Articles

Prevalence of Dyschromatopsia in adolescents in Pinar del Río province

0000-0002-4224-6039Elisbeth Pérez-Montes de Oca^{1  *}  , 0000-0001-9349-6831Yanet Romero-Reinaldo²  , 0000-0001-5329-2690Osmany Marcheco-Moreira³ 

¹University of Medical Sciences of Havana. Faculty of Medical Sciences "Victoria de Girón". Havana, Cuba.

²University of Medical Sciences of the Revolutionary Armed Forces. Central Military Hospital "Dr. Luis Días Soto". Havana, Cuba.

³University of Medical Sciences of the Revolutionary Armed Forces. Dr. Carlos J. Finlay" Central Military Hospital. Havana, Cuba.

ABSTRACT

Introduction:

dyschromatopsia is a vision disorder that makes it impossible to distinguish colors. It is manifested by the deficiency, inefficiency or inexistence of cone and rod photopigments. It has an approximate incidence of 8-10 % in men and 0.,4 % in women in a general population.

Objective:

To determine the prevalence of dyschromatopsia in adolescents in the province of Pinar del Río in the year 2021.

Methods:

An observational, descriptive and transversal study was carried out in adolescent patients diagnosed with dyschromatopsia in the province of Pinar del Río during the year 2021. The universe was composed of 959 patients. Adolescent patients studied in the health area through the Pinar del Río clinics diagnosed with dyschromatopsia through the Ishihara test were included. Patients without visual impairment and those older than 19 years were excluded. Descriptive statistics were used, the results were obtained as absolute and relative percentage frequencies.

Results:

The prevalence of dyschromatopsia in adolescentes in Pinar del Río province was 2,81 %, with a prevalence rate of 28 adolescent dyschromatopsia per 1,000. The male sex predominated (96,29 %). The municipality with the highest prevalence rate was Sandino, with 121,2 per 1000 subjects, followed by Minas de Matahambre (80x1000) and Viñales (41,6x1000).

Conclusions:

Dyschromatopsia in the province of Pinar del Río occurred more frequently in male adolescents aged 14 years. The municipality with the highest prevalence rate was Sandino.

Key words:

INTRODUCTION

Color blindness is a vision disorder that makes it impossible to distinguish colors (dyschromatopsia). It is named after the British physicist John Dalton who was a carrier of this visual disease, which became known only after his death.¹

This disorder is manifested by the deficiency, ineffectiveness or non-existence of photopigments by specialized sensory cells, the cones and rods, which are found in the retina of the eye. Both specialized cells are made up of pigments called conjugated proteins (cyanopsin, chloropsin and rhodopsin), and these in turn are made up of proteins called opsin bound to the carotenoid 11-cis-retinal. These proteins are responsible for sending the sensory stimulus through the optic nerve to the cerebral cortex. Even when chromatic discrimination is abnormal in these people, acuity is not affected by this alteration, the latter being caused by independent and isolated causes.^1,2,3

People with this disorder have two types of photoreceptors, i.e., one type of cone is absent, producing a total visual impairment. What the observer does is to match the colors with the mixture of two photopigments.^2,7

It has three classifications: protanopia: absence of the red photoreceptor. They confuse red with gray and blue with purple. Protanopes have their neutral point at the 492 nm wavelength, perceiving it as white. Deuteranopia: absence of the green photoreceptor. They mistake green and purple for gray.

Deuteranopes have their neutral point at the 499 nm wavelength, perceiving it as white. Tritanopia: absence of the blue photoreceptor. They confuse greenish yellow and purplish pink with gray; yellowish green with bluish purple and orange with purplish red. The tritanopes have their neutral point at the wavelength of 570 nm, perceiving it as white.¹

Dyschromatopsia occurs with an incidence of approximately 8-10 % in men and 0,4 % in women in a general population. Sex differences have been described in the proportion of people affected by congenital pathologies, since they affect 8 % of the male population and only 0,5 % of the female population, due to the hereditary factor affecting the X chromosome.^1,4,6

Congenital dyschromatopsias seem to be more frequent in North America and Western Europe; it has also been suggested that non-Caucasian races present a lower incidence, but the exact causes of the variations in frequency are not known.^1,7,8

The present study was carried out with the objective of determining the prevalence of Dyschromatopsia in adolescents in the province of Pinar del Río.

METHODS

An observational, descriptive and cross-sectional study was carried out in adolescent patients diagnosed with dyschromatopsia in Pinar del Río Province during the year 2021.

The universe was composed of 959 adolescents in the province. A purposive sampling of patients with visual impairment was carried out in the place and period described above, resulting in a total of 28 patients diagnosed with dyschromatopsia. Adolescent patients diagnosed with dyschromatopsia through the Ishihara test were included, with complete individual clinical histories, by means of a medical checkup in the health area through the Pinar del Río clinics. Patients without visual impairment and those older than 19 years were excluded. Descriptive statistics were used, the results obtained were made as absolute and relative percentage frequencies.

Medical records were used as the primary source of information. The variables age and sex were studied. The information was collected by means of a data collection form.

The data obtained were deposited in a database and processed using Microsoft Office Excel. Descriptive statistics were used for data analysis, using absolute and relative percentage frequencies.

The ethical principles established in the Declaration of Helsinki were taken into account during the research. As part of the research, confidentiality was guaranteed for all data obtained, which were used strictly for research purposes.

RESULTS

The prevalence of dyschromatopsia in adolescents in Pinar del Río province was 2,81 %, with a prevalence rate of 28 adolescent dyschromatopsia per 1000 adolescents. Male subjects predominated (96,29 %). Only one female subject was identified with this disease (3,7 %). The average age was 14 years.

The municipality with the highest prevalence rate was Sandino, with 1212 per 1000 subjects, followed by Minas de Matahambre (80x1000) and Viñales (416x1000). (Table 1).

Table 1 Prevalence of dyschromatopsia in adolescents in Pinar del Rio province. 

Municipality	Population	Dyschromatopsia	Rate*
Los Palacios	54	1	18,5
Consolación del Sur	174	4	22,9
Pinar del Río	176	2	11,3
San Luis	80	1	12,5
San Juan y Martínez	84	2	23,8
Guane	105	2	19
Mantua	68	1	14,7
Sandino	33	4	121,2
La Palma	62	2	32,2
Viñales	48	2	41,6
Minas de Matahambre	75	6	80

* Rate per 1,000 adolescents

DISCUSSION

Color vision is very important for life. Some difficulties may be encountered in daily activities, for example, in matching the color of clothes, in recognizing flowers and plants, or in choosing a ripe fruit. In addition, it can also affect driving since it has been detected that drivers with color vision deficiency have more difficulties in recognizing traffic signs, in studies that use colors as a means of learning and jobs in which the defect in color vision can cause situations of insecurity or danger.^7,9,10

Some authors refer to the lack of knowledge of the prevalence and severity of acquired dyschromatopsias, due to the fact that the greatest importance has been given to congenital dyschromatopsias and most of the research refers only to these. However, the present work encompasses congenital and acquired dyschromatopsias in general.^9,11

The article published by Valera¹⁾ The ages of the patients attended ranged from three to 91 years. The pseudoisochromatic tests used were HRR, Matsubara (for children) and D15 and D15 desaturated. All were found to be optimal. In such cases, for the former, a color vision illumination lamp with a 45º stand was used, and for the latter the same lamp, but with a 180º flat stand, placed 40 cm away from the patient. On the other hand, in our research, patients in adolescence were studied and diagnosed by means of the Ishihara test.

We will continue comparing with the Colombian study carried out in 1979 for two different locations in Mexico, which obtained averages of 2,36 and 2,53 %.¹² Later in the research carried out by Valera in the whole country Mexico, 3,2 % were found.¹ These results differ although they are similar to our article in which 2.,81 % were found. In both studies the pathology predominates in the male sex.

It is very important to know how people's visual function is in order to detect visual pathologies that can manifest themselves earlier by means of chromatic anomalies and to know how they cope in their daily life, since it is essential to have a good chromatic vision.^13,14,15

CONCLUSIONS

Dyschromatopsia in the province of Pinar del Río occurred more frequently in male adolescents aged 14 years. The municipality with the highest prevalence rate was Sandino, followed by Minas de Matahambre and Viñales.

BIBLIOGRAPHIC REFERENCES

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Funding

The authors did not receive funding for the development of this article

Received: March 30, 2022; Accepted: January 03, 2023

The authors declare that there is no conflict of interest

EPMdeO:Conceptualization, data curation, formal analysis, validation, visualization, writing-revision and editing.

YRR: Conceptualization, data curation, formal analysis, validation, visualization, writing-revision and editing.

OMM: Conceptualization, data curation, formal analysis, validation, visualization, writing-revision and editing