The dyschromatopsia of optic neuritis: a descriptive analysis of data from the optic neuritis treatment trial.
The dyschromatopsia of optic neuritis: a descriptive analysis of data from the optic neuritis treatment trial.
复制标题
视神经炎的色盲：视神经炎治疗试验数据的描述性分析。
DOI：
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发表时间：
1995
期刊：
影响因子：
--
通讯作者：
B. Katz
中科院分区：
文献类型：
--
作者：
B. Katz
目的
我们试图描述视神经炎的色觉障碍，确定色觉障碍的类型和严重程度及其与中心视力和空间敏锐度的关系，检查色觉障碍随时间的变化，并确定Köllner规则对视神经炎患者的适用性。
方法
我们分析了视神经炎治疗试验（ONT）中收集的色觉表现的原始数据。ONT旨在评价皮质类固醇作为急性脱髓鞘性视神经炎的治疗方法，并进行长期结局和自然史分析。在1988年7月1日至1991年6月30日期间，488例患者入组本试验。所有患者均接受了广泛的神经和眼科检查，包括标准化的视觉功能测试，包括色觉测试。因此，ONTT人群提供了一个独特的机会，可以在一个大型、同质、特征良好的视神经炎患者队列中描述获得性色觉异常的特征。我们使用FM-100评分的定量分析，从这个病人队列，以确定色觉障碍的严重程度，色觉障碍的选择性（极性的错误）和色觉障碍的类型（轴混淆），通过采用象限分析FM-100评分。
结果
FM-100数据的高选择性和低选择性分析结果显示，在视神经炎急性期，出现蓝/黄、红/绿色和非选择性颜色缺陷;在纯缺陷患者中，蓝/黄缺陷比红/绿色缺陷更常见。然而，在急性事件后6个月，分析显示红色/绿色缺陷比蓝色/黄色缺陷更常见。在急性和6个月时有选择性颜色缺陷的患者中，缺陷可能随着时间的推移而改变，也可能保持不变。6个月时持续性色觉障碍的可能性与初始中心视力丧失的严重程度相关，但色觉障碍的类型（红/绿色与蓝/黄色）无关。
结论
我们的研究结果表明，在视神经炎急性发作时，大多数选择性颜色缺损是蓝色/黄色缺损，而在6个月时，更多的选择性缺损是红色/绿色缺损，尽管这两种类型的缺损（以及非选择性缺损）在急性和6个月时都可以看到。尽管ONT的入选标准严格，但我们研究的患者数量庞大，色觉与视力的相关性以及纵向随访，本研究表明没有单一类型的颜色缺陷与视神经炎一致相关。脱髓鞘性视神经炎不符合Köllner规则。此外，在恢复过程中，一些患者的缺陷类型发生了变化。因此，缺陷的类型甚至可能在个体患者康复时不一致。缺陷的类型似乎与测试时的空间视觉有关，但6个月时存在的缺陷类型与初始视力丧失的严重程度无关。因此，在评估与视神经炎相关的颜色缺陷时，必须考虑中枢视觉功能的水平。
PURPOSE
We sought to characterize the dyschromatopsia of optic neuritis, to determine the type and severity of color defect present and its relation to central vision and spatial acuity, to examine changes in this dyschromatopsia over time, and to determine the applicability of Köllner's rule to patients with optic neuritis.
METHODS
We analyzed the raw data on color vision performance as assembled within the Optic Neuritis Treatment Trial (ONTT). The ONTT was designed to evaluate corticosteroids as a treatment for acute demyelinating optic neuritis and to allow long-term outcome and natural history analyses. Between July 1, 1988 and June 30, 1991, 488 patients were enrolled in this trial. All patients underwent extensive neurologic and ophthalmologic examinations including standardized testing of visual function that included testing of color vision. The ONTT population thus afforded a unique opportunity to characterize acquired dyschromatopsias in a large, homogenous, well-characterized cohort of patients with optic neuritis. We used quantitative analysis of FM-100 scores from this patient cohort to determine the severity of the dyschromatopsia, the selectivity of the dyschromatopsia (polarity of errors) and the type of dyschromatopsia (axis of confusion) by employing quadrant analysis of FM-100 scores.
RESULTS
The results of high-and low-selectivity analyses of the FM-100 data showed that during the acute phase of optic neuritis, blue/yellow, red/ green, and non-selective color defects occurred; among patients with pure defects, blue/yellow defects were more frequent than red/green defects. At 6 months after the acute event, however, analyses showed that red/green defects were more common than blue/yellow defects. Among patients with selective color defects both acutely and at 6 months, the defect was as likely to change over time as remain the same. The likelihood of persistent dyschromatopsia at 6 months was related to the severity of initial central acuity loss, but the type of dyschromatopsia present (red/green versus blue/yellow) was not.
CONCLUSIONS
Our results suggest that at the time of the acute attack of optic neuritis, the majority of selective color defects were blue/yellow defects, whereas at 6 months, more of the selective defects were red/green defects, though both types of defects (as well as nonselective defects) were seen acutely and at 6 months. Despite the rigorous inclusion criteria of the ONTT, the large number of patients we studied, correlation of color vision with visual acuity, and longitudinal follow up, this study showed that no single type of color defect was consistently associated with optic neuritis. Demyelinating optic neuritis does not obey Köllner's rule. Moreover, the type of defect present changed in some patients over the course of recovery. Thus, the type of defect may not even be consistent in individual patients as they recover. The type of defect appeared to be related to spatial vision at the time of the test, but the type of defect present at 6 months was not related to the severity of the initial visual loss. Therefore, in evaluating color defects associated with optic neuritis, the level of central visual function must be considered.
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影响因子：
158.5
作者：
BECK, RW;CLEARY, PA;BROWN, CH
通讯作者：
BROWN, CH
视神经炎的色盲部分是由视野损伤的中心凹/中心凹周围分布决定的。
影响因子：
4.4
作者：
Silverman,SE;HartJr,WM;Gordon,MO;Kilo,C
通讯作者：
Kilo,C
DOI：
--
发表时间：
1988
期刊：
Clinical vision sciences
影响因子：
--
作者：
D. Pelli;J. Robson;A. Wilkins
通讯作者：
D. Pelli;J. Robson;A. Wilkins
影响因子：
13.7
作者：
HartJr,WM;Burde,RM
通讯作者：
Burde,RM
影响因子：
4.4
作者：
A. Vingrys;P. King-Smith
通讯作者：
A. Vingrys;P. King-Smith