Innovative Color Vision Testing (simultaneous congenital & acquired) Stuart P Richer, OD, PhD, FAAO...
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Innovative Color Vision Testing (simultaneous congenital & acquired) Stuart P Richer, OD, PhD, FAAO Director, Ocular Preventive Medicine James A Lovell Federal Health Care Facility Associate Professor, Family and Preventive Medicine, Rosalind Franklin University of Medicine & Science / Chicago Medical School North Chicago, Illinois 60064, USA Assistant Clinical Professor, UIC Dept of Ophthalmology and Visual Science - Chicago Stuart.Richer1 @VA.GOV AAO 11 Nov 2014 AFOS
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Transcript of Innovative Color Vision Testing (simultaneous congenital & acquired) Stuart P Richer, OD, PhD, FAAO...
Innovative Color Vision Testing(simultaneous congenital & acquired)
Stuart P Richer, OD, PhD, FAAO
Director, Ocular Preventive Medicine
James A Lovell Federal Health Care Facility
Associate Professor, Family and Preventive Medicine, Rosalind Franklin University of Medicine & Science /
Chicago Medical School
North Chicago, Illinois 60064, USA
Assistant Clinical Professor, UIC Dept of Ophthalmology and Visual Science - Chicago
AAO 11 Nov 2014AFOS
Rabin Cone Contrast Testby Innova Systems
• 15 Years of US Air Force research
• Published, Peer Reviewed
• Validated against Anomaloscope
• Innova Approved as Sole Color Vision Test for US Air Force
• Over 400 in Use Worldwide
• Colored letters stimulate single cone type / pathway
• Decreasing contrast steps detects cone function threshold
• Numeric scores provide Hereditary vs. Acquired discrimination
• Change over time metric
1 V Z N F U
2 F V N H P
3 R P F D U
4 Z E D H P
5 H R P E D
6 D R E Z U
7 N Z V E H
8 U V R N F
9 E R P D N
10 D V H F E
1 H V R N F
2 D R E Z U
3 N Z V E P
4 Z E D N F
5 H R P E D
6 F V N H P
7 R P F D U
8 V Z N F H
9 H P F D N
10 V H U R E
1 D R E Z U
2 F V N H P
3 R P F D U
4 N Z V E H
5 H R P E D
6 V Z N F U
7 Z E D H P
8 U V R N F
9 H P F D N
10 V N P U D
Red Cone Green Cone Blue Cone
Cone Contrast Sensitivity
Rabin Cone Contrast Test by Innova Systems
• A Color Vision Test Sensitive Enough to Detect Severity of Cone Deficiency
• Used to Detect and Monitor Acquired Color Deficiency– AMD– Glaucoma– Diabetic Retinopathy– MS– Parkinson’s Disease– TBI– Retinal Toxicity due to High
Risks meds such as Plaquenil
0
10
20
30
40
50
60
70
80
90
100
0 10 20 30 40 50 60 70 80 90 100
CCT Score (right Eye)
CCT Score (left Eye)
> 2SD
Normal upper right quadrant
75
75
Green deficiency (n=183)
Red deficiency (n=43)
Normals (n=92)
Upper 5% color
deficients
> 5SD
60
60
> 5SD
In color deficiency and in normals
Color Normalvs.
Deficient
a
BLUE CONE LOSS1. Acquired blue cone loss occurs early in
eye disease, sometimes before visual field defect(s)
2. Very few blue cones: small amount of damage has large effect
3. Secondary to disease, trauma or toxicity
4. Often asymmetric
Rabin Cone Contrast in Eye DiseaseAcquired Color Deficiency
0
25
50
75
100
RedScore
GreenScore
BlueScore
0 0.5 1 1.5 2 2.5
Central Serous
Normal Eye
Rabin Log Score
Acquired Color Deficiency in Central Serous Retinopathy
normal range
Red cone
Green cone
Blue
Red cone
Green cone
Blue (Tritan)
Blue
RE & LE 20/20
Acquired Color Deficiency in Optic Neuritis
(Blue – Tritan)
0 20 40 60 80 100
Blue Cone Rabin Score
RE(20/15
VA)
LE(20/15
VA)
2 SDs
5 line decrease
Normal mean
Resolved Optic Neuritis
Right Eye•Tritan Defect•MRI & CSF—•Probable MS
170 ms
LE
RE
109 ms
170 ms
LE
RE
109 ms VEP
170 ms
LE
RE
109 ms
170 ms
LE
RE
109 ms VEP
Current Research• Military - Cases of Optic Neuropathy
– Identified with RCCT that was missed by all other equipment. – Cone recovery shown with RCCT.
• Military – Central Serous Retinopathy• Military – Traumatic Brain Injury
– Identified with RCCT
• Duke University – Dry AMD– Clinical Trial results: the AREDS 3 intermediate AMD group exhibited visual
dysfunction on the Rabin Cone Contrast Test, in the presence of normal visual acuity
– New clinical trial begins fall 2014
• Other: Diabetes , MS, Plaquenil, Alzheimers, Glaucoma, Macular Pigment Density Loss
Patient BenefitSimultaneous Hereditary + Acquired Color Vision Evaluation
1. Identification of patients at-risk for developing disease.
2. Earlier recognition and intervention of disease.
3. Rapid detection of disease progression.
4. Evaluation of treatment efficacy.
Improved Quality of
Care
Macular Health Center
• VEP………………………………….………….…$156.77• ERG……………………………………………….$184.67• Macular Pigment ……………………………$25.00
• OCT ………………………………………………..$50.73• Multi-Spectral Imaging…………………...$91.41• Rabin cone contrast sensitivity………..$67.28• Gene Testing – Macula Risk,99213…. $81.30
• Total per Patient…………..………………...$657.16• x 50 patients/year……………..……....$32,858.00
Rabin Cone Contrast TestEye Disease Detection and Monitoring
byInnova Systems
AFOS Room FAAO Booth #314
