# Comparison of Heidelberg Multi-Color Anomaloskop with NEITZ anomaloscope OT-II to diagnose color-vision deficiency

## TL;DR

This study compares two devices for diagnosing color-vision deficiency and finds they agree closely, though some systematic errors exist.

## Contribution

The study provides a detailed comparison of two widely used color-vision diagnostic tools and identifies their agreement and error patterns.

## Key findings

- HMC and OT-II showed high agreement with ICC values above 0.94 for most measurements.
- Bland–Altman analysis revealed systematic errors in specific measurements like maximum red–green mixture and yellow monochromatic values.
- Fixed and proportional errors were observed in some parameters, indicating device-specific biases.

## Abstract

To determine the degree of agreement between the results of the Heidelberg Multi-Color Anomaloskop (HMC) and NEITZ anomaloscope OT-II (OT-II).

Retrospective.

The study included 53 patients who underwent color-vision testing at Kariya Toyota General Hospital between March 2019 and April 2022. The participants included 2 patients with normal color vision, 10 with protanopia, 3 with protanomaly, 22 with deuteranopia, and 16 with deuteranomaly. Color-vision testing was performed using the Ishihara Test for Colour Deficiency, Standard Pseudoisochromatic Plates Part 1, Farnsworth Dichotomous Test for Color Blindness Panel-15, HMC, and OT-II. An agreement was determined using intraclass correlation coefficients (ICC) and Bland–Altman analysis. The minimum, median, and maximum red–green mixture and yellow monochromatic values of the equal values obtained from HMC and OT-II were examined.

The ICCs between the results of HMC and OT-II were 0.979, 0.979, and 0.985, for the minimum, median, and maximum red–green mixture and 0.943, 0.755, and 0.919 for the yellow monochromatic values, respectively (p < 0.0001 in all). In the Bland–Altman analysis, the differences were mostly within the limits of agreement. Fixed errors were observed for the maximum red–green mixture and minimum yellow monochromatic values. Proportional errors were observed for the maximum red–green mixture and yellow monochromatic values.

HMC and OT-II showed high agreement for all values in the ICC and Bland–Altman analyses. In the Bland–Altman analysis, systemic errors were observed in the maximum red–green mixture value and the minimum and maximum yellow monochromatic values.