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S.S. Block, D. Lee, J. Hoeppner, A. Birr; Comparison of the Neitz Test of Color Vision to the Ishihara Color Vision tests and the anomaloscopic classification . Invest. Ophthalmol. Vis. Sci. 2004;45(13):1384.
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Purpose:The purpose of this study was to compare the results of the Neitz Test of Color Vision (Neitz) to the anomaloscope, which is the gold standard for color vision testing, as well as to compare the Ishihara color vision test, which is a commonly used screening for color vision, to the anomaloscope. Methods:The first part of the study involved forty students (25 males, 15 females) from the Illinois College of Optometry. Each subject was tested with the Neitz and Ishihara tests under the Macbeth Easel lamp as well as the anomaloscope. Only one of the 3 forms of the Neitz test was used. The second part of the study asked 5 color deficient subjects to complete each of the 3 forms of the Neitz test under both the Macbeth lamp and the recommended light source (daylight fluorescent). Results:The anomaloscope identified 14 color abnormals out of the 40 subjects. Sensitivity of the Neitz test as compared to the anomaloscope was 100%, specificity 86.4%, and PPV 70%. The responses from one subject were inconclusive based on the Neitz scoring criteria. One subject was abnormal but could not be classified. There was agreement in the diagnosis in only 4 of color vision abnormal subjects between the Neitz and anomaloscope. Sensitivity and specificity of the Ishihara as compared to the anomaloscope were both 100%. Five color deficient individuals were retested and demonstrated identical outcomes for each of the 6 administrations of the Neitz tests (3 forms, 2 illumination sources). Conclusions:The Neitz test has been recently released to screen color vision for large groups of children or adults. The test can be administered under fluorescent lights or daylight. The results show that the Neitz test has high sensitivity and specificity and moderate PPV however, the diagnostic aspect of the test fails to agree with the gold standard. In addition, figure ground confusion in the adult subjects may prevent accurate diagnosis. The Ishihara has high sensitivity, specificity, and PPV and is still the test of choice.
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