Raman Rajiv, Verma Aditya, Srinivasan Sangeetha, Bhojwani Deepak
Shri Bhagwan Mahavir Vitreoretinal services, Sankara Nethralaya, Chennai, India.
GMS Ophthalmol Cases. 2018 Mar 8;8:Doc05. doi: 10.3205/oc000087. eCollection 2018.
Tritan anomaly is a known acquired color defect seen in diabetic patients, with or without the evidence of clinical signs of diabetic retinopathy (DR). We report a case of a 45-year-old diabetic patient with tritan pattern color defect associated with obstructive sleep apnea and its partial reversal with continuous positive airway pressure (CPAP) ventilation. A 45-year-old male with diabetes, wildlife photographer by profession, presented with specific complaints of seeing all objects in the surrounding with a greenish tinge in both the eyes. He underwent a comprehensive eye examination including Farnsworth-Munsel 100 (FM 100) hue test, multifocal electroretinogram, microperimetry, spectral domain optical coherence tomography (SDOCT), and arterial oxygen saturation. The subject was found to have a low arterial oxygen saturation (PaO2) of 86%. He was then advised inhalation of 100% oxygen for 15 min, following which he reported improvement in his visual symptoms. FM 100, OCT, and microperimetry were repeated after oxygenation. He was referred to a specialty hospital for further evaluation of the cause for reduced blood oxygen saturation and was further advised for sleep study, where he was diagnosed to have obstructive sleep apnea (OSA) with an apnea-hypopnea index of 20.9. The subject was advised weight loss measures and oral application of continuous positive airway pressure. Since then, he is under our regular follow-up and has never experienced or complained of any color vision problems. This case report highlights the presence of associated systemic disorders like obstructive sleep apnea in individuals with diabetes that can present with color vision problems.
三原色异常是糖尿病患者中一种已知的后天性色觉缺陷，无论有无糖尿病视网膜病变（DR）的临床体征证据。我们报告一例45岁糖尿病患者，其患有与阻塞性睡眠呼吸暂停相关的三原色模式色觉缺陷，经持续气道正压通气（CPAP）后部分逆转。一名45岁男性糖尿病患者，职业为野生动物摄影师，主诉双眼看周围所有物体都带有绿色色调。他接受了全面的眼科检查，包括 Farnsworth-Munsel 100（FM 100）色调试验、多焦视网膜电图、微视野检查、光谱域光学相干断层扫描（SDOCT）和动脉血氧饱和度检测。发现该患者动脉血氧饱和度（PaO2）低至86%。随后建议他吸入100%氧气15分钟，之后他报告视觉症状有所改善。吸氧后重复进行FM 100、OCT和微视野检查。他被转诊至专科医院进一步评估血氧饱和度降低的原因，并被进一步建议进行睡眠研究，结果诊断为阻塞性睡眠呼吸暂停（OSA），呼吸暂停低通气指数为20.9。建议该患者采取减肥措施并口服持续气道正压通气设备。从那时起，他一直在我们的定期随访中，从未经历或抱怨过任何色觉问题。本病例报告强调了糖尿病患者中存在如阻塞性睡眠呼吸暂停等相关全身性疾病，这些疾病可能导致色觉问题。
