百分制色觉定量检测表对正常人及先天性色觉异常者色觉感色力及辨色力的评估

Study on color sensitivity and color discrimination in normal and congenital color vision deficiency

目的通过自行设计百分制色觉定量检测表(百分制量表)检查正常人及先天性色觉异常者色觉感色力和辨色力的差异。设计诊断技术评价。研究对象采用俞自萍色盲本筛查色觉正常者48例(男性46例,女性2例);采用Farnsworth Munsell(FM-100)色相检测法确诊的红色觉异常者28例(男性27例,女性1例),绿色觉异常者71例(男性68例,女性3例)。方法采用自制百分制量表检测受试者的色觉感色力和辨色力,并对评分进行对比分析,采用中位数(四分位数)描述。主要指标红色、绿色及蓝色感色力和红绿、红蓝及绿蓝辨色力百分制量表评分。结果用百分制量表评价,正常人红色、绿色、蓝色感色力评分分别为96(95,97)、98(97,98)、95(92.25,96);红绿、红蓝、绿蓝辨色力评分分别为97(97,98)、96(95,97)、98(97,98)。与正常人相比,先天性红色觉异常患者的红色感色力[91.5(89.25,93)]、蓝色感色力[93(90,95)]和红蓝辨色力[90.50(86.25,92)]评分下降(Z=-6.837、-3.151、-6.780,P均<0.01);先天性绿色异常患者红色感色力[95(94,96)]、蓝色感色力[91(88,93)]、红绿辨色力[96(96,97)]和红蓝辨色力[94(93,95)]评分下降(Z=-3.982、-4.863、-3.789、-5.370,P均<0.001)。据红色感色力诊断先天性红色觉异常:曲线下面积0.874(95%CI:0.800~0.949,P<0.001);绿色感色力诊断先天性绿色觉异常:曲线下面积0.650(95%CI:0.539~0.762,P=0.02)。截断界值点为红色感色力93.5,敏感度为85.7%,特异性为83.1%。结论使用自行设计的百分制色觉定量检测表客观地检查先天性色觉异常是可行的,其中红色感色力评分更敏感。

Objective To compare the differences of color sensitivity and color discrimination between normal and congenital color vision deficiency by using self-designed percentile color vision quantitative test table(percentile table).Design Diagnostic technique evaluation.Participants Forty-eight subjects with normal color vision(46 males and 2 females),28 patients with abnormal red vision(27 males and 1 female)and 71 patients with abnormal green vision(68 males and 3 females).Methods The color sensitivity and color discrimination of the subjects were measured by the percentage table,and the scores were compared and analyzed,and described by the median(quartile).Main Outcome Measures Color sensitivity scores of red,green and blue;color discrimination scores of red-green,red-blue and green-blue.Results Using the percentile table,the color sensitivity scores of red,green and blue were 96(95,97),98(97,98)and 95(92.25,96),respectively.The color discrimination scores of red-green,red-blue,and green-blue were 97(97,98),96(95,97)and 98(97,98),respectively.Compared with normal controls,the scores of red color perception[91.5(89.25,93)],blue color perception[93(90,95)]and red-blue color discrimination[90.50(86.25,92)]were decreased in patients with congenital abnormal red perception(Z=-6.837,-3.151,and-6.780,all P<0.01).The scores of red color perception[95(94,96)],blue color perception[91(88,93)],red-green color discrimination[96(96,97)]and red-blue color discrimination[94(93,95)]decreased in patients with congenital green abnormalities(Z=-3.982,-4.863,-3.789 and-5.370,all P<0.001).The diagnosis of red color deficiency by red color perception score:the area under the curve(AUC)of ROC was 0.874(95%CI:0.800-0.949,P<0.001).The diagnosis of green color deficiency by green color perception score:AUC of ROC was 0.650(95%CI:0.539-0.762,P=0.02).The cut-off point of red color perception was 93.5,sensitivity 85.7%and specificity 83.1%.Conclusion It is feasible to objectively detect congenital color vision deficiency with a self-made percentile color vision quantitative test table,and the red color perceptionis more sensitive.