Evaluation of a significantly shorter version of the Farnsworth-Munsell 100-hue test in patients with three different optic neuropathies.

We tested the hypothesis that a subset of the Farnsworth-Munsell 100-hue test (FM-100) would be a sensitive, specific, and practical means of monitoring color vision in patients with chronic optic nerve disorders. We retrospectively analyzed the records of 1,113 patients affected with optic neuritis (ON), Graves' ophthalmopathy with suspected optic neuropathy, or idiopathic intracranial hypertension with suspected optic neuropathy (IIH). One hundred six records of patients showed that an FM-100 had been performed (23 ON, 46 Graves', 37 IIH). Forty additional patients were studied prospectively (11 ON, 17 Graves', 12 IIH). The sensitivity and specificity of all possible 21 chip subtests were compared against the same statistics for the entire test. We found that for these three optic nerve disorders, a test consisting of chips 22-42 had nearly the same sensitivity and specificity as the entire test when compared with the clinical diagnosis. At 90% specificity, the ratio of sensitivities of the short version to the original version of the test were IIH, 53%/45%; optic neuritis, 85%/79%; and Graves', 67%/70%. The majority of the clinical value of the test can be achieved in one fourth of the original examination time.