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Colour vision as a screening tool for sub‐clinical retinal disease
Author(s) -
KONSTANTAKOPOULOU E,
BARBUR JL
Publication year - 2012
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2012.3473.x
Subject(s) - mesopic vision , photopic vision , retinal , ophthalmology , medicine , retina , glaucoma , subclinical infection , optometry , chromatic scale , color vision , pathology , biology , optics , neuroscience , physics
Purpose Age‐related retinal diseases start developing at a subclinical level, as gradual photoreceptor dysfunction, ganglion cell apoptosis etc. Subtle retinal changes disturb the fine intraretinal signal transmission and despite the lack of clinically detectable signs can cause an impairment of chromatic sensitivity that precedes the loss of performance in processing other stimulus attributes. Colour vision can be used as a sensitive screening tool for retinal diseases when the tests are carried out at lower light levels. Methods The health of the retina (HR) index was introduced to detect early changes caused by disease by capturing the worsening of chromatic sensitivity as the light level changes from photopic to mesopic (J Opt Soc Am A Opt Image Sci Vis 29,2:A27‐A35,2012). This approach makes it possible to separate changes caused by normal aging from the effects of sub‐clinical retinal disease. Chromatic sensitivity was measured in 60 subjects (mean age 47.6 years, range 16‐79 years) at four light levels using the Colour Assessment and Diagnosis (CAD) test; measurement of pre‐receptoral absorption by the crystalline lens and the macular pigment and the size of the pupil allowed an estimation of retinal illuminance. Results The HR index proved largely independent of age (r2~0.2), but ~11% of clinically normal older subjects showed impaired chromatic sensitivity that could reflect the development of retinal pathology. Some of these subjects developed AMD and Glaucoma 2.5 years after the assessment. Patients with identified retinal disease also show abnormal HR indices. Conclusion The HR index is a single number that captures information about the health of the retina irrespective of age and can be used to screen for sub‐clinical signs of retinal diseases.