Innovative Color Vision Testing (simultaneous congenital & acquired) Stuart P Richer, OD, PhD, FAAO Director, Ocular Preventive Medicine James A Lovell Federal Health Care Facility Associate Professor, Family and Preventive Medicine, Rosalind Franklin University of Medicine & Science / Chicago Medical School North Chicago, Illinois 60064, USA Assistant Clinical Professor, UIC Dept of Ophthalmology and Visual Science - Chicago  Stuart.Richer1@VA.GOV AAO 11 Nov 2014 AFOS

Rabin Cone Contrast Test by Innova Systems 15 Years of US Air Force research Published, Peer Reviewed Validated against Anomaloscope Innova Approved as Sole Color Vision Test for US Air Force Over 400 in Use Worldwide

Rabin Cone Contrast Test by Innova Systems Colored letters stimulate single cone type / pathway Decreasing contrast steps detects cone function threshold Numeric scores provide Hereditary vs. Acquired discrimination Change over time metric

Color Normal vs. Deficient A Color Vision Test Sensitive Enough to Detect Severity of Cone Deficiency Used to Detect and Monitor Acquired Color Deficiency AMD Glaucoma Diabetic Retinopathy MS Parkinson’s Disease TBI Retinal Toxicity due to High Risks meds such as Plaquenil Color Normal vs. Deficient

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BLUE CONE LOSS Acquired blue cone loss occurs early in eye disease, sometimes before visual field defect(s) Very few blue cones: small amount of damage has large effect Secondary to disease, trauma or toxicity Often asymmetric

Rabin Cone Contrast in Eye Disease Acquired Color Deficiency 25 50 75 100 Red Score Green Score Blue Score

Acquired Color Deficiency in Central Serous Retinopathy Blue (Tritan) Red cone Normal Eye Green cone Blue RE & LE 20/20 Red cone Central Serous Green cone Blue normal range 0.5 1 1.5 2 2.5 Rabin Log Score

Acquired Color Deficiency in Optic Neuritis (Blue – Tritan) Resolved Optic Neuritis Right Eye Tritan Defect MRI & CSF— Probable MS Normal mean 2 SDs RE (20/15 VA) 5 line decrease LE (20/15 VA) 20 40 60 80 100 Blue Cone Rabin Score

Current Research Military - Cases of Optic Neuropathy Identified with RCCT that was missed by all other equipment. Cone recovery shown with RCCT. Military – Central Serous Retinopathy Military – Traumatic Brain Injury Identified with RCCT Duke University – Dry AMD Clinical Trial results: the AREDS 3 intermediate AMD group exhibited visual dysfunction on the Rabin Cone Contrast Test, in the presence of normal visual acuity New clinical trial begins fall 2014 Other: Diabetes , MS, Plaquenil, Alzheimers, Glaucoma, Macular Pigment Density Loss

Improved Quality of Care Patient Benefit Simultaneous Hereditary + Acquired Color Vision Evaluation Identification of patients at-risk for developing disease. Earlier recognition and intervention of disease. Rapid detection of disease progression. Evaluation of treatment efficacy. Improved Quality of Care

Macular Health Center VEP………………………………….………….…$156.77 ERG……………………………………………….$184.67 Macular Pigment ……………………………$25.00 OCT ………………………………………………..$50.73 Multi-Spectral Imaging…………………...$91.41 Rabin cone contrast sensitivity………..$67.28 Gene Testing – Macula Risk,99213…. $81.30 Total per Patient…………..………………...$657.16 x 50 patients/year……………..……....$32,858.00

AFOS Room F AAO Booth #314 630.920.8880 Cheryl@InnovaSystemsUSA.com Rabin Cone Contrast Test Eye Disease Detection and Monitoring by Innova Systems AFOS Room F AAO Booth #314 630.920.8880 Cheryl@InnovaSystemsUSA.com