Abstract
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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Francois J, Verriest G (1961) On acquired deficiency of color vision with special reference to its detection and classification by means of the tests of Farnsworth. Vis Res 1:201–219
Griffin JF, Wray SH (1978) Acquired color vision defects in retrobulbar neuritis. Am J Ophthalmol 86:193–201
Cruysberg JR, Pinckers A (1982) Acquired color vision defects in compressive optic neuropathy. Neuro Ophthalmol 2:169–181
Melamud A, Hagstrom S, Traboulsi E (2004) Color vision testing. Ophthalmic Genet 25:159–187
Cox J (1960) Color vision defects acquired in diseases of the eye. Br J Physiol Opt 17:195–216
Hart WM (1987) Acquired dyschromatopsia. Surv Ophthalmol 32:10–31
Katz B (1995) The dyschromatopsia of optic neuritis: a descriptive analysis of data from the optic neuritis treatment trial. Trans Am Ophthalmol Soc 93:685–708
Schneck ME, Haegerstrom-Portnoy G (1997) Color vision defect type and spatial vision in the optic neuritis treatment trial. Invest Ophthalmol Vis Sci 38:2278–2289
Hardy LH, Rand G, Rittler MC (1945) Tests for the detection and analysis of color blindness. I. An evaluation of the Ishihara test. Arch Ophthalmol 34:295–302
Hardy LH, Rand G, Rittler MC (1954) The H-R-R polychromatic plates. 1. A test for the detection, classification, and estimation of the degree of defective color vision. Arch Ophthalmol 51:216–228
Aroichane M, Pieramici DJ, Miller NR, Vitale S (1996) comparative study of Hardy–Rand–Rittler and Ishihara color plates for the diagnosis of nonglaucomatous optic neuropathy. Can J Ophthalmol 31:350–355
Dain SJ (2004) Colorimetric analysis of four editions of the Hardy–Rand–Rittler pseudoisochromatic tests. Vis Neurosci 21:437–443
Cole BL, Lian KY, Lakkis C (2006) The new Richmond HRR pseudochromatic test for colour vision is better than the Ishihara test. Clin Exp Optom 89:73–80
Bailey JE, Neitz M, Tait DM, Neitz J (2004) Evaluation of an updated HRR color vision test. Vis Neurosci 21:431–436
Beck RW, Cleary PA, Trobe JD, Kaufman DI, Kupersmith MJ, Paty DW, Brown CH (1993) The effect of corticosteroids for acute optic neuritis on the subsequent development of multiple sclerosis. The Optic Neuritis Study Group. N Engl J Med 329:1764–1769
Ischemic Optic Neuropathy Decompression Trial Research Group (1995) Optic nerve decompression surgery for nonarteritic anterior ischemic optic neuropathy (AION) is not effective and may be harmful. JAMA 273:625–632
Levin LA, Beck RW, Joseph MP, Seiff S, Kraker R (1999) The treatment of traumatic optic neuropathy: the International Optic Nerve Trauma Study. Ophthalmology 106:1268–1277
DeLong ER, DeLong DM, Clarke-Pearson DL (1988) Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics 44:837–845
Bueti D, Walsh V (2009) The parietal cortex and the representation of time, space, number and other magnitudes. Philos Trans R Soc Lond B Biol Sci 364:1831–1840
McCulley TJ, Golnik KC, Lam BL, Feuer WJ (2006) The effect of decreased visual acuity on clinical color vision testing. Am J Ophthalmol 141:194–196
Danesh-Meyer HV, Papchenko TL, Savino PJ, Gamble GD (2007) Brightness sensitivity and color perception as predictors of relative afferent pupillary defect. Invest Ophthalmol Vis Sci 48:3616–3621
Matti AI, Chu ER, Keane M, Pesudovs K, Chen CS (2011) Comparison of Ishihara and Hardy–Rand–Rittler pseudoisochromatic plates in non-arteritic anterior ischaemic optic neuropathy. Neuro Ophthalmol 35:181–186
Author information
Authors and Affiliations
Corresponding author
Additional information
The authors have full control of all primary data, and agree to allow Graefe’s Archive for Clinical and Experimental Ophthalmology to review their data upon request.
Rights and permissions
About this article
Cite this article
Huna-Baron, R., Glovinsky, Y. & Habot-Wilner, Z. Comparison between Hardy–Rand–Rittler 4th edition and Ishihara color plate tests for detection of dyschromatopsia in optic neuropathy. Graefes Arch Clin Exp Ophthalmol 251, 585–589 (2013). https://doi.org/10.1007/s00417-012-2073-x
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00417-012-2073-x