Publication: Cuantificación de la visión cromática en pacientes con distintas patologías retinianas
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2020-06-17
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Universidad Complutense de Madrid
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Abstract
Introducción: la degeneración macular asociada a la edad (DMAE) y la retinosis pigmentaria (RP) son dos patologías degenerativas retinianas que afectan al área visual central y periférica ocasionando problemas en la función visual. Por ello, el objetivo es cuantificar la alteración de la visión cromática para conocer el grado de pérdida según la patología retiniana y su relación con la agudeza visual (AV), medida en diferentes contrastes.
Métodos: este estudio transversal de carácter retrospectivo, se realizó en 63 sujetos (23- 94 años), clasificados en DMAE húmeda, DMAE seca y RP. Se evaluó la visión al color mediante el test de Farnsworth D-15 saturado cuantificando su defecto cromático mediante el método de Vingrys. El estado visual se analizó mediante el test de AV ETDRS al contraste 100% y 10%.
Resultados: la prueba del color muestra que el 44% de pacientes tiene defecto tipo tritán, el 39% no manifiestan ninguna anomalía cromática y se tiene valores inferiores al 10% en defectos tipo deután y protán. Entre los parámetros descritos por Vingrys para cuantificar la visión al color destacan el ángulo de confusión (α) y el índice de confusión (C-index). Se tiene en DMAE seca un α=76,25 ± 26,38 y C-index=3,32 ± 2,02; para DMAE húmeda α=90,63 ±38,65 y C-index=2,53 ± 0,65; y RP tiene α=74,98 ± 22,96 y C-index=74,98 ± 22,96. En relación con la AV logMAR en contraste 100% se obtiene en DMAE húmeda 0,79 ± 0,49, DMAE seca 0,34 ± 0,24 y RP 0,30 ± 0,24, empeorando los resultados cuando el contraste es 10% en DMAE húmeda (1,23±0,77), DMAE seca (0,66±0,33) y RP (0,48±0,25).
Conclusiones: el defecto cromático más prevalente en DMAE y RP se da en el eje de anomalía tritán. Además, la AV se muestra disminuida cuando se reduce el contraste del test ETDRS de 100% a 10%.
Introduction: Age-related macular degeneration (AMD) and retinitis pigmentosa (RP) are both retinal degenerative diseases that affect the central and peripheral visual area, causing problems in visual function. The aim of this project is to quantify the alteration of color vision so as to know the degree of loss according to the retinal pathology and its relationship with visual acuity (VA), which is measured in different contrasts. Methodology: This retrospective cross-sectional study was conducted on 63 participants (from 23 to 94 years old), who were categorized as wet AMD, dry AMD and RP. Color vision was evaluated using the Farnsworth D-15 saturated test, which quantifies the color defect according to the Vingrys method. The visual state was analyzed using the ETDRS VA test at 100% and 10% contrast. Results: The color test shows that 44% of patients have a tritan defect, 39% have no chromatic anomaly, and below 10% show values in deutan and protan defects. The main parameters reported using Vingrys method for quantifying color vision are the confusion angle (α) and confusion index (C- index). Results for dry AMD are α=76,25 ± 26,38 and C-index=3,32 ± 2,02; for wet AMD are α=90,63 ± 38,65 and C-index=2,53 ± 0,65; while RP has α=74,98 ± 22,96 and C-index=74,98 ± 22,96. In relation to the logMAR VA at 100% contrast, results showed 0,79±0,49 for wet AMD, 0,34±0,24 for dry AMD and 0,30±0,24 for RP. When the contrast is at 10%, the results were worse in all fields: 1,23±0,77 for wet AMD, 0,66±0,33 for dry AMD and 0,48±0,25 for RP. Conclusions: The most prevalent color defect in AMD and RP occurs on the tritan anomaly axis. In addition, VA seems to be diminished when the contrast of the ETDRS test is reduced from 100% to 10%.
Introduction: Age-related macular degeneration (AMD) and retinitis pigmentosa (RP) are both retinal degenerative diseases that affect the central and peripheral visual area, causing problems in visual function. The aim of this project is to quantify the alteration of color vision so as to know the degree of loss according to the retinal pathology and its relationship with visual acuity (VA), which is measured in different contrasts. Methodology: This retrospective cross-sectional study was conducted on 63 participants (from 23 to 94 years old), who were categorized as wet AMD, dry AMD and RP. Color vision was evaluated using the Farnsworth D-15 saturated test, which quantifies the color defect according to the Vingrys method. The visual state was analyzed using the ETDRS VA test at 100% and 10% contrast. Results: The color test shows that 44% of patients have a tritan defect, 39% have no chromatic anomaly, and below 10% show values in deutan and protan defects. The main parameters reported using Vingrys method for quantifying color vision are the confusion angle (α) and confusion index (C- index). Results for dry AMD are α=76,25 ± 26,38 and C-index=3,32 ± 2,02; for wet AMD are α=90,63 ± 38,65 and C-index=2,53 ± 0,65; while RP has α=74,98 ± 22,96 and C-index=74,98 ± 22,96. In relation to the logMAR VA at 100% contrast, results showed 0,79±0,49 for wet AMD, 0,34±0,24 for dry AMD and 0,30±0,24 for RP. When the contrast is at 10%, the results were worse in all fields: 1,23±0,77 for wet AMD, 0,66±0,33 for dry AMD and 0,48±0,25 for RP. Conclusions: The most prevalent color defect in AMD and RP occurs on the tritan anomaly axis. In addition, VA seems to be diminished when the contrast of the ETDRS test is reduced from 100% to 10%.
Description
Facultad de Óptica y Optometría. Curso 2019/2020