Abstract
We report normative cone contrast sensitivity values, right–left eye agreement, and sensitivity and specificity values for the cone contrast test-HD (CCT-HD). We included 100 phakic eyes with color vision normal (CVN) and 20 dichromatic eyes (10 with protanopia and 10 with deuteranopia). The CCT-HD was used to measure L, M, and S-CCT-HD scores, and the right and left eyes were evaluated for agreement using Lin’s concordance correlation coefficient (CCC) and Bland–Altman analysis to investigate the sensitivity and specificity of the CCT-HD based on diagnosis with an anomaloscope device. All cone types were in moderate agreement with the CCC (L-cone: 0.92, 95% CI, 0.86–0.95; M-cone: 0.91, 95% CI, 0.84–0.94; S-cone: 0.93, 95% CI, 0.88–0.96), whereas the Bland–Altman plots showed that the majority of cases (L-cone: 94%; M-cone: 92%; S-cone: 92%) fell within the 95% limits of agreement and showed good agreement. The ${\rm mean}\;{\pm}\;{\rm standard}$ error L, M, and S-CCT-HD scores for protanopia were ${0.6}\;{\pm}\;{1.4}$, ${74.7}\;{\pm}\;{2.7}$, and ${94.6}\;{\pm}\;{2.4}$, respectively; for deuteranopia, these were ${84.0}\;{\pm}\;{3.4}$, ${40.8}\;{\pm}\;{3.3}$, and ${93.0}\;{\pm}\;{5.8}$, respectively; and for age-matched CVN eyes (${\rm mean}\;{\pm}\;{\rm standard}$ deviation age, ${53.1}\;{\pm}\;{5.8}$ years; age range, 45–64 years), these were ${98.5}\;{\pm}\;{3.4}$, ${94.8}\;{\pm}\;{3.8}$, and ${92.3}\;{\pm}\;{3.4}$, respectively, with significant differences between the groups except for S-CCT-HD score (Bonferroni corrected $\alpha = {0.0167}$, $p \lt {0.0167}$). The sensitivity and specificity of the CCT-HD were 100% for protan and deutan in diagnosing abnormal types in those aged 20 to 64 years; however, the specificity decreased to 65% for protan and 55% for deutan in those aged ${\gt} {65}$ years. The CCT-HD is comparable to the diagnostic performance of the anomaloscope in the 20–64-year-old age group. However, the results should be interpreted cautiously in those ${\ge} {65}$ years, as these patients are more susceptible to acquired color vision deficiencies due to yellowing of the crystalline lens and other factors.
© 2023 Optica Publishing Group
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