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L. Membrey, H. Jayaram, P. Moradi, D. Ezra, H. Sheth, A. Laidlaw; Recovery of Colour Vision After Surgery for Rhegmatogenous Retinal Detachment Involving the Macula . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5508.
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Purpose: To investigate changes in colour vision after retinal detachment surgery and to compare three types of colour vision assessment Methods: Patients were recruited who had macular involving rhegmatogenous retinal detachment. Colour vision was assessed using the Ishihara Pseudoisochromatic Plates (IPP), the Farnsworth Munsell 100 hue (FM) test and the Cambridge Colour Contrast trivector (CCCT) test done in random order. In addition refractive error was assessed together with LogMAR acuity using the EDTRS chart and contrast sensitivity using the Pelli–Robson chart. They underwent ocular examination with pupil dilation with LOCS III lens opacity grading and optical coherence tomography (OCT) of the macular. Testing was done prior to retinal detachment surgery and then at 2 months postoperatively Results:Six patients (2 male) were recruited with a mean age of 56 years (SD 6.5). They had a median refractive error of –3.5 (IQ range –5.3 to 0.0) at baseline which increased to –6.7 (IQ range –8.1 to –4.1) (p=0.04) at 2 months. All subjects showed evidence of central macular reattachment on OCT scanning at 2 months. There was an increase in the number of EDTRS letters from 3.0 (IQ range 0.0 to 22.0) at baseline to 27.0 (IQ range 25.5 to 31.0) (p=0.04) at 2 months. There was also an increase in the Pelli–Robson contrast sensitivity from 1.0 (IQ range 0.0 to 6.0) at baseline to 10.0 (IQ range 9.0 to 12.0 (p=0.04). None of the subjects could identify any of the IPPs apart from the test plate at baseline. At 2 months only one error was made by one subject on the IPP. At baseline only 3 subjects were able to order the FM caps and the square root of their total error scores were 25.9, 26.7 and 33.2. The median of the square root of the total error score was 10.3 (IQ range 9.6 to 14.7) at 2 months. None of the subjects responded to the maximum threshold stimulus on the CCT at baseline. At 2 months the median protan, deutan and tritan thresholds were 124.0 (IQ range 111.0 to 202.3), 171.0 (IQ range 151.0 to 225.5) and 469.0 (IQ range 280.8 to 966.3). Two subjects showed a tritan axis postoperatively on the FM and CCCT, these were also the subjects with the greatest lens yellowing on LOCS III grading. Conclusions: Abnormalities of colour vision may occur after successful retinal reattachment surgery and these are demonstrable with the Farnsworth Munsell 100 hue test and the more recently developed Cambridge Colour Contrast test. The Ishihara pseudoisochromatic plates appear to be less sensitive to these colour vision defects. Tritan defect seen postoperatively may be associated with yellowing of the crystaline lens.
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