Silverman S E, Hart W M, Gordon M O, Kilo C
Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri 63110.
Invest Ophthalmol Vis Sci. 1990 Sep;31(9):1895-902.
Most hypotheses of acquired dyschromatopsia invoke the mechanism of selective damage to specific components of the afferent visual system to explain the predominance of red-green and blue-yellow hue-discrimination defects found in neural and retinal disorders, respectively. However, this pattern of hue-discrimination disturbance in ocular disease may vary. There are frequent exceptions which are inadequately explained by existing hypotheses. In an effort to explain the pattern and pathogenesis of acquired dyschromatopsias better, the authors examined patients with nonproliferative diabetic retinopathy (DR) and late-stage retrobulbar neuritis (RBN) using age-corrected Farnsworth-Munsell 100-hue testing and threshold static perimetry. As expected, most DR eyes showed some degree of relative blue-yellow dyschromatopsia (89%) with few showing a greater weighting towards red-green dyschromatopsia (11%). However, an approximately equal number of RBN eyes had a relative blue-yellow (48%) versus red-green dyschromatopsia (52%). For RBN, the authors found a strong association between the spatial distribution of field defect and the type of relative hue-discrimination disturbance. Eyes with greater field depression at the fovea relative to the perifovea showed a relative preponderance of red-green dyschromatopsia (68%) as opposed to blue-yellow dyschromatopsia (32%), whereas eyes with greater relative perifoveal impairment showed a relative preponderance of blue-yellow dyschromatopsia (100%). This relationship between the relative spatial distribution of visual field damage and the relative hue-discrimination deficit in RBN was statistically significant (P = 0.002). Such an association was not found for DR.(ABSTRACT TRUNCATED AT 250 WORDS)
大多数后天性色觉异常的假说都援引传入视觉系统特定成分的选择性损伤机制,来分别解释在神经和视网膜疾病中发现的红绿色和蓝黄色色调辨别缺陷的优势情况。然而,眼部疾病中这种色调辨别障碍的模式可能有所不同。存在一些常见的例外情况,现有假说对此解释并不充分。为了更好地解释后天性色觉异常的模式和发病机制,作者使用年龄校正的 Farnsworth-Munsell 100色调测试和阈值静态视野检查法,对非增殖性糖尿病视网膜病变(DR)和晚期球后视神经炎(RBN)患者进行了检查。正如预期的那样,大多数DR眼表现出一定程度的相对蓝黄色色觉异常(89%),只有少数表现出更偏向红绿色觉异常(11%)。然而,RBN眼中相对蓝黄色觉异常(48%)和红绿色觉异常(52%)的数量大致相等。对于RBN,作者发现视野缺损的空间分布与相对色调辨别障碍的类型之间存在密切关联。相对于周边凹,中央凹视野缺损更大的眼睛表现出红绿色觉异常(68%)相对占优势,而非蓝黄色觉异常(32%),而周边凹相对损伤更大的眼睛则表现出蓝黄色觉异常(100%)占优势。RBN中视野损伤的相对空间分布与相对色调辨别缺陷之间的这种关系具有统计学意义(P = 0.002)。DR未发现这种关联。(摘要截取自250字)