Comparison of Cone Contrast Tests for Color Vision Screening
Abstract
Good test-retest reliability is essential to predict relevant performance (e.g. flying performance) and maintain sensitivity/specificity. The cone contrast test (CCT) has been used since 2011 for aircrew color vision screening. However, there is very little test-retest reliability data. This research compares the color calibration and test-retest reliability of four versions of the CCT: 1) Innova Systems, v18 (New Innova), 2) Innova Systems, v13.11 (Old Innova), 3) NCI Vision Systems, v14 (NCI), and 4) Konan Medical CCT-HD, v1.0.0.1 (Konan). Monocular CCT scores were measured for L-, M-, and S-cones for 67 subjects. Each subject repeated each test 4 times: (1) right eye (OD) day 1; (2) left eye (OS) day 1; (3) OD day 2; and (4) OS day 2. We used a Bland-Altman analysis to compare the 95 percent limits of agreement (LOA) for Test 1 and Test 2 for each of the 4 tests and for each eye. Based on the cone contrast measurement results, the Konan Medical CCT HD clearly has the most precise calibration. In contrast, the difference between measured and desired contrast for the Innova and NCI CCTs is much larger on average. Results also revealed that LOAs were lowest (i.e. best test-retest reliability) for the Konan L- and M-cone tests. For the S-cone, the Konan had the largest LOAs. However, there was a large ceiling effect for the S-cone test for both the Innova and NCI tests. Although all of the CCTs have been shown to reliably screen for color deficiency (for pass/fail criterion of 75), only the Konan CCT-HD provides precision color calibration, high test-retest reliability for L- and M-cones, and can fully characterize both color deficient and color normal individuals to support Air Force Medical Service objectives to develop better, more diagnostic, threshold level aeromedical tests.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jul 01, 2019
- Accession Number
- AD1154166
Entities
People
- Alex Van Atta
- Eleanor O'keefe
- Elizabeth Shoda
- Eric Seemiller
- James Gaska
- Jonelle Knapp
- Marc Winterbottom
- Steve Hadley
Organizations
- 711th Human Performance Wing
- KBR, Inc.