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[Neurophysiological basis and clinical tests for assessment of X-linked color vision deficiencies in school children].

Vision screening of school children at 5-6 years of age must include color vision screening. X-linked dyschromatopsia is the most frequent disorder affecting 8% of boys and 0.4% of girls. This paper presents the physiology of these deficiencies caused by an alteration of the spectral absorption properties of one of the cone pigments (protanomalous or deuteranomalous trichromats) or the absence of one of the pigments (protanopia or deuteranopia), the most frequent. Absence of two of the pigments (blue cone monochromacy) is very rare and differs from achromatopsia. The physiological basis of the main tests for easy clinical screening are presented. Testing methods designed for children are reviewed. The Ishihara test is the most widely used screening test specific for congenital color defects. If the plates are correctly read, the child has normal color vision. If not, arrangement tests such as Panel D 15 and desaturated Panel D 15 tests can be used to diagnose the type of the defect (protan or deutan) and grade the degree of color deficiency according to a strategy adapted to children. Examples of results are presented for each axis along which caps are confused, providing a quick and easy preliminary diagnosis. Early detection of color vision malfunction in children allows parents and teachers to make necessary adjustments to the teaching methods for appropriate learning.

Adolescent↗

Spectral tuning of pigments underlying red-green color vision.

Variations in the absorption spectra of cone photopigments over the spectral range of about 530 to 562 nanometers are a principal cause of individual differences in human color vision and of differences in color vision within and across other primates. To study the molecular basis of these variations, nucleotide sequences were determined for eight primate photopigment genes. The spectral peaks of the pigments specified by these genes spanned the range from 530 to 562 nanometers. Comparisons of the deduced amino acid sequences of these eight pigments suggest that three amino acid substitutions produce the approximately 30-nanometer difference in spectral peaks of the pigments underlying human red-green color vision, and red shifts of specific magnitudes are produced by replacement of nonpolar with hydroxyl-bearing amino acids at each of the three critical positions.

Amino Acid Sequence↗

Long wavelength pass filters designed for the management of color vision deficiencies.

This study reports on the effectiveness of long wavelength pass filters dispensed as tinted spectacles as an aid for individuals with congenital red-green color vision deficiencies. The effectiveness of the filters was evaluated by the performance on a series of clinical color vision tests and a questionnaire after the subjects had tried the lenses for 1 week. The lenses improved performance on color vision tests that required discrimination between large color differences, particularly between red and green hues. However, performance was degraded on tests which required fine color discrimination or used colors that were located parallel to the tritan confusion axis. The improved performance on certain tests was primarily based on brightness artificats induced by the filters, whereas the degraded performance on the other tests was due to the absorption of short- to midwavelength light by the filters. A slight majority (56%) of the subjects rated the filters as being moderate to highly effective in improving their color discrimination. Nevertheless, only 17% were interested in actually purchasing a pair. Common reasons for rejecting the filters were the color distortions produced by the red filters and fewer colors were actually perceived when wearing the filters.

Adolescent↗

Men's fabric preferences related to age, inherent color vision, and perceptual disembedding ability.

Non-random samples of 27 color-normal and 27 color-blind men between the ages of 18 and 52 were administered measures of color vision, fabric preferences, and perceptual disembedding (field dependence). Pearson product-moment correlation and analysis of variance were used to test associations among the variables. Results showed the rank order of men's fabric preferences from least to most preferred were pattern, large design, tint, textured, small design, shade, smooth, and plain. There was one significant relationship between age and a preference for tints. No significant relationships were found among fabric preferences and color vision, fabric preference and field dependence, or age and field dependence. Color-blind men were significantly more field-independent than color-normal men in the sample. It was concluded that social as opposed to inherent factors helped to determine men's fabric preferences.

Adolescent↗

Psychophysical measurement of spectral sensitivity and color vision in red-light-reared tree shrews (Tupaia belangeri).

The role of the spectral lighting environment on the post-natal development of spectral sensitivity and color vision was studied in tree shrews (Tupaia belangeri) that were born and reared to adulthood in cyclic red light. Normal tree shrews are dichromats, possessing short-wavelength-sensitive (SWS) and long-wavelength-sensitive (LWS) cone receptors and a small population of rods. Red-light-rearing (RLR) produced differential stimulation of the cone types by effectively eliminating photic stimulation of the SWS cones, without depriving the LWS cones. Spectral sensitivity and color vision were measured behaviorally for RLR shrews and normal shrews under different ambient light levels. Spectral sensitivity functions were deutan-like, exhibiting maxima at ca 450 and 550 nm and a minimum at 510 nm. No significant differences in spectral sensitivity were observed between RLR and control animals. Furthermore, all animals demonstrated deutan-type dichromatic color vision evidenced by their ability to discriminate monochromatic lights from equally-bright achromatic lights except for a "neutral point" near 505 nm. These results demonstrate that a population of functional SWS cones survived the lack of post-natal photic stimulation. However, RLR shrews differed from controls in that they were poorer at making chromatic/achromatic discriminations. While no severe disorganization of color vision was evident, the poorer discrimination displayed by the RLR animals is likely the result of changes in post-receptoral visual mechanisms.

Animals↗

Color vision deficiencies in the course of acute alcohol withdrawal.

Thirty-six male patients with a diagnosis of chronic alcoholism were detoxified and color vision tests were performed on day 4, 11, and 32 of their abstinence on an inpatient basis (Ishihara color plates, Nagel anomaloscope, three color-matching tests according to Farnsworth). Of the 36 patients, 47.2% manifested color vision deficiencies. The frequency of congenital red/green defects (11.1%) and a ratio of 3:1 deutan/protan defects showed no significant difference from the incidence in the normal population. In 36.1%, manifest acquired color vision deficiencies were diagnosed. Within the course of withdrawal, a marked improvement of these disturbances could be proved. The degree of the disturbance seems to correlate with the severity of withdrawal symptoms, but seems to be unrelated to acute toxic effects of alcohol, nicotine, or medication.

Adult↗

Color vision: a sensitive indicator of exposure to neurotoxins.

In the last 15 years an increasing number of studies have investigated color discrimination in workers exposed to various neurotoxins. Color vision was generally evaluated using the Lanthony D-15 desaturated panel (D-15 d), a test suited to identify mild acquired impairments, that can be easily performed at the workplace. In most studies, results were quantitatively expressed using the method of Bowman or that of Vingrys and King-Smith: the former is the most widely reported, while the latter gives information on the type of color defect. Applying D-15 d, or other color perception tests, impairment in color vision was observed among workers exposed to several solvents (styrene, perchloroethylene, toluene, n-hexane, and carbon disulfide), or to solvent mixtures, and also to metals like mercury. Chemical related color vision loss is a sub-clinical early effect, and in most studies proved dose-related. For styrene and perchloroethylene, and also for solvent mixtures, an impairment was observed at exposure levels lower than the current occupational limits, suggesting that these limits may be inadequate for a proper protection of visual function of workers.

Carbon Disulfide↗

Color vision tests to identify elevated digoxin levels.

The purpose of this study was to determine the usefulness of color vision screening in identifying patients with elevated digoxin levels (greater than or equal to 2.0 ng/ml). Test-retest color vision measurements were obtained on 56 subjects with elevated digoxin levels and 93 non-digoxin subjects. Two tests, the Ishihara and Sahlgren's Saturation Test (SST), identified digoxin levels of 2.9 ng/ml or more. These tests also yielded a high percentage of improved retest scores among subjects with elevated digoxin levels (greater than or equal to 2.7 ng/ml) of more than 4-days duration and a low percentage of improved retest scores among the non-digoxin group. The Ishihara, SST, and other bedside color vision tests may prove useful in the routine monitoring of patients on digoxin therapy, especially those with a high risk for toxicity.

Adult↗