Turkiye Klinikleri Journal of Pediatrics

.: ORIGINAL RESEARCH
Prevalence and Severity of Color Vision Deficiency Among Turkish Children
Türk Çocuklarında Renkli Görme Bozukluklarının Sıklık ve Ağırlığının Değerlendirilmesi
Funda DİKKAYAa, Ayşe ÖZPINARa
aİstanbul Medipol University Faculty of Medicine, Department of Ophthalmology, İstanbul, TURKEY
Turkiye Klinikleri J Pediatr. 2020;29(2):75-81
doi: 10.5336/pediatr.2019-72628
Article Language: EN
Full Text
ABSTRACT
 Objective: To determine the prevalence of color vision deficiency, ratio of deutan/protan and the distribution of the severity of color vision deficiency among Turkish children and to evaluate the usability the Color Assessment and Diagnosis (CAD) test in children. Material and Methods: A total of 1374 children (627 girls and 747 boys) of age 6-16 years were included in this study. The first 15 plates of the Ishihara test were used to evaluate to screen for color deficiency. Those who made three or more errors had their color vision examined using the CAD test to determine the type and severity of color vision deficiency. The prevalence of color vision deficiency in boys and girls, ratio of deutan and protan deficieny and the distribution of the severity of loss were calculated. The correlations of the CAD test result and number of mistakes on the Ishihara test with age were also evaluated. Results: Thirty seven boys (4.95%) and 3 girls (0.47%) made 3 or more errors and were categorized as having color vision deficiency. In total, 32 subjects completed the CAD test, 22 subjects (68.7%) were classified as deutan and 10 (31.2%) as protan with the ratio of 2.2:1. In terms of the CAD based color vision grading system for red-green deficiency 3 subjects (9.3%) were classed as color vision (CV) category 3, 5 subjects (15.6%) as CV category 4 and 24 subjects (75%) as CV category 5. There was no significant correlation between the CAD test result and number of mistakes on the Ishihara test with age (r=-0.075, p=0.684 and r=-0.191, p=0.295 respectively). Conclusion: The results reveal severe loss of red-green color vision in 75% of the children with color vision deficiency. The study also demonstrates that the CAD test can be used in children as young as six years.

Keywords: Color vision; color vision defects; child; color perception tests; Turkey
ÖZET
 Amaç: Türk çocuklarında renkli görme bozukluğunun prevalansı, dötan/protan oranı ve ağırlığına göre renkli görme bozukluğunun dağılımının saptanması ve Renk Değerlendirme ve Tanı testinin çocuklarda kullanılabilirliğini değerlendirmektir. Gereç ve Yöntemler: Yaşları 6 ile 16 arasında değişen 627'si kız 747'si erkek toplam 1374 çocuk çalışmaya dahil edildi. Renkli görme bozukluğunun taranmasında İshihara testinin ilk 15 plakası kullanıldı. Üç ve üzerinde hata yapanlar renkli görme bozukluğunun tipi ve ağırlığının tespit edilebilmesi için Renk Değerlendirme ve Tanı testi ile değerlendirildi. Kızlarda ve erkeklerdeki renkli görme bozukluğunun prevalansı, dötan/protan oranı ve ağırlığına göre renkli görme bozukluğunun dağılımı hesaplandı. Renk Değerlendirme ve Tanı testinin sonuçları ile İshihara testindeki hata sayısının yaş ile olan korelasyonu da değerlendirildi. Bulgular: İshihara testinde 3 ve üzerinde hata yapan 37 erkek (%4,95) ve 3 kız (%0,47) renkli görme bozukluğu olanlar grubunda değerlendirildi. Olgulardan 32 tanesi Renk Değerlendirme ve Tanı testini tamamlayabildi. Bu olgulardan 22 tanesi (%68,7) dötan, 10 tanesi (%31,2) protandı ve dötan/protan oranı 2,2:1 idi. Renk Değerlendirme ve Tanı testinin kırmızı- yeşil renkli görme bozukluğu ağırlık sınıflandırmasına göre olgulardan 3'ü (%9,3) renkli görme kategori 3, 5'i (%15,6) kategori 4 ve 24'ü (%75) kategori 5'e dahildi. Renk Değerlendirme ve Tanı testinin sonucu ve İshihara testindeki hata sayısı ile yaş arasında korelasyon tespit edilmedi (r=-0,075, p=0,684 ve r=-0,191, p=0,295 sırasıyla). Sonuç: Sonuçlar renkli görme bozukluğu olan çocukların %75'inin ağır kırmızı-yeşil renkli görme bozukluğuna sahip olduğunu göstermektedir. Çalışma aynı zamanda Renk Değerlendirme ve Tanı testi'nin çocuklarda 6 yaşından itibaren kullanılabilir olduğunu göstermektedir.

Anahtar Kelimeler: Renkli görme; renkli görme bozuklukları; çocuk; renk algılama testleri; Türkiye
REFERENCES:
  1. Simunovic MP. Color vision deficiency. Eye (Lond). 2010;24(5):747-55. [Crossref]  [PubMed] 
  2. DeMarco P, Pokorny J, Smith VC. Full-spectrum cone sensitivity functions for X-chromosome-linked anomalous trichromats. J Opt Soc Am A. 1992;9(9):1465-76. [Crossref]  [PubMed] 
  3. Grassivaro Gallo P, Panza M, Viviani F, Lantieri PB. Congenital dyschromatopsia and school achievement. Percept Mot Skills. 1998;86(2):563-9. [Crossref]  [PubMed] 
  4. Grassivaro Gallo P, Oliva S, Lantieri PB, Viviani F. Color blindness in Italian Art High School Students. Percept Mot Skills. 2002;95(3 Pt 1):830-4. [Crossref]  [PubMed] 
  5. Grassivaro Gallo P, Panza M, Lantieri PB, Risso D, Conforti G, Lagonia P, et al. Some psychological aspects of color blindness at school: a field study in Calabria and Basilicata (Southern Italy). Color Res Appl. 2003;28(3):216-20. [Crossref] 
  6. Barbur JL, Rodriguez-Carmona M. Color vision requirements in visually demanding occupations. Br Med Bull. 2017;122(1):51-77. [Crossref]  [PubMed] 
  7. Barbur JL, Harlow AJ, Plant GT. Insights into the different exploits of color in the Visual Cortex. Proc Biol Sci. 1994;258(1353):327-34. [Crossref]  [PubMed] 
  8. Schwartz SH. Visual Perception: A Clinical Orientation. 3rd ed. New York: McGraw-Hill; 2004. p.471.
  9. Citirik M, Acaroglu G, Batman C, Zilelioglu O. Congenital color blindness in young Turkish men. Ophthalmic Epidemiol. 2005;12(2):133-7. [Crossref]  [PubMed] 
  10. Modarres M, Mirsamadi M, Peyman GA. Prevalence of congenital color deficiencies in secondary-school students in Tehran. Int Ophthalmol.1997;20(4):221-2. [Crossref]  [PubMed] 
  11. Al-Aqtum MT, Al-Qawasmeh MH. Prevalence of color blindness in young Jordanians. Ophthalmologica. 2001;215(1):39-42. [Crossref]  [PubMed] 
  12. Xie JZ, Tarczy-Hornoch K, Lin J, Cotter SA, Torres M, Varma R. Multi-Ethnic Pediatric Eye Disease Study Group. Color vision deficiency in preschool children: the multi-ethnic pediatric eye disease study. Ophthalmology. 2014;121(7):1469-74. [Crossref]  [PubMed]  [PMC] 
  13. Chia A, Gazzard G, Tong L, Zhang X, Sim EL, Fong A, et al. Red-green color blindness in Singaporean children. Clin Exp Ophthalmol. 2008;36(5):464-7. [Crossref]  [PubMed] 
  14. Osuobeni EP. Prevalence of congenital red-green color vision defects in Arab boys from Riyadh, Saudi Arabia. Ophthalmic Epidemiol. 1996;3(3):167-70. [Crossref]  [PubMed] 
  15. Woldeamanuel GC, Geta TG. Prevalence of color vision deficiency among school children in Wolkite, Southern Ethiopia. BMC Res Notes. 2018;11(1):838. [Crossref]  [PubMed]  [PMC] 
  16. Birch J. Efficiency of the Ishihara Test for identifying red-green color deficiency. Ophthalmic Physiol Opt. 1997;17(5):403-8. [Crossref]  [PubMed] 
  17. Civil Aviation Authority. Minimum Color Vision Requirements for Professional Flight Crew. Part III. Recommendations for New Color Vision Standards. Norwich, UK: The Stationary Office; Report No: CAA Paper; 2009/04.
  18. T.C. Resmî Gazete (23.02.2018, Sayı: 52217814-010-E.1429). Sivil Havacılık Genel Müdürlüğü Havacılık Sağlık Talimatı (SHT-MED) AMC1 MED. B.075 Madde b-2. 2018.
  19. T.C. Resmî Gazete (06.12.2013, Sayı: 10600330-659/9) T.C. Sağlık Bakanlığı Türkiye Hudut ve Sahiller Sağlık Genel Müdürlüğü Gemi Adamları Sağlık Yönergesi Ek 1 Madde B-e.
  20. Jägle H, Pirzer M, Sharpe LT. The Nagel anomaloscope: its calibration and recommendations for diagnosis and research. Graefe's Arch Clin Exp Ophthalmol. 2005;243(1):26-32. [Crossref]  [PubMed] 
  21. Squire TJ, Rodriguez-Carmona M, Evans AD, Barbur JL. Color vision tests for aviation: comparison of the anomaloscope and three lantern types. Aviat Space Environ Med. 2005;76(5):421-9.

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