Abstract
PurposeTo evaluate effects of age and simulated and real cataractous changes on color vision as measured by the high-definition cone contrast test (CCT).MethodsTwenty-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. Last, 25 subjects underwent CCT before and after cataract surgery.ResultsCCT scores were most reliable in the nonmydriatic condition without pinhole correction. Progressively dense brown filters produced small decreases 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 = −1.09; 95% confidence interval [CI], −1.30 to 0.86) than M-cones (slope = −0.80; 95% CI, −1.03 to −0.58) and L-cones (slope = −0.66; 95% CI, −0.88 to −0.44). CCT scores increased for S-cones but reduced for L- and M-cones in pseudophakic subjects compared with phakic patients. CCT scores after cataract surgery increased for S-cones, M-cones, and L-cones by 33.0 (95% CI, 8.6 to 57.4), 24.9 (95% CI, 3.8 to 46.0), and 22.0 (95% CI, −3.2 to 47.3), respectively.ConclusionsCCT 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 RelevanceCCT testing, which quantifies hereditary and acquired color deficiency, can also quantify the degree of cataract severity and, combined with other parameters, can provide more precise guidance for cataract extraction to optimize patient care.
Highlights
Color vision is an integral part of visual function that gradually decreases with age.[1,2,3]
Studies performed were compliant with the Health Insurance Portability and Accountability Act of 1996 and all participants enrolled in the perioperative cone contrast threshold (CCT) testing provided informed written consent
The CCT scores gradually decreased from baseline when a progressively more dense ND was placed between the CCT and viewer’s eye
Summary
Color vision is an integral part of visual function that gradually decreases with age.[1,2,3] visual fields and acuity are the only elements routinely measured or considered in clinical trials. Senescent changes, including senile miosis and increased density and opacity of optical media,[2,4] diminish the amount of light reaching the retina where visual. TVST | November 2020 | Vol 9 | No 12 | Article 11 | 2 transduction initiates visual acuity, contrast sensitivity, and color vision.[5] The most common etiology for decreased media clarity is lenticular opacification. The translucent lens begins to yellow and harden toward brunescence, increasing its absorption of short-wavelength visible light, causing acquired tritan deficits.[6,7,8] Increasing lens density and the eventual progression to cataracts increase forward light scattering, decreasing retinal illumination, contrast sensitivity, and visual acuity while increasing glare.[2]
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