The Effect of Tinted Filters on the Visual Function of Patients with Retinitis Pigmentosa

Published date: Dec 19 2025

Journal Title: Journal of Ophthalmic and Vision Research

Issue title: ‎Volume 20 - 2025

Pages: 1 - 8

DOI: 10.18502/jovr.v20.17489

Alireza Riazifaralirezariazifarop@gmail.comNoor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran

Ali Mirzajanimirzajani.a@iums.ac.irRehabilitation Research Center, Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran

Hassan Hashemihhahsemi@noorvision.comNoor Ophthalmology Research Center, Noor Eye Hospital, Tehran

Alireza Jamalialirezajamali.1371@gmail.comRehabilitation Research Center, Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran

Mehdi Khabazkhoobkhabazkhoob@yahoo.comDepartment of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran

Razieh Bahreinibahr4360@pacificu.eduPacific University College of Optometry, Forest Grove, Oregon

Abbasali YektaDepartment of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad

Ebrahim Jafarzadehpurjafarzadehpur@gmail.comRehabilitation Research Center, Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran

Purpose: To investigate the effect of tinted filters on contrast threshold (CT) and visual evoked potentials (VEPs) in patients with retinitis pigmentosa (RP).

Methods: In this cross-sectional study, RP patients with best corrected visual acuity better than 1 log MAR were evaluated. The CT was measured using the Freiburg Acuity and Contrast Test, and pattern reversals were analyzed for both time and frequency components. The effects of gray (15% light transmission, 410 nm cutoff), brown (18% light transmission, 410 nm cutoff), and yellow (27% light transmission with a 470 nm cutoff) tinted filters were evaluated and compared.

Results: Eighteen participants (mean age 32.78 ± 7.35 years; 72.2% male) were evaluated. The mean CT of Weber was 3.46 ± 3.2%. Yellow filters decreased CT (mean difference [MD]: –0.597%, P = 0.054). Brown filters did not produce a significant change in the CT (MD: 0.233%, P = 0.620), while the gray filters caused a significant increase in the CT (MD: 1.423%, P = 0.004). Mode frequency (Fmod) decreased with gray filters (MD: –2.33%, P = 0.004). The latency and amplitude of VEPs improved with yellow filters (P < 0.05) but worsened with gray filters (P < 0.05). Additionally, the spherical equivalent showed an inverse correlation with CT in patients with RP (r = –0.997, P < 0.001).

Conclusion: Using tinted filters as a low-vision aid can modify contrast sensitivity and both frequency and time domains of VEPs in patients with RP. Yellow filters appear to improve visual function, whereas gray filters may worsen it.

Keywords: Contrast Sensitivity, Retinitis Pigmentosa, Tinted Filters

1. Parmeggiani F. Clinics, epidemiology and genetics of retinitis pigmentosa. Curr Genomics 2011;12:236-237.

2. Mishra C, Sen S, Kannan NB, Ramasamy K. Unilateral retinitis pigmentosa associated with cystoid macular oedema. Natl Med J India 2023;36.

3. O’Neal TB, Tripathy K, Luther EE. Retinitis pigmentosa. StatPearls Publishing; 2024.

4. Nguyen XT, Moekotte L, Plomp AS, Bergen AA, van Genderen MM, Boon CJ. Retinitis pigmentosa: Current clinical management and emerging therapies. Int J Mol Sci 2023;24:7481.

5. Hartong DT, Berson EL, Dryja TP. Retinitis pigmentosa. Lancet 2006;368:1795-1809.

6. Alexander KR, Rajagopalan AS, Seiple W, Zemon VM, Fishman GA. Contrast response properties of magnocellular and parvocellular pathways in retinitis pigmentosa assessed by the visual evoked potential. Invest Ophthalmol Vis Sci 2005;46:2967-2973.

7. Cedrún-Sánchez JE, Chamorro E, Bonnin-Arias C, Aguirre-Vilacoro V, Castro JJ, Sánchez-Ramos C. Visual discrimination increase by yellow filters in Retinitis pigmentosa. Optom Vis Sci 2016;93:1537-1544.

8. Abraham CH, Morny E, Aboagye-MacCarthy A, Ocansey S, Ntodie M, Sakyi-Badu G, et al. The effect of filters and varying illumination on contrast sensitivity in eyes with moderate to severe visual impairment. Int Ophthalmol 2023;43:3329-3337.

9. Eperjesi F, Fowler CW, Evans BJ. Do tinted lenses or filters improve visual performance in low vision? A review of the literature. Ophthalmic Physiol Opt 2002;22:68-77.

10. Orlans HO, Merrill J, Barnard AR, Charbel Issa P, Peirson SN, MacLaren RE. Filtration of short-wavelength light provides therapeutic benefit in retinitis pigmentosa caused by a common rhodopsin mutation. Invest Ophthalmol Vis Sci 2019;60:2733-2742.

11. Mahjoob M, Heydarian S. Effects of color filters and anti-reflective coating on contrast sensitivity under glare condition. J Res Clin Med 2020;8:28.

12. Mahjoub M, Shandiz JH, Validad MH, Moghadam HM, Tayebeh HK, Abadi RT. The effect of color filters on the visual acuity and contrast sensitivity in low vision patients. Majallah-i Danishgah-i Ulum-i Pizishki-i Babul 2010;11:53- 57.

13. Papathanasopoulos PG, Papakostopoulos D. Pattern reversal visual evoked potentials in retinitis pigmentosa. Int J Psychophysiol 1994;16:245-250.

14. Kothari R, Bokariya P, Singh S, Singh R. A comprehensive review on methodologies employed for visual evoked potentials. Scientifica 2016;2016:9852194.

15. Sharpe LT, Stockman A, Jagla W, Jägle H. A luminous efficiency function, V*(λ), for daylight adaptation. J Vis 2005;5:948-968.

16. Carracedo G, Carballo J, Loma E, Felipe G, Cacho I. Contrast sensitivity evaluation with filter contact lenses in patients with retinitis pigmentosa: A pilot study. J Optom 2011;4:134-139.

17. Mohammadi A, Hashemi H, Mirzajani A, Yekta A, Jafarzadehpur E, Khabazkhoob M. Comparison of two methods for measuring contrast sensitivity in anisometropic amblyopia. J Curr Ophthalmol 2018;30:343-347.

18. Odom JV, Bach M, Brigell M, Holder GE, McCulloch DL, Mizota A, et al.; International Society for Clinical Electrophysiology of Vision. ISCEV standard for clinical visual evoked potentials: (2016 update). Doc Ophthalmol 2016;133:1-9.

19. Hassankarimi H, Jafarzadehpur E, Mohammadi A, Noori SM. Low-contrast pattern-reversal visual evoked potential in different spatial frequencies. J Ophthalmic Vis Res 2020;15:362-371.

20. Janáky M, Pálffy A, Horváth G, Tuboly G, Benedek G. Pattern-reversal electroretinograms and visual evoked potentials in retinitis pigmentosa. Doc Ophthalmol 2008;117:27-36.

21. Krefman RA. Reversed telescopes on visual efficiency scores in field-restricted patients. Am J Optom Physiol Opt 1981;58:159-162.

22. Van den Berg T. Red glasses and visual function in retinitis pigmentosa. Documenta Ophthalmologica 1989;73:255- 274.

23. Ahmad A, Sughra U, Habib M, Imran MA, editors. Contrast sensitivity improvement with yellow filter in low vision patients. ISRA Med J 2018;9:402-405.

24. Wetzel C, Auffarth GU, Krastel H, Blankenagel A, Alexandridis E. [Improving contrast sensitivity by cut-off filters in high adaptation luminance levels in retinitis pigmentosa]. Ophthalmologe 1996;93:456-462.

25. Leat SJ, North RV, Bryson H. Do long wavelength pass filters improve low vision performance? Ophthalmic Physiol Opt 1990;10:219-224.

26. Sadeghpour N, Alishiri AA, Ajudani R, Khosravi MH, Amiri MA, Sadeghpour O. Quantity and quality of vision using tinted filters in patients with low vision due to diabetic retinopathy. J Ophthalmic Vis Res 2015;10:429-432.

27. Morrissette DL, Mehr EB, Keswick CW, Lee PN. Users’ and nonusers’ evaluations of the CPF 550 lenses. Am J Optom Physiol Opt 1984;61:704-710.

28. Mahjoob M, Heydarian S, Koochi S. Effect of yellow filter on visual acuity and contrast sensitivity under glare condition among different age groups. Int Ophthalmol 2016;36:509- 514.

29. Kalikivayi V, Kalikivayi L. Influence of various densities of yellow and pink tinted spectacles on contrast sensitivity. Clin Exp Ophthalmol 2021;1.

30. Sharma R, Joshi S, Singh KD, Kumar A. Visual evoked potentials: Normative values and gender differences. J Clin Diagn Res 2015;9:CC12–CC15.

31. Paranhos FR, Katsum O, Arai M, Nehemy MB, Hirose T. Pattern reversal visual evoked response in retinitis pigmentosa. Doc Ophthalmol 1998-1999;96:321-331.

32. Swanson WH, Birch DG, Anderson JL. S-cone function in patients with retinitis pigmentosa. Invest Ophthalmol Vis Sci 1993;34:3045-3055.

33. Leat SJ, North RV, Bryson H. Do long wavelength pass filters improve low vision performance? Ophthalmic Physiol Opt 1990;10:219-224.

34. Phillips SM, Smith GD. Light absorption by charge transfer complexes in brown carbon aerosols. Environ Sci Technol Lett 2014;1:382-386.

35. Álvaro L, Linhares JM, Formankiewicz MA, Waugh SJ. Coloured filters can simulate colour deficiency in normal vision but cannot compensate for congenital colour vision deficiency. Sci Rep 2022;12:11140.

36. Bastien K, Mallet D, Saint-Amour D. Characterizing the effects of enchroma glasses on color discrimination. Optom Vis Sci 2020;97:903-910.

37. de Fez MD, Luque MJ, Viqueira V. Enhancement of contrast sensitivity and losses of chromatic discrimination with tinted lenses. Optom Vis Sci 2002;79:590-597.

38. Mahjoob M, Azimi A, Heravian J, Momeni Moghadam H, Mahjoob F. The effect of various colors of sunglasses in visual function. Majallah-i Danishgah-i Ulum-i Pizishkii Kirmanshah 2012;16:e78875.

39. Bailie M, Wolffsohn JS, Stevenson M, Jackson AJ. Functional and perceived benefits of wearing coloured filters by patients with age-related macular degeneration. Clin Exp Optom 2013;96:450-454.

40. Huchzermeyer C, Fars J, Kremers J, Kühlewein L, Kempf M, Ott S, et al. Photoreceptor-specific temporal contrast sensitivities in RP1L1-associated occult macular dystrophy. Invest Ophthalmol Vis Sci 2023;64:33.

41. Stoimenova BD. The effect of myopia on contrast thresholds. Invest Ophthalmol Vis Sci 2007;48:2371-2374.

42. Li Z, Hu Y, Yu H, Li J, Yang X. Effect of age and refractive error on quick contrast sensitivity function in Chinese adults: A pilot study. Eye 2021;35:966-972.

43. Karatepe AS, Köse S, Eğrilmez S. Factors affecting contrast sensitivity in healthy individuals: A pilot study. Turk J Ophthalmol 2017;47:80-84.