Quantifying Color Vision Changes Associated with Cataracts Using Cone Contrast Thresholds

Abstract

Color Vision Changes Associated with Cataracts 2 Abstract Purpose: The cone contrast threshold (CCT) test quantified color vision changes in subjects of all ages and those undergoing cataract surgery. Methods: Twenty-four healthy volunteers from two cohort studies performed CCT using best corrected visual acuity, filters, mydriasis, and pinhole correction. Retrospective cross-sectional study of patients seen in eye clinics evaluated the relationship between age and color vision, and age and lens status in 355 eyes. Lastly, 25 subjects performed CCT before and after cataract surgery. Results: CCT scores were most reliable in the non-mydriatic condition without pinhole correction. Progressively dense brown filters produced small but significant reductions in S-cone sensitivity. Linear regression analysis of phakic subjects showed a decline for all cone classes with age. Rate of decline was greater for S-cones (slope (95% CI) = -1.09 (-1.23, 0.94)) than Mcones (slope (95% CI) = -0.80 (-0.95, -0.66)) and L-cones (slope (95% CI) = -0.66 (-0.81, -0.52)). CCT scores increased for S-cones but reduced for L-and M-cones in pseudophakic subjects compared to phakic patients. CCT scores after cataract surgery increased for S-cones, M-cones, and L-cones by 33.0 (p<0.001), 24.9 (p=0.001), and 22.0 (p=0.008). Conclusions: CCT assessment allows for clinically practical quantitation of color and contrast vision improvement after cataract surgery and aging patients who note poor vision despite good visual acuity. Translational Relevance: CCT testing, historically used in research, is now a clinically practical tool to evaluate age and cataract related changes in color and contrast vision and routinely quantify vision beyond black and white visual acuity testing.

Multimodal Imaging in Ocular Siderosis

“…Color vision has been shown to be reduced in patients with cataracts. 8,9 However, in this patient's case, only blue color vision returned to normal following cataract surgery. Red and green color discrimination was significantly impaired 1.5 months following cataract extraction, and green color discrimination remained significantly impaired for more than 1 year post cataract surgery.…”

Color vision assessment following cataract surgery using anomaloscope

“…This study did not compare anomaloscopic parameters with age-matched non-cataract subjects but with eyes following IOL implantation. As described by Mehta [24], color vision deterioration in elderly cataract patients depends, to a certain extent, on natural aging of the lens. Therefore, the effect of cataract itself might be less significant than described in this paper.…”

“…The aim of the study was to analyze the influence of cataract on anomaloscopic parameters of color vision. To date, the influence of cataract on color vision was analyzed using the Farnsworth-Munsell 100-Hue test [23] and the Cone Contrast Test [24]. Anomaloscopic examination was used only to determine potential differences in color vision following the implantation of different IOLs in the same subjects or to compare color vision in IOL eyes with a control group [32][33][34].…”

“…This suggests that cataract patients may suffer from impaired vision in various hue ranges. Another research, focused on the impact of cataract on color vision, was presented by Mehta et al [24]. The researchers used the High-Definition Cone Contrast Test (CCT), prior to and following surgery, to measure cataract-related changes in color vision.…”

Quantitative cone contrast threshold testing in patients with differing pathophysiological mechanisms causing retinal diseases

“…Military screenings using CCT demonstrate 96-100% sensitivity and specificity for protan, deutan, and tritan CVD compared to the anomaloscope. 1,11 Our study team has also demonstrated in data under review that there was no learning effect, or improvement in scores, when individuals repeated this test multiple times 12 Figure 1: a) Cone contrast threshold test isolates cone opsins by providing photopic background to suppress rod function and adjusts Landolt C optotype contrast for each cone opsin. b) The quantitative output indicates a mean score with error for each individual cone opsin and these are reported as normal, borderline or abnormal.…”