接受地高辛维持治疗患者的获得性色觉缺陷
Acquired colour vision deficiency in patients receiving digoxin maintenance therapy.
作者信息
Lawrenson J G, Kelly C, Lawrenson A L, Birch J
机构信息
Applied Vision Research Centre, Department of Optometry and Visual Science, City University, London EC1V 0HB, UK.
出版信息
Br J Ophthalmol. 2002 Nov;86(11):1259-61. doi: 10.1136/bjo.86.11.1259.
BACKGROUND/AIMS: Disturbances of colour vision are a frequently reported sign of digoxin toxicity. The aim of this study was to investigate the incidence of acquired colour vision deficiency in elderly hospitalised patients receiving maintenance digoxin therapy.
METHODS
30 patients (mean age 81.3 (SD 6.1) years) receiving digoxin were tested using a battery of colour vision tests (Ishihara, AO Hardy Rand Rittler plates, City tritan test, Lanthony tritan album, and the Farnsworth D15). These were compared to an age matched control group. Serum digoxin concentrations were determined from venous blood samples.
RESULTS
Slight to moderate red-green impairment was found in approximately 20-30% of patients taking digitalis, and approximately 20% showed a severe tritan deficiency. There was no correlation between colour vision impairment and serum digoxin level.
CONCLUSIONS
Formal colour vision testing of elderly patients taking digitalis showed a high incidence of colour deficiency, suggesting that impairment of retinal function can occur even at therapeutic drug levels. As a result, colour vision testing in this population would have limited value for the detection of drug toxicity.
背景/目的：色觉障碍是地高辛毒性的常见表现。本研究旨在调查接受维持性地高辛治疗的老年住院患者获得性色觉缺陷的发生率。
方法
使用一系列色觉测试（石原氏色盲测试、AO哈迪·兰德·里特勒色板、城市三原色测试、兰托尼三原色相册和法恩斯沃思D15）对30名接受地高辛治疗的患者（平均年龄81.3（标准差6.1）岁）进行测试。将这些患者与年龄匹配的对照组进行比较。从静脉血样本中测定血清地高辛浓度。
结果
服用洋地黄的患者中约20%-30%存在轻度至中度红绿色觉障碍，约20%表现为严重的蓝黄色觉缺陷。色觉障碍与血清地高辛水平之间无相关性。
结论
对服用洋地黄的老年患者进行正规的色觉测试显示色觉缺陷发生率很高，这表明即使在治疗药物水平下视网膜功能也可能受损。因此，对该人群进行色觉测试对检测药物毒性的价值有限。
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