Ophthalmic Plastic and Reconstructive Surgery (OKO), Advanced Eye Medical Group, Mission Viejo, California; Lake Erie College of Osteopathic Medicine at Seton Hill (TSE), Greensburg, Pennsylvania; Sackler Faculty of Medicine (MBV), Tel Aviv University, Tel Aviv, Israel; Hunter College (RFH), the City University of New York, New York, New York; and New York Eye and Ear Infirmary of Mount Sinai (RB), New York, New York.
J Neuroophthalmol. 2018 Mar;38(1):13-16. doi: 10.1097/WNO.0000000000000637.
Ishihara color plates (ICP) are the most commonly used color vision test (CVT) worldwide. With the advent of new technologies, attempts have been made to streamline the process of CVT. As hardware and software evolve, smartphone-based testing modalities may aid ophthalmologists in performing more efficient ophthalmic examinations. We assess the validity of smartphone color vision testing (CVT) by comparing results using the Eye Handbook (EHB) CVT application with standard Ishihara color plates (ICP).
Prospective case-control study of subjects 18 years and older with visual acuity of 20/100 or better at 14 inches. The study group included patients with any ocular pathology. The color vision deficient (CVD) group was patients who failed more than 2 plates. The control group had no known ocular pathology. CVT was performed with both ICP and EHB under standardized background illuminance. Eleven plates were tested with each modality. Validity of EHB CVT and acceptance of EHB CVT were analyzed. Statistical analyses were performed using Bland-Altman plot with limits of agreement (LOA) at the 95th percentile of differences in score, independent samples t tests with 95% confidence interval (CI), and Pearson χ tests.
The Bland-Altman plot showed agreement between correct number of plates in EHB and ICP for the study subjects (bias, -0.25; LOA, -1.92 to 1.42). Agreement was also observed between the correct number of plates in EHB and ICP for the controls (bias, -0.01; LOA, -0.61 to 0.59) and CVD (bias, -0.50; LOA, -4.64 to 3.64) subjects. The sensitivity of EHB was 0.92 (95% CI 0.76-1.07) and the specificity of EHB was 1.00 (95% CI 1.00-1.00). Fifty-nine percent preferred EHB, 12% preferred ICP, and 29% had no preference.
In healthy controls and patients with ocular pathology, there was an agreement of CVT results comparing EHB with ICP. Overall, the majority preferred EHB to ICP. These findings demonstrate that further testing is required to understand and improve the validity of smartphone CVT in subjects with ocular pathology.
石原氏色盲测试图（ICPT）是目前世界上最常用的色觉测试（CFT）。随着新技术的出现，人们试图简化 CFT 流程。随着硬件和软件的发展，基于智能手机的测试模式可能有助于眼科医生进行更高效的眼科检查。我们通过比较使用 Eye Handbook（EHB）CFT 应用程序与标准石原氏色盲测试图（ICPT）的结果，来评估智能手机色觉测试（CFT）的有效性。
对视力在 14 英寸处至少为 20/100 的 18 岁及以上的患者进行前瞻性病例对照研究。研究组包括患有任何眼部疾病的患者。色盲（CVD）组为通过超过 2 个色盲板测试的患者。对照组为无已知眼部疾病的患者。在标准化背景光照下使用 ICP 和 EHB 进行 CFT。使用两种方式测试 11 个色盲板。分析 EHB CFT 的有效性和接受程度。采用 Bland-Altman 图和差异得分的 95%置信区间（CI）进行独立样本 t 检验以及 Pearson χ检验，分析两种测试方式的一致性。
Bland-Altman 图显示了研究对象中 EHB 和 ICP 的正确色盲板数量之间的一致性（偏差，-0.25；LOA，-1.92 至 1.42）。在对照组（偏差，-0.01；LOA，-0.61 至 0.59）和 CVD 受试者（偏差，-0.50；LOA，-4.64 至 3.64）中，EHB 和 ICP 的正确色盲板数量之间也观察到了一致性。EHB 的敏感性为 0.92（95%CI 0.76-1.07），特异性为 1.00（95%CI 1.00-1.00）。59%的人更喜欢 EHB，12%的人更喜欢 ICP，29%的人没有偏好。
在健康对照组和眼部疾病患者中，EHB 与 ICP 的 CFT 结果具有一致性。总体而言，大多数人更喜欢 EHB 而不是 ICP。这些发现表明，需要进一步测试才能了解和提高眼部疾病患者智能手机 CFT 的有效性。
