color Vision Meter, 2. Mean tritan score of 100 hue test, 3. The matching range, mid matching point, and anomalous quotient of the Moreland equation with the Color Vision Meter. RESULTS: While in the OHT group only the matching range of the Moreland equation was enlarged, all three variables (matching range, mid matching point and anomalous quotient) of the Moreland equation were significantly changed in the glaucoma group. The mean tritan score of the 100 hue test showed in the OHT group only a slight difference compared to normals, and in the glaucoma group a low significance and a low sensitivity. The matching range of the Moreland equation seems to be most useful with a sensitivity of 87.1% and a specificity of 93.6%. CONCLUSION: Our results show that the new anomaloscope Color Vision Meter 712 should be considered as a quick screening test for the examination of blue-color vision disturbances in glaucoma because of its higher sensitivity, its easier use for examiner and patients, and its shortened examination time (5 min per equation).

Adult↗

Normal test scores in the Farnsworth-Munsell 100 hue test.

One hundred and sixty persons aged from 10 to 69 years (106 women, 54 men) with healthy eyes were studied with the Farnsworth-Munsell 100 hue (FM100) test. The mean of the results in the total scores and in the individual box scores in the right and left eye were calculated. The total score was also separately calculated in women and men. The test was administered under the illumination of Macbeth Easel lamp, 1000 lux, and the right eye was tested first. The results were calculated in six different age groups, 10-19 years, 20-29 years, etc. The mean of the total scores in the right eye varied from 7.44+/-2.46 (SD) to 10.07+/-2.03 in different age groups and in the left eye from 7.56+/-2.36 to 10.16+/-2.68. The scores changed significantly with the age: the correlation between the age and the test scores by linear regression gave significant results, in the right eye (R = 0.308, P = 0.0001), and in the left eye (R = 0.246, P = 0.0021). The present study with the normal error scores in the FM100 test and its individual boxes in persons aged 10-69 years gives clinicians working with colour vision defects a possibility to estimate the normality or abnormality of the results in their patients.

Adolescent↗

Color perimetry with personal computer.

Color visual field analysis has proven highly sensitive for early visual impairments diagnosis in M. S., yet it has never attained widespread popularity usually because the procedure is difficult to standardize, the devices are costly, and the test is fatiguing. We propose a computerized procedure running on standard PC, cost effective, clonable, and easy handled. 264 colored patches subtending 1 degree angle of vision, with selected hues and low saturation levels are sequentially and randomly displayed on gray equiluminous background of the PC screen subtending 24 degrees x 40 degrees angle of vision. The subject is requested to press a switch at the perception of the stimulus. The output provides colored maps with quantitative informations. Comparison between normals and a selected population of Patients with Multiple Sclerosis and with Glaucoma without luminance visual field defects, showed high statistical difference.

Adult↗

[Lanthony's New Color Test. V. Classification of the grays].

It is easy to make a shortened Lightness Discrimination Test (LDT) using the grey caps of the New Color Test (NCT). The shortened test shows the reduction in contrast sensitivity as well as the original LDT in squint amblyopia multiple sclerosis, optic neuritis and cerebral tumours. So it is a useful complement to the NCT.

Amblyopia↗