Farnsworth 100 Hue測驗之臨床應用價值

Abstract

Part Ⅰ. An evaluation of the clinical application of the Farnsworth 100-hue test on congenital color defect The purpose of this paper is to evaluate the clinical application of the Farnthworth 100 Hue test on congenital color defect. Totally 71 patients are screened by two pseudo-isochromatic plate, Ishihara color plate and Tokyo Medical College test. By Negel's anomaloscope they are classified as 26 deuteranomalia. 14 extreme deuteranomalia, 14 deuteranopia. 8 protanomalia 3 extreme protanomalia, and 6 protanopia. Both Farnsworth 100 Hue test and panel D-15 test are tested for study and comparison. A typical protan pattern is noted in 100% of protanopia, 66.7% of extreme protanomalia and only 25% of protanopia. The average confusion pattern is ranged from cap 13.9±0.54 to cap 25.5±5.3 in left side, and from cap 57.2±3.04 to cap 73.9±3.34 in right side. The average confusion axis is from cap 18.7±2.38 to cap 65.7±2.42. A typical deuteran pattern is noted in 100% of deuteranopia and extreme deuteranomalia and only 11.5% of deuteranomalia. The average confusion pattern is ranged from 10.58±1.10 to cap 21.58±1.00 in left side and from cap 51.67±1.84 to cap 63.51±1.18. The average confusion axis is from cap 16±1.42 to cap 58.2±1.28. On the basis of these findings, the cap number, from which marked confusion begins in left side, the shape of the confusion pattern and the midpoints by which the confusion axis formed are the triad in differentiating protan from deuteran. No protan patient confuses the color arrangement before cap 13 while only 3.4% of deuteran confuses after that cap. The confusion pattern of deuteran is often characterized by narrow and pronounced shape while protan by wider and unmarked protrusion. The mid point of deuteran in right side is between cap 56 to 61 while that of protan ranges between cap 62 to cap 70. To find out the mid-point, a quick and easy method is suggested by the author by averaging the numbers of the two caps where the confusion range begins and ends. A comparison of the accuracy of this method with the standard method suggested by the manual of the Farnsworth 100 Hue test shows no difference. The sensitivity of the panel D-15 test is 87% of the Farnthworth 100 Hue test. Part Ⅱ. An evaluation of the clinical application of the Farnsworth 100-hue test on acquired color vision defect. The purpose of this part Ⅱ is to evaluate the clinical application of the Farnsworth 100 Hue test on acquired color vision defect. The color vision of 146 patients with a variety of retinal and optic nerve disease is studied. We also use Panel D-l5 test on some of these patients for comparison. The color vision of 20 patients with amblyopia, whether it is caused by anisometropia or by strabismus, is normal as compared to it's normal fellow eye. (P＞0.05) High myopia is also innocent itself in color vision unless macular degeneration or chorioretinal degeneration is accompanied. Patients with macular and retinal disease are usually characterized by having yellow-blue defect except heredomacular degeneration. In 37.5% of heredomacular degeneration red-green defect is shown in our study. Central serous chorioretinopathy is a specific and rather popular disease in Taiwan. Thirty three patients with this disease are included in this study. On the basis of our findings, the changes of the confusion pattern of this test in follow-up cases are more sensitive than any other functional tests during the course of the disease. Patients with optic nerve disease are usually characterized by having red-green defect except hereditary dominant optic atrophy, papilledema and glaucoma, in which yellow-blue defect is the only finding. It is interesting to find out that the color vision of optic nerve atrophy caused by head injury in our deta has more component of yellow-blue defect than other etiology. We suspect that it may be resulted from the injury to dominant cerebral hemisphere. The sensitivity of the panel D-l5 test is only 32.5% of the Farnsworth 100 Hue test, but it is a valuable test when the error scores of the 100 Hue test is more than 300, and so the confusion axis can't be determined.