Diagnosis of color vision in children with congenital partial atrophy of the optic nerve

Abstract

Background. The study of color vision is of great importance in the diagnosis and monitoring of visual functions in patients with of the partial atrophy of optic nerve (PAON). Due to the fact that PAON is one of the main causes of blindness and low vision in children, there is no doubt about the importance of effective diagnosis of color vision not in children with this pathology.Purpose: to evaluate the effectiveness of the diagnosis of color vision in children with congenital partial atrophy of the optic nerve using developed own tests in comparison with classical methods. The Rabkin and Neitz-test tables create conditions under which the examined child is given two tasks at once – color discrimination and shape identification. At the same time, the integration of information about color and shape may be difficult in children with PAON.Materials and methods. In 2020–2022 years 72 school-age children were observed, who, after a standard ophthalmological examination, were divided into two groups: 1) 37 children with congenital bilateral PAON; 2) 35 children of the control group with no pathology of the fundus and normal indicators of visual functions. To study color vision, we used our own developed test images (Patent RU 2760085 of 02.04.2021), as well as classical tests – polychromatic tables E.B. Rabkin and Neitz-test.Results. In the control group, when studying color vision according to Rabkin tables, four children had some difficulties with determining the shape of test figure in three of the 27 main tables. At the same time, the children named the colors of individual circles that make up the images correctly. In the Neitz-test, only one child did not distinguish between the shapes of brown and green tones of minimal saturation. The other children correctly identified the colored shapes in all the test images. The study with the developed tests did not cause any difficulties for any of the children of the control group. With minimal saturation, all children distinguished chromatic images from achromatic ones and correctly distinguished shades. In the group of children with PAON in the study with classical tests, 15 (40.5%) children experienced significant difficulties with determining the shape of the test figure in some Rabkin tables (while correctly naming the colors of individual circles) and 12 (32.4%) children – in Neitz-test images. Normal trichromasia was detected in 18 (48.6%) children and in 4 (10.8%) children – abnormal trichromasia according to both Rabkin’s tables and Neitz-test. With the developed tests, 6 (16.2%) children had color vision disorders. At the same time, abnormal trichromasia was detected in 4 of them according to the Rabkin and Neitz-test tables.Conclusion. The test images developed by us are easy to perform and do not pose a difficult visual task for the child to identify the chromatic shape. In this regard, they allow for effective diagnosis of color vision in children in normal and ophthalmopathology, and are also promising for use in children not only of school age, but also of younger age.