Marisa Rodriguez-Carmona

Supplementation with the carotenoids lutein or zeaxanthin improves human visual performance

Background:u2002 Macular pigment (MP) is found in diurnal primate species when vision spans a range of ambient illumination and is mediated by cone and rod photoreceptors. The exact role of MP remains to be determined. In this study we investigate two new hypotheses for possible MP functions.

The effects of supplementation with lutein and/or zeaxanthin on human macular pigment density and colour vision.

Background:u2002 Both yellow‐blue (YB) discrimination thresholds and macular pigment optical density (MPOD) measurements in the eye exhibit large variability in the normal population. Although it is well established that selective absorption of blue light by the macular pigment (MP) can significantly affect trichromatic colour matches, the extent to which the MP affects colour discrimination (CD) sensitivity remains controversial.

Sex-related differences in chromatic sensitivity.

Generally women are believed to be more discriminating than men in the use of color names and this is often taken to imply superior color vision. However, if both X-chromosome linked color deficient males (8%) and females (<1%) as well as heterozygote female carriers (15%) are excluded from comparisons, then differences between men and women in red-green (RG) color discrimination have been reported as not being significant (e.g., Pickford, 1944; Hood et al., 2006). We re-examined this question by assessing the performance of 150 males and 150 females on the color assessment and diagnosis (CAD) test (Rodriguez-Carmona et al., 2005). This is a sensitive test that yields small color detection thresholds. The test employs direction-specific, moving, chromatic stimuli embedded in a background of random, dynamic, luminance contrast noise. A four-alternative, forced-choice procedure is employed to measure the subjects thresholds for detection of color signals in 16 directions in color space, while ensuring that the subject cannot make use of any residual luminance contrast signals. In addition, we measured the Rayleigh anomaloscope matches in a subgroup of 111 males and 114 females. All the age-matched males (30.8 +/- 9.7) and females (26.7 +/- 8.8) had normal color vision as diagnosed by a battery of conventional color vision tests. Females with known color deficient relatives were excluded from the study. Comparisons between the male and female groups revealed no significant differences in anomaloscope midpoints (p = 0.709), but a significant difference in matching ranges (p = 0.040); females on average tended to have a larger mean range (4.11) than males (3.75). Females also had significantly higher CAD thresholds than males along the RG (p = 0.0004), but not along the yellow-blue (YB) discrimination axis. The differences between males and females in RG discrimination may be related to the heterozygosity in X-linked cone photo pigment expression common among females.

Loss of chromatic sensitivity in AMD and diabetes: a comparative study.

Background:u2002 Abnormalities in rod and cone photoreceptor morphology have been reported in normal aging retinas in the absence of known pathology and have been taken as an indicator of susceptibility to retinal disease. Some loss of visual performance may therefore precede retinal structural changes that can be detected reliably using conventional fundus imaging techniques. Red/green (RG) and yellow/blue (YB) colour discrimination thresholds are sensitive measures of normal retinal function and poor YB discrimination is often taken as an indicator of retinal disease, though it is generally acknowledged that RG loss is also present in most cases of acquired deficiency. Although structural changes in age‐related macular degeneration (AMD) and diabetes share some similarities, significant differences remain and this may result in different patterns of RG and YB loss.

A study of unusual Rayleigh matches in deutan deficiency

Rayleigh match data were modeled with the aim of explaining the locations of match midpoints and matching ranges, both in normal trichromats and in subjects with congenital color deficiency. Model parameters included the wavelength of peak sensitivity of cone photopigments, the effective photopigment optical density, and the noise amplitude in the red-green color channel. In order to avoid the suprathreshold, perceptual effects of extreme L:M cone ratios on color vision, selective post-receptoral amplification of cone signals is needed. The associated noise is also amplified and this causes corresponding changes in red-green threshold sensitivity. We propose that the noise amplitude and hence the size of the matching range in normal trichromats relates to the known inter-subject variation in the relative numbers of L and M cones. If this hypothesis can be shown to account for the extremes of the red-green matching range measured in normal trichromats, it is of interest to establish the extent to which it also predicts the unexpected, small matching ranges that are observed in some subjects with red-green color deficiency. A subset of subjects with deutan deficiency that exhibited less common Nagel matches were selected for genetic analysis of their cone pigment genes in order to confirm the type of deficiency, and to predict the corresponding peak wavelength separation (delta lambda(max)) of their two, long-wavelength cone pigments. The Rayleigh match model predicted accurately the midpoint and the range for the spectral differences specified by the genes. The prediction also required plausible selection of effective optical density of the cone pigments and noise. The noise needed varied, but the estimates were confined to lie within the limits established from the matching ranges measured in normal trichromats. The model predicts correctly the small matching ranges measured in some deuteranomalous subjects, principally accounted for by a low estimate of noise level in the red-green channel. The model also predicts the normal matches made by some subjects that rely on two hybrid genes and therefore exhibit red-green thresholds outside the normal range, typical of mild deuteranomaly.

Recovery of vision and pupil responses in optic neuritis and multiple sclerosis

The recovery of visual performance and pupil responses were investigated in patients with demyelinating optic neuritis (ON) and multiple sclerosis (MS). The pupil constriction amplitude and the time delay (latency) of the pupil response were measured in 14 patients with a history of unilateral ON in response to either achromatic (luminance) or chromatic (isoluminant) stimulus modulation. Five of these subjects were diagnosed later with MS. In addition, we measured detection thresholds for achromatic stimuli using standard visual field perimetry and chromatic thresholds using a new colour assessment and diagnosis (CAD) test that isolates the use of colour signals. The results show that, despite significant improvements in visual function following the acute phase (as assessed using visual acuity and fields), significant pupil response deficits remain. The findings also demonstrate that accurate measurements of pupil responses and chromatic thresholds can reveal deficits that remain undetected with more conventional techniques. These preliminary findings suggest that the techniques described here can provide useful information about remitting and relapsing demyelinative phases, often observed during MS and ON.

Processing of color signals in female carriers of color vision deficiency.

The aim of this study was to assess the chromatic sensitivity of carriers of color deficiency, specifically in relation to dependence on retinal illuminance, and to reference these findings to the corresponding red-green (RG) thresholds measured in normal trichromatic males. Thirty-six carriers of congenital RG color deficiency and 26 normal trichromatic males participated in the study. The retinal illuminance was estimated by measuring the pupil diameter and the optical density of the lens and the macular pigment. Each subjects color vision was examined using the Color Assessment and Diagnosis (CAD) test, the Ishihara and American Optical pseudoisochromatic plates, and the Nagel anomaloscope. Carriers of deuteranopia (D) and deuteranomaly (DA) had higher RG thresholds than male trichromats (p < 0.05). When referenced to male trichromats, carriers of protanomaly (PA) needed 28% less color signal strength; carriers of D required ∼60% higher thresholds at mesopic light levels. Variation in the L:M ratio and hence the absolute M-cone density may be the principal factor underlying the poorer chromatic sensitivity of D carriers in the low photopic range. The increased sensitivity of PA carriers at lower light levels is consistent with the pooling of signals from the hybrid M and the M cones and the subsequent stronger inhibition of the rods. The findings suggest that signals from hybrid photopigments may pool preferentially with the spectrally closest normal pigments.

Variability in normal and defective colour vision: Consequences for occupational environments

Abstract New findings in relation to both normal and defective colour vision provide improved understanding of chromatic mechanisms in human vision and account for much of the variability observed in both normal trichromats and in subjects with congenital colour deficiency. The principal methods for assessing colour vision and the techniques employed to isolate the use of colour signals are reviewed. Data on the continuous distribution of colour thresholds within deutan and protan observers and the variability within normal trichromatic colour vision are presented and the principal factors that contribute to this variability examined. The need to quantify the severity of colour vision loss and to classify accurately the subjects colour vision is examined in relation to colour assessment requirements in occupational environments. A method of establishing pass/fail limits that are functionally safe without disadvantaging subjects with congenital colour deficiency is described. Also discussed are the uses of novel colour tests to reveal acquired loss of chromatic sensitivity as an indication of early-stage diseases of the eye as well as the value such tests may have in early detection and subsequent treatment.

Colour vision requirements in visually demanding occupations

Normal trichromatic colour vision (CV) is often required as a condition for employment in visually demanding occupations. If this requirement could be enforced using current, colour assessment tests, a significant percentage of subjects with anomalous, congenital trichromacy who can perform the suprathreshold, colour-related tasks encountered in many occupations with the same accuracy as normal trichromats would fail. These applicants would therefore be discriminated against unfairly. One solution to this problem is to produce minimum, justifiable CV requirements that are specific to each occupation. This has been done successfully for commercial aviation (i.e. the flight crew) and for Transport for London train drivers. An alternative approach is to make use of new findings and the statistical outcomes of past practices to produce graded, justifiable CV categories that can be enforced. To achieve this aim, we analysed colour assessment outcomes and quantified severity of CV loss in 1363 subjects. The severity of CV loss was measured in each subject and statistical, pass/fail outcomes established for each of the most commonly used, conventional colour assessment tests and protocols. This evidence and new findings that relate severity of loss to the effective use of colour signals in a number of tasks provide the basis for a new colour grading system based on six categories. A single colour assessment test is needed to establish the applicants CV category which can range from supernormal, for the most stringent, colour-demanding tasks, to severe colour deficiency, when red/green CV is either absent or extremely weak.

Occupational color vision standards: new prospects

Occupational color vision standards in transport have been implemented for 100 years. A review of these standards has taken place early this century prompted by antidiscrimination laws in the workplace and several transport accidents. The Australian and Canadian Railways have developed new lanterns to address their occupational medical requirements. The Civil Aviation Authority in the UK has adopted the Color Assessment and Diagnosis (CAD) test as the standard for assessing color vision for professional flight crews. The methodology employed using the CAD test ensures that color deficient pilot applicants able to complete the most safety-critical task with the same accuracy as normal trichromats can be accepted for pilot training. This methodology can be extended for setting new color vision standards in other work environments.