Ophthalmologica, Basel 177: 284-291 (1978)
Lanthony’s New Color Test Part I A . Pinckers Institute of Ophthalmology (Head: A. F. Deutman), University of Nijmegen, Nijmegen
The New Color Test (NCT) is disigned by Lanthony and manufactured by Luneau in Paris [1975]. There are 60 colored caps with value 6, divided into 4 series of differ ent saturation according to the chroma scales 2, 4, 6 and 8 respectively, thus rep resenting four 15 Hue tests. In addition to the 60 colored caps the NCT has 10 grey caps with a reflection coefficient varying from Y = 12% to Y = 60%.
Test Procedure Fifteen colored caps of an equal chroma scale are mixed with the grey caps and then presented to the subject who is asked to separate the 25 caps into two groups; a colored and a grey group, (a) If the separa tion is incorrect the subject is asked to ar range the caps considered as grey from dark to white, (b) If the separation was correct the subject has to arrange the colored caps in the way as the panel D-15, starting with a cap of his own choice. The NCT enables to detect the confusion
direction and also the neutral zone. Accord ing to the NCT manual [1975] the neutral zone in acquired deficiencies does not neces sarily coincide with the confusion direc tion. In this study we compared the NCT with the panel D-15, retest desaturated panel (1975) according to Lanthony (value/chroma 8/2) and the AOH-R-R in 31 subjects and thereafter we compared the NCT with the AOH-R-R in 114 subjects. The reason for this set up was that the NCT manual sug gests that there is an approximate equiva lence between the AOH-R-R and the NCT, the NCT chroma 2 being equivalent to ‘supermild’, chroma 4 to ‘mild’, chroma 6 to ‘me dium’ and chroma 8 to ‘strong’ AOH-R-R defect. The subjects examined worked at the Nijmegen University; none of them were un der ophthalmological control at the time of examination.
Illumination 6 Philips T. L. tubes, 1,750 lx, placed at 1 m above the examination table, used for all the tests performed.
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Introduction
Lanthony’s New Color Test
285
Comparison between NCT, D-15, D8/2 and AOH-R-R in 31 Subjects (61 Eyes)
Table I. Selection by AOH-R-R; 55 normal eyes
AOH-R-R Panel D-15 NCT 6/2 D 8/2
ME
55 53 47 29
—
//BY
-
7 8
I 0-15
(BY) 2
NCT 6/2
(No) 2
08/2
(BY)2 (BY)13 (M E)5 (RG)1 (No)26
I
I
(No)53
(ME)7
-
-
3
No
1ME 2ME //BY //RG Total
No 1ME 1//T Total
28 3 31
10 2 12
5 1
3 1 4
6
1 1 2
47 7 1 55
Table III. Comparison between AOH-R-R and NCT (114 subjects, 228 eyes) Age, years
Subjects, n
Codification Eyes, n AOH-R-R results
15-20 20-25 25-30 30-35 35-40 40-45 45-50 50-55 Total
8 28 35 20 12 4 5 2 114
206 SNo supermild 2 mild RG 4 medium RG 10 strong RG 3 NE 3 — Total 228
1
medium 3
mild 1
strong 1
'll
1
/ \
i
BY) 1
(BY)1
(ME) 2 (RG) 1
(RG)1
1
(No) 45
_
2 1 15
NCT 6/2
ermild '1
(No) 55
-
Table II. NCT 6/2 versus desaturated panel 8/2
RG defect l A O H -R -R
//RG
!
(BY) 1 ¡(mixed)l (BY)1
I ¡1
/RG) 1[(Dr/T) 1 (No) 3 (ME) 3 (RG) 11
!
(XX) 1
J
(No) 2
!
(RG) 1
, I
\(R G ) 1 (No) 1 (RG) 1
I (RG) 1
1 (RG) 1
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In these 61 eyes the AOH-R-R results are as follows: normal screening (SNo): 55 eyes; supermild RG defect: 1 eye; mild RG defect: 1 eye (amblyopia); medium RG de fect: 3 eyes; strong RG defect: 1 eye. The schematic representation of all the results is shown below. Not all the patients with normal AOHR-R results passed the other tests without error, the sequence being AOH-R-R:D-15: NCT6/2:D8/2 = 55:53:45:26. Table I is bas ed on the normal AOH-R-R results and in dicates a gradual increase in sensitivity from AOH-R-R test to the desaturated panel (D8/2). The results of the NCT 6/2 plot ted against the desaturated panel are shown in table II. Figure 1 represents normal panel D-15 results (53 eyes) retested with the desaturat ed panel 8/2. The desaturated panel 8/2 shows blue-yellow confusions and this cor responds to the findings of Pinckers et al. [1976] shown in figure 2. The conclusions of this first investiga tion are: (a) if the panel 8/2 result is nor mal, examination with the NCT 6/2 yields no further information; (b) the panel D 8/2 tends to false-positive blue-yellow confu sions; (c) false-positive red-green confusions
No
Pinckers
286
TEST 15
HUE
D È S A T U R É de L A N T H O N Y selon F A R N S W O R T H - M U N S E L L
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A g e : ..... -...
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Diagnostic : .......... .................. ................................
TEST S T A N D A R D ordre donné par le sujet :
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
TEST D É S A T U R É ordro donné par le sujet :
T ES T S T A N D A R D ( No 53)
T E S T D E S A T U R E ( No 2 9 )
LUNCAU OPHTALMOLOGIE • 3 . A u l O I oimiov /» » • 7 3 0 0 6 PARIS
with the panel D 8/2 are not excluded; (d) there is a gradual increase in sensitivity from the AOH-R-R, via the panel D-15 and the NCT 6/2 to the desaturated panel D 8/2 .
The New Color Test As mentioned before we compared the results of the AOH-R-R and the NCT in 114 subjects (228 eyes); the subjects studied
in the first part are not included. The age incidence and the results of the AOH-R-R examination are represented in table III. The AOH-R-R was normal in 206 eyes; of these the NCT 6/2 separation phase was correct in 194 eyes and incorrect in 12 eyes. In fact more cases in the first instance per formed an incorrect separation, but most of them corrected themselves when asked to arrange the grey caps from dark to white. It is for this reason that we asked to classify
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Fig. 1. Panel D 8/2 results in cases with normal panel D-15 performance; only 2 cases made a red-green confusion.
Lanthony’s New Color Test
TEST S T A N D A R D ordre donné par 1« tujct :
287
—
— 1
TEST D É S A T U R É ordre donné por le sujet :
—
— 2
v_y —
3
— 4
— 5
6
7
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““
v_>— v_y— > f
—
TEST ST A N D A R D
8
9 1—
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10
11 2
12
13
14
15
v_y v_y v_>
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the (remaining) colored caps also in the 12 cases, listed as incorrect separation. The results are shown here: NCT 6/2 classifica tion if AOH-R-R is normal (206 eyes): No: 162 eyes; MEs: 27 eyes; //BY: 13 eyes; //DT: 2 eyes; //RG: 2 eyes. There is no exact correlation between the caps of the panel D-15 or the D 8/2
and the caps of the NCT. It is therefore not surprising that the distribution of the minor errors (MEs) in the NCT is less confined to the blue-yellow region of the spectrum (fig. 3) than the desaturated 8/2 version shows (fig. 2). However, the incorrect se sepa rated colored NCT caps, listed also if cor rected afterwards, indicate, nevertheless, an
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Fig. 2. Panel D 8/2 results in cases with nor mal panel D-15 performance in another group of subjects. After Pinckers et al. [1976].
Pinckers
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N C T 6/2 resu lts if AO H - R - R : S 'N o
ME'S
incorrect separation often corrected afterw a rd s by the subject
Fig. 3. Top: distribution of mi nor errors in the classification phase (please compare to top of figure 2). Bottom: schematic rep resentation of incorrect separated grey caps.
error accumulation in the blue-green to pur ple-blue region of the spectrum. Most of the subjects examined (72%) fall in the age groups 20-35 years; accord ing to Verriest [1963], blue-yellow discrim ination is optimal in this period of life. We therefore may conclude that the NCT sep aration phase tends to false-positive errors in the blue-green to purple-blue region of the spectrum. In the Hue classification phase the tendency to false-positive blue-yellow confusions is less pronounced than with the desaturated 8/2 test, the reason being that (a) the NCT 6/2 is less sensitive than the panel D 8/2, and (b) the intervals between the NCT Hues are not identical to these of the panel D-15 and D 8/2.
We can make some remarks as to the test results in congenital red-green defects. (a) The separation phase. There is an in correct separation in most but not all cases. A characteristic feature is that the subjects arrange grey caps in the colored group. The NCT manual states that this is exclusively found in congenital color defectives. Fig ure 4 illustrates that the confused grey caps indicate a neutral zone in the red and green part of the spectrum. (b) The classification phase. Notwith standing that we are dealing with congenital color defectives, which implicates that one cone mechanism is involved, the AOH-R-R classification does not predict the NCT re sults. This discrepancy in our opinion is not
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classification des g ris
Lanthony's New Color Test
289
N E W COLOR T ES T d e L A N T H O N Y s e lo n M U N S EL L I 1. - EPR EU V i DB SEPARATION I
Nom,
Age
D a t e , ____
O C • OD
Fig. 4. Neutral zones in con genital red-green defective sub jects.
surprising because we must not forget that we are comparing a PIC test with a relative ly great visual angle to a Hue discrimination test with a relatively small visual angle.
Congenital Achromatopsia A final test was the examination of 10 congenital achromats, diagnosed by their clinical picture, ERG and color vision re
sults, including the anomaloscope. 9 of the 10 achromats could not perform any separa tion at all; their NCT 6/8 results are shown in figure 5. 1 patient made an incomplete separation; the remaining ‘colored caps’ were classified in a DT (scotopic) pattern. From this examination we may conclude that our findings in achromatopsia are the same as stated in the NCT manual. The conclusions of the second part are: (a) in general the statements made in the
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IUNIAU OAHtALMOkOGlI
Pinckers
290
N EW COLOR TEST de L A N T H O N Y s e lo n M U N SELL I 2, - EPREUVE DE CLASSIFICATION ]
4
--------- ------ ------ ------ ------ ------ ------ ------ ------ ------ . 4
.. R
RJ
JR
J
JV
VJ
V
VB
CLASSIFICATION
BV
B
BP
PB
P
PR
RP
DES GRIS
Fig. 5. NCT 6/8 results in 9 congenital achromats, who could not perform any separation at all. The hatched area represents their classification of the caps from dark to white and gives an im pression of their scotopic sensi tivity curve.
VB CLASSIFICATION
DES CO U LEURS
1* 9» itptu/m I
Summary In general the statements in the manual of the New Color Test are confirmed, but there is no exact correlationship between the AOH-R-R classification and the NCT classification. There is a gradual increase in sensitivity from the AOH-R-R, via the panel D-15 and the NCT 6/2 to the desaturated panel 8/2. Thus, if the panel 8/2 result is normal the NCT 6/2 yields no further information.
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manual of the New Color Test are confirm ed, especially concerning congenital redgreen defectives and congenital achromats; (b) there is no exact correlationship between the AOH-R-R classification and the NCT classification; (c) interpretation of an incor rect separation is difficult because most of the normal subjects correct themselves when asked to arrange the grey caps.
Lanthony’s New Color Test
Im allgemeinen werden die Feststellungen in der Beschreibung des neuen Farbtestes bestätigt, obwohl keine exakte Beziehung zwischen der AOHR-R und der NCT Klassifikation besteht. Es besteht ein graduelles Ansteigen in der Empfindlichkeit vom AOH-R-R via Panel D-15 und NCT 6/2 zum desaturierten Panel 8/2 Test. Das bedeutet, wenn der Panel 8/2 Test normal ausfällt, gibt der NCT 6/2 keine weiteren Informa tionen.
Résumé En général, les constatations du manuel du nouveau test des couleurs (NCT) sont confirmées, mais il n’y a pas de corrélation exacte entre la classification AOH-R-R et celle du NCT. Il y a une augmentation graduelle de la sensi bilité depuis l’AOH-R-R en passant par le tableau D-15 et le NCT 6/2 jusqu’au tableau désaturé 8/2. De cette manière, si le résultat du tableau 8/2 est normal, le NCT 6/2 n’apporte pas d’information supplémentaire.
References Lanthony, P.: Etude de la saturation au cours des dyschromatopsies acquises au moyen de l’al bum de Munsell. Annls Oculist. 207: 743-651 (1974). Manuel du test 15 Hue désaturé de Lanthony selon Farnsworth-Munsell (Luneau Ophtalmologie, 3, rue d’Edimbourg, Paris 1975). Manuel du New Color Test de Lanthony selon Munsell (Luneau Ophtalmologie, 3, rue d’Edim bourg, Paris 1975). Pinckers, A.; Nabbe, B. et v. d. Bogaard, P.: Le test 15 Hue de Lanthony. Annls Oculist. 209: 731-738 (1976). Verriest, G.: Further studies on acquired deficiency of color discrimination. J. opt. Soc. Am. 54: 185 (1963).
A. Pinckers, MD, Department of Ophthalmology, University of Nijmegen, Nijmegen (The Netherlands)
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Zusammenfassung
291