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Color vision defect type and spatial vision in the optic neuritis treatment trial
M E Schneck1, G Haegerstrom-Portnoy
1Smith-Kettlewell Eye Research Institute, San Francisco, California 94115-1821, USA.
Purpose:
To describe the types of color vision defects present in the acute phase of the disease and 6 months into recovery in the 438 participants of the Optic Neuritis Treatment Trial.
Methods:
Patients meeting strict eligibility criteria were seen within 8 days of the onset of symptoms and then at regular follow-up visits. At the first and 6-month visits (and subsequent annual visits), spatial vision (acuity, contrast sensitivity), visual fields, and color vision were measured. Farnsworth-Munsell 100-hue tests were scored by a variant of the method of quadrant analysis described by Smith et al (Am J Ophthalmol. 1985; 100:176-182).
Results:
Most persons show mixed red-green (RG) and blue-yellow (BY) color defects (one type predominating, accompanied by a lesser defect of the other type). BY defects tend to be slightly more common in the acute phase of the disease, with slightly more RG defects at 6 months. Persons may shift defect type over time. Defect type was not related to any of the spatial vision measures at either test time or to treatment group; however, severity of color defect was related to both spatial vision measures and treatment group.
Conclusions:
Contrary to common clinical wisdom, optic neuritis is not characterized by selective RG defects. Color defect type cannot be used for differential diagnosis of optic neuritis.