Farnsworth-Munsell 100-hue Test Research Articles

Color perception deficits in co-existing attention-deficit/hyperactivity disorder and chronic tic disorders

Preliminary findings suggest that color perception, particularly of blue-yellow stimuli, is impaired in attention-deficit/hyperactivity disorder (ADHD) as well as in chronic tic disorders (CTD). However, these findings have been not replicated and it is unclear what these deficits mean for the comorbidity of ADHD + CTD. Four groups (ADHD, CTD, ADHD + CTD, controls) of children with similar age, IQ and gender distribution were investigated with the Farnsworth-Munsell 100 Hue Test (FMT) and the Stroop-Color-Word Task using a factorial design. Color perception deficits, as indexed by the FMT, were found for both main factors (ADHD and CTD), but there were no interaction effects. A preponderance of deficits on the blue-yellow compared to the red-green axis was detected for ADHD. In the Stroop task only the 'pure' ADHD group showed impairments in interference control and other parameters of Stroop performance. No significant correlations between any FMT parameter and color naming in the Stroop task were found. Basic color perception deficits in both ADHD and CTD could be found. Beyond that, it could be shown that these deficits are additive in the case of comorbidity (ADHD + CTD). Performance deficits on the Stroop task were present only in the 'pure' ADHD group. Hence, the latter may be compensated in the comorbid group by good prefrontal capabilities of CTD. The influence of color perception deficits on Stroop task performance might be negligible.

Tilted disc syndrome and colour vision

To study colour vision in patients with tilted disc syndrome. Colour vision was examined using Boström-Kugelberg (B-K) plates, Farnsworth-Munsell 100-hue test (FM-100) and Farnsworth panel D-15 and Lanthony desaturated panel tests. A total of 35 eyes of 21 patients were examined. Seventeen eyes (49%) of 11 patients were found to have a colour vision defect in at least one eye. The severity of the colour vision defect differed between eyes for six of eight patients with bilateral tilted discs. In two of these patients, colour vision was normal in one eye. Seven patients had a unilateral tilted disc and three of these individuals had a colour vision defect in the affected eye. Of all eyes with a colour vision defect, a red-green defect was found in four eyes (24%), a blue defect in one eye (6%), and a mixed defect in 12 eyes (70%). Colour vision defects were not related to visual acuity or to severity of visual field defects. This is the first report of colour vision defects in tilted disc syndrome. In the differential diagnosis of tilted disc syndrome, chiasmal lesions and glaucoma, the examination of colour vision may add valuable information. Further, it is recommended that young people with tilted disc syndrome undergo an examination of colour vision so that they can be given appropriate career guidance.

Colour vision defects in occupational chronic solvent encephalopathy

Occupational chronic solvent encephalopathy (CSE) is associated with a number of neurobehavioural disorders including defects of visual perception. The purpose of this study was to characterize colour vision defects in CSE patients. Colour vision was tested in bright illumination with the Farnsworth-Munsell 100-hue test in workers who had CSE due to occupational exposure to common industrial solvents. Before assessing colour vision, the subjects' ocular health and visual functions were evaluated. On the basis of this evaluation, 36 subjects with healthy eyes were selected and their colour vision was tested monocularly. The colour vision performance of the patient group was, statistically, significantly inferior to that of a control group matched by age at a group level. A mixed form of reduced colour sensitivity was found in 42% (n=15/36) of the cases, affecting the entire range of Munsell hues. No association was found between the length and intensity of exposure and colour vision performance. Our results show that CSE patients can have significantly impaired colour discrimination ability, although their eyes are healthy and their other visual functions are normal. This may indicate toxic damage to higher level visual processing, possibly the colour selective regions of the cerebral cortex.

Scotopic sensitivity and color vision with a blue-light-absorbing intraocular lens

To investigate possible adverse effects of a yellow-tinted intraocular lens (IOL) on scotopic sensitivity and hue discrimination. Departments of Ophthalmology, Columbia University and New York University School of Medicine, New York, New York, USA. Nine patients with a yellow-tinted IOL in 1 eye and a colorless ultraviolet IOL in the fellow eye and 9 young phakic subjects with and without a yellow-tinted clip-on lens were tested. Hue discrimination was measured with the Farnsworth-Munsell (FM) 100-hue test. Dark-adapted thresholds to 440 nm, 500 nm, and 650 nm lights were measured at 23 locations using a modified Humphrey perimeter, and dark-adapted thresholds to white light were measured at 15 degrees temporal retina. In the 9 patients, there were no significant differences in dark-adapted sensitivities to 440, 500, 650 nm, or white-light stimuli and no differences in FM 100-hue error scores between eyes with yellow-tinted IOLs and those with colorless IOLs. Similarly, in young phakic subjects, there were no significant differences in FM 100-hue error scores or dark-adapted sensitivity to the white light with and without the yellow-tinted clip-on lens. However, with the clip-on lens, mean sensitivities to the 440 nm, 500 nm, and 650 nm stimuli were significantly decreased by 2.7 to 2.8 dB, 0.7 to 1.0 dB, and 0 to 1.2 dB, respectively. Results suggest that implantation of a yellow-tinted IOL has non-significant effect on scotopic sensitivity and hue discrimination.

Comparison of visual function following implantation of Acrysof Natural intraocular lenses with conventional intraocular lenses

Recently an intraocular lens (IOL) has been introduced which blocks blue light. As blocking blue light may be to the patient's detriment, this study was designed to evaluate visual function following implantation of a blue-blocking (Acrysof Natural) IOL. Patients were recruited for this non-randomized controlled interventional study, from those attending a private rural ophthalmology clinic for cataract surgery (n = 93). Only those who had previously had a conventional IOL implanted into one eye were offered an Acrysof Natural IOL for the second eye. Postoperatively patients underwent refracted Snellen visual acuity, contrast sensitivity using a CSV-1000E instrument and colour vision testing using a Farnsworth D-15 test, with a subset (n = 20) undergoing a Farnsworth-Munsell 100-Hue test. Results were then compared between eyes. Finally, a subset (n = 63) completed a survey designed to assess the subjective impact of the Acrysof Natural IOL. There were no statistically significant differences between eyes implanted with conventional IOLs compared with Acrysof Natural IOLs for visual acuity (t = 0.57; P = 0.57), contrast sensitivity (t = 0.43; P = 0.67 for 3 cycles per degree [cpd], t = 0.56; P = 0.58 for 6 cpd, t = 0.09; P = 0.93 for 12 cpd and t = 0.16; P = 0.87 for 18 cpd) or colour vision with the Farnsworth D-15 (Chi(2) = 0.38; P = 0.55) or the Farnsworth-Munsell 100-Hue test t = 0.34; P = 0.74). Most subjects reported that they could not tell a difference between the two IOLs subjectively or that any difference experienced was not significant. Our sample did not show any significant differences between eyes implanted with conventional IOLs and the Acrysof Natural IOL. We would suggest that the Acrysof Natural IOL may be used without any significant difference in visual function.

Changes in Colour Discrimination during the Menstrual Cycle

A group of normal women of reproductive age were recruited to investigate colour discrimination during the various phases of the menstrual cycle. Colour vision was tested with the Farnsworth-Munsell 100-hue arrangement test, and the test was administered at 3 time points: the beginning of the cycle, ovulation, and the end of the cycle. We found that colour discrimination was better at ovulation than at the other 2 time points. It is possible that psychological as well as hormonal factors could contribute to improved colour vision performance at ovulation.

Introducing a New Computer-based Test for the Clinical Evaluation of Color Discrimination

To evaluate the Portal color sort test (PCST), a new computer-based test of color vision, by comparing it with a series of clinical tests of color vision in normal and color deficient subjects. Prospective clinical laboratory study. Fifty-nine subjects with normal trichromatic vision or with congenital color vision defects underwent a series of color vision tests that included the 15-plate Ishihara test, the D-15 Farnsworth-Munsell test (D-15), the Farnsworth-Munsell 100-Hue test (FM 100-Hue), and the PCST under rigorous standardized conditions, as recommended by the respective manufacturers. The PCST generates a numerical discrimination score comparable to the FM 100-Hue. To test validity, discrimination scores generated by the PCST were compared with scores on the FM 100-Hue. The Spearman rank correlation between discrimination scores on the FM 100-Hue and the PCST was 0.8 (P < .001). Reliability was assessed by asking patients to retake the PCST at a later sitting. Patients retaking the PCST achieved similar scores on their second sitting as on the first. The correlation in the score between the two tests was 0.7 (95% confidence interval [CI]: 0.4-0.9, P < .001). Median (quartiles) time to complete the PCST was 3.1 minutes. This was faster than the FM 100-Hue time (P < .001), but slower than both the Ishihara and the D-15 (both P < .001). This study suggests that the PCST, a test of color vision deficiency, can be used effectively and reliably as a tool for screening (comparable to the Ishihara plates and the D-15) and grading (comparable to the FM 100-Hue) color discrimination ability.

End‐box scoring artefact evaluation of the Farnsworth‐Munsell 100‐Hue colour vision test

The scoring artefact in the Farnsworth-Munsell 100-Hue test, arising from the grouping of the caps into four boxes, was investigated. The traditional method of scoring performed with the numbers of the anchor caps disregarded and the alternative scoring performed with the numbers of the anchor caps employed, were compared. For the traditional method of scoring, we revealed an increase of the error score of the outside (end-box) caps when the total error score was above 240. On the contrary for scoring performed with the numbers of the anchor caps employed, the difference between the error score of the outside caps and the average error per cap is not significant. To mitigate the end-box artefact and to improve the reliability of the Farnsworth-Munsell 100-Hue test, corrections to the traditional method of scoring are proposed.

Contrast Sensitivity and Color Vision in HIV-infected Individuals Without Infectious Retinopathy

To investigate the relationship between abnormal contrast sensitivity and abnormal color vision among human immunodeficiency virus (HIV)-infected individuals who have normal visual acuity and to seek host factors that predict these abnormalities. Noninterventional, cross-sectional study. We evaluated 71 HIV-infected subjects with visual acuity of 20/25 or better, clear media, and no vision-threatening retinal lesions. Visual function was determined using the Pelli-Robson contrast sensitivity test and the Farnsworth-Munsell 100-Hue color test (FM-100). Results were compared with published values for normal populations and to measures of HIV disease severity. We evaluated two levels of impairment for each visual function. "Mild dysfunction" was defined as > or =1 standard deviation (SD), but <2 SD from normal means. "Abnormal" was defined as > or =2 SD from normal means. The prevalences of abnormal contrast sensitivity and abnormal color vision were 7.0% and 9.9%, respectively. We did not identify relationships between impaired contrast sensitivity and impaired color vision. Impaired color vision was associated with increasing age (r = 0.36, P = .002). We could not identify significant correlations between either contrast sensitivity or color vision values and the following factors: current or nadir (lowest previous) CD4+ T-lymphocyte count, HIV blood level, and Karnofsky score. Abnormal contrast sensitivity and abnormal color vision can occur independently in HIV-infected individuals and can be present in the absence of severe immunosuppression.

Color vision and macular recovery time in epileptic adolescents treated with valproate and carbamazepine

Visual dysfunction has been reported in patients diagnosed with epilepsy. Some of these visual disturbances may be attributable to either the disease process, or the anticonvulsant therapy prescribed to control the seizures. The aims of our study were to evaluate whether color vision and macular function are impaired in epileptic adolescents, to study if the monotherapy with valproic acid (VPA) and carbamazepine (CBZ) can affect color vision and macular function and to determine the possible relationship between color vision, retinal function and antiepileptic drugs (AEDs) dosage and their serum concentrations. We examined 45 (16 male and 29 female, mean age +/- SD, 15.71 +/- 2.01 years) Caucasian epileptic patients suffering from various types of cryptogenic epilepsy before the beginning of therapy and after 1 year of VPA or CBZ monotherapy and 40 sex- and age-matched healthy controls. Color vision was assessed by Farnsworth Munsell (FM) 100-hue test and total error score (TES) was evaluated. This test consists of colored caps: the testee has to arrange the caps according to their colors macular function was assessed by nyctometry evaluating initial recovery time (IRT) and summation method (SM). This test evaluates visual acuity after a period of intense illumination of macula. Analysis of variance was used to evaluate the difference between controls and patients; moreover, Pearson's correlation test have been performed. Before the beginning of therapy, there were no differences in color vision and macular function between controls and epileptic patients. After 1 year, the patients, treated with VPA or CBZ, showed a deficit in FM 100-hue test. At nyctometry, all patients showed no significant variation of macular function between baseline evaluation and second evaluation at end of the follow-up. Our study demonstrates that, in our group of epileptic patients, epilepsy per se does not affect color vision and retinal function. In contrast, after 1 years of therapy with VPA and CBZ these patients showed a deficit in FM 100-hue test although nyctometry evaluation continued to be normal allowing to exclude an impairment in macular function. Further investigations are required to determine the pathophysiological alteration(s) that are at the basis of color perception defects.

Colour perception in ADHD

Attention-deficit/hyperactivity disorder (ADHD) is associated with unexplained impairments on speeded naming of coloured stimuli. These deficits may reflect hypofunctioning retinal dopaminergic mechanisms impairing particularly blue-yellow colour discrimination. Colour perception and rapid colour naming ability were investigated in 14 children with ADHD and 13 healthy peers matched for age, gender, and IQ, using the Farnsworth-Munsell 100 Hue Test (FMT) and the Stroop-Colour-Word test. Children with ADHD committed more errors on the FMT, particularly on discrimination of colours along the blue-yellow axis, and were slower on Stroop subtests involving colour naming. However, the latter deficit was accounted for similarly by blue-yellow and red-green discrimination abilities. Blue-yellow colour perception problems in ADHD contribute to but do not fully explain the observed slowed colour naming.

Color perception with AcrySof Natural and AcrySof single-piece intraocular lenses under photopic and mesopic conditions

To examine color perception in patients receiving bilateral implantation of an ultraviolet (UV) and blue-light filtering intraocular lens (IOL) (AcrySof Natural SN60AT, Alcon Laboratories Inc.) or a UV-only filtering IOL (AcrySof SA60AT) and to compare the results with those in a phakic group. Cincinnati, Ohio, USA. In this prospective study, age-matched subjects who passed the Ishihara test and had visual acuities of 20/25 or better were recruited. There were 2 pseudophakic groups (bilateral SN60AT or SA60AT IOLs) and 1 phakic group. The Farnsworth-Munsell (FM) 100-hue test was administered to each subject twice under different conditions. The phakic and AcrySof Natural SN60AT groups were tested under photopic and mesopic conditions. The SA60AT subjects were further divided into subgroups (with and without yellow clip-on lenses) and tested under photopic and mesopic conditions. A 1-way analysis of variance (ANOVA) of the square-root-transformed total error score showed no statistical differences (P = .637) between the treatment groups. Similarly, a 1-way ANOVA of the red-green error score (P = .729) and blue-yellow error score (P = .484) indicated no statistically significant differences between the treatment groups. The ANOVA results of the FM 100-hue test under mesopic conditions showed that the total error score in the AcrySof Natural IOL group was significantly lower (P = .046) than in the phakic group. There were no between-group differences in error scores under mesopic conditions. The FM 100-hue testing showed no difference in color perception between subjects with AcrySof Natural IOLs and those in an age-matched phakic control group or in those with a UV-only filtering AcrySof IOL with or without yellow clip-on lenses.

Improvement in colour vision parameters following successful trabeculectomy

To determine whether colour vision improves following reduction of intraocular pressure (IOP) in glaucoma patients. The medical records of 29 glaucoma patients (41 eyes) were reviewed. Inclusion criteria required subjects to have made more than four visits to the Glaucoma Service Laboratory and to undergo a thorough eye examination including a Farnsworth-Munsell 100-hue colour vision test and Goldmann tonometry before and after pressure lowering. Colour vision parameters of total error score (TES), yellow-blue score (YBS) and red-green score (RGS) were measured. The study group consisted of 21 eyes of glaucoma patients who underwent uncomplicated trabeculectomy with an IOP reduction of >/= 20% from baseline. The control group consisted of 21 eyes of glaucoma patients matched for age and colour vision, who received medication and/or underwent surgery with a post-intervention IOP reduction of < 20% from baseline. The primary outcome was a comparison of pre- and post-intervention colour vision parameters between the two groups. There was a statistically significant improvement in TES (43 +/- 44, p < 0.001), RGS (19 +/- 27, p = 0.0077) and YBS (23 +/- 29, p = 0.0007) in the study group compared with the control group. The improvement in TES (r = 0.52, p < 0.001), RGS (r = 0.55, p < 0.001) and YBS (r = 0.40, p = 0.008) was correlated with the percentage of IOP reduction. There was no statistically significant difference between improvement in Y-B and R-G scores in the study group. Intraocular pressure reduction of >/= 20% post-trabeculectomy was associated with an improvement in colour vision. Colour vision tests may be useful as an adjunctive outcome measure for therapeutic interventions.

Colour vision and retinal nerve fibre layer photography in patients with an Acrysof® Natural intraocular lens

To study colour vision and retinal nerve fibre layer (RNFL) photographs in patients with an Acrysof Natural intraocular lens (IOL). We carried out a randomized double-blind study. An Acrysof Natural IOL (model SN60AT) was implanted in 25 eyes of 19 patients and an Acrysof IOL (model SA60AT) was implanted in 27 eyes of 18 control patients. The patients returned for colour vision tests and fundus photography 1-6 months after the surgery. Standard pseudoisochromatic plates, part 2, were correctly interpreted and the Farnsworth-Munsell 100-hue test (FM 100) total and individual box scores were normal in all IOL eyes. In the FM 100 hue test there were no significant differences in the results of the total error scores or the error scores of the individual boxes between the eyes with Acrysof Natural and those with Acrysof lenses. The yellow coloration of the Acrysof Natural IOL did not affect the visibility of the RNFL in photographs. The Acrysof Natural IOL did not affect colour vision in the tested patients, even in the blue region of the spectrum, and can be implanted in patients who need to have normal colour vision for the purposes of their occupation. The Acrysof Natural IOL does not interfere with RNFL photography and can also be used in patients with glaucoma.

Evaluation of the New Web-Based “Colour Assessment and Diagnosis” Test

The purpose of the study was to determine the sensitivity, specificity, and repeatability of the web-based Colour Assessment and Diagnosis (CAD) test in comparison to current tests of color vision. Thirty color normals and 30 color deficients, identified and diagnosed by the Nagel anomaloscope, were tested. The results of the CAD test were compared with standard tests like Nagel anomaloscope, Ishihara (concise version, 2001), Hardy, Rand and Rittler (HRR; 4 ed) pseudoisochromatic test, and the Farnsworth Munsell 100 (FM-100) hue test. Using the Nagel anomaloscope as the "gold standard," the sensitivity with the CAD test was 93.33%, Ishihara 96%, HRR 100%, and the FM-100 hue 100%. The specificity was 100% with CAD and the Ishihara color plates, whereas it was 33% with the HRR and 83% with the FM-100 hue test. The concurrent validity of the CAD test for color normals was 93.75%. The concurrent validity of CAD test for color deficiency was 100%. Thus, anyone failing the CAD test has a color defect. The coefficient of agreement for the Nagel anomaloscope and the CAD test was 0.93, with Ishihara it was 0.96, with the HRR it was 0.33, and with FM-100 hue it was 0.83. These results showed that the CAD test is a valid test for identifying congenital red-green color deficiency. Further testing is required in a larger population of anomalous trichromats.

Colour Vision in Migraine: Selective Deficits for S-Cone Discriminations

Three studies are reported that explore colour perception in migraine. In each, sensitivity for colours detected selectively by the S-cones and the L- and M-cones was assessed separately. The first study assessed the discrimination of small colour differences using the Farnsworth-Munsell 100-hue test. The second assessed threshold detection for purple, yellow, red and green targets on five equiluminant background colours. The third examined supra-threshold colour scaling using two colour series, purple-yellow and red-green. Each study indicated that differences in colour perception between migraine and control groups were restricted to colours detected by the S-cones, there were no differences in performance for colours detected by the L- and M-cones. The results are discussed in terms of possible pathologies in the early visual pathways.

Colour vision and contrast sensitivity losses of mercury intoxicated industry workers in Brazil

We evaluated vision loss in workers from fluorescent lamp industries ( n = 39) who had retired due to intoxication with mercury vapour and had been away from the work situation for several years (mean = 6.32 years). An age-matched control group was submitted to the same tests for comparison. The luminance contrast sensitivity (CSF) was measured psychophysically and with the sweep visual evoked potential (sVEP) method. Chromatic red–green and blue–yellow CSFs were measured psychophysically. Colour discrimination was assessed with the Farnsworth–Munsell 100-hue test, Lanthony D-15d test and Cambridge Colour Vision Test. Patient data showed significantly lower scores in all colour tests compared to controls ( p < .001). The behavioural luminance CSF of the patients was lower than that of controls ( p < .001 at all frequencies tested). This result was confirmed by the electrophysiologically measured sweep VEP luminance CSF except at the highest frequencies—a difference that might be related to stimulus differences in the two situations. Chromatic CSFs were also statistically significantly lower for the patients than for the controls, for both chromatic equiluminant stimuli: red–green ( p < .005) and blue–yellow ( p < .04 for all frequencies, except 2 cycles per degree (cpd), the highest spatial frequency tested) spatial gratings. We conclude that exposure to elemental mercury vapour is associated with profound and lasting losses in achromatic and chromatic visual functions, affecting the magno-, parvo- and koniocellular visual pathways.

Reduced Stroop Interference for Opponent Colors May Be Due to Input Factors: Evidence From Individual Differences and a Neural Network Simulation.

Sensory or input factors can influence the strength of interference in the classic Stroop color-word task. Specifically, in a single-trial computerized version of the Stroop task, when color-word pairs were incongruent, opponent color pairs (e.g., the word BLUE in yellow) showed reduced Stroop interference compared with nonopponent color pairs (e.g., BLUE in red). In addition, participants' color discrimination ability was measured by standard color vision tests (i.e., Farnsworth-Munsell 100-Hue Test and Ishihara plates). Error rates in the Farnsworth-Munsell test correlated positively with the amount of Stroop interference. Neural network simulations (variants of J. D. Cohen, K. Dunbar, & J. L. McClelland's, 1990, model) showed that only a distributed trichromatic input layer was able to simulate these findings. Thus, sensory input from the color system needs to be incorporated into current accounts of the Stroop effect.

Dominant Optic Atrophy Caused by a Novel OPA1 Splice Site Mutation (IVS20+1G→A) Associated with Intron Retention

Dominant optic atrophy (DOA) is the most common form of inherited primary optic neuropathy. The purpose of the current study was to report a novel OPA1 splice site mutation and investigate the impact of the mutation on pre-mRNA splicing in a female proband and her father diagnosed with DOA. We evaluated visual acuity, retinal fundi and kinetic visual fields. Color vision phenotypes were determined using the Farnsworth Panel D-15 and the Farnsworth-Munsell 100-hue tests. All 28 coding exons of the OPA1 gene were analyzed with polymerase chain reaction (PCR) amplification and direct sequencing. Total RNA extraction from white blood cells followed by reverse transcription-PCR (RT-PCR) was performed. We identified a novel heterozygous G to A mutation at position +1 of intron 20 (g.IVS20+1G→A) in both patients. RT-PCR analysis revealed that the first 25 bp from intron 20 plus exon 20 were spliced onto exon 21. No difference in expression of mutant and wild-type transcripts was found within the linear range of amplification. Clinically, both patients exhibited reduced visual acuities, pallor of optic discs, decreased sensitivities of central visual fields and blue-yellow color vision defects. Previously, only one mechanism (skipping of exon) of pre-mRNA splicing defects has been reported among OPA1 splice site mutations. Our study demonstrates that the mechanism of intron retention is a novel type of pre-mRNA splicing defects. The mutant transcript with a premature termination codon is likely to encode a truncated protein, due to a translational frameshift (V672fsX675), that lacks 289 amino acids of the C-terminal end. Therefore, it is suggested that haploinsufficiency underlies DOA in the patients. However, we could not exclude the possibility that the truncated protein has a dominant negative activity because the mutant transcript is insusceptible to nonsense-mediated mRNA decay.

A fast system for reporting the Farnsworth?Munsell 100-hue colour vision test

We have developed a system for rapidly reporting the Farnsworth-Munsell (FM) 100-hue test using a personal computer and a bar code scanner. The computer generated report duplicates the conventional manual report of the FM 100-hue test so is very familiar to ophthalmologists and optometrists. The new system has proved to be of great assistance both in saving time and in eliminating arithmetic errors in the scoring calculations. The scanner technique produces two reports, one for each eye, within 4 min of the patient completing the test. This compares with the 60 min required by the conventional manual reporting system. In addition, it also gives a statistical analysis of the results in accordance with Verriest norms. The program is very versatile and user friendly, achieving a standard not present in the other FM 100-hue computerised systems currently available. As a consequence it makes this valuable diagnostic test much more accessible to patients and clinicians.