Impaired color vision associated with diabetic retinopathy: Early treatment diabetic retinopathy study report no. 15

PURPOSE: To report color vision abnormalities associated with diabetic reti nopathy. METHODS: Color vision function was measured at baseline in 2,701 patients e nrolled in the Early Treatment Diabetic Retinopathy Study, a randomized tri al investigating photocoagulation and aspirin in the treatment of diabetic retinopathy, Hue discrimination was measured by the Farnsworth-Munsell 100- Hue test, and errors in color vision were reported as the square root of th e total 100-Hue (SQRT 100-Hue) score. RESULTS: Approximately 50% of the Early Treatment Diabetic Retinopathy Stud y population had color vision scores (SQRT 100-Hue score) worse than 95% of the normal population reported by Verriest and associates. The factors mos t strongly associated with impaired hue discrimination were macular edema s everity, age, and presence of new vessels. A tritan-like defect was promine nt and increased in magnitude with increasing severity of macular edema. Ho wever, many patients had color discrimination impairment without macular ed ema. CONCLUSIONS: Impaired color vision is a common observation among participan ts enrolled in the Early Treatment Diabetic Retinopathy Study. Compared wit h published data on normal subjects, approximately 50% of the patients in t he Early Treatment Diabetic Retinopathy Study had abnormal hue discriminati on. Macular edema severity, age, and the presence of new vessels were the f actors most strongly associated with impaired color discrimination. A trita n-like defect was prominent and increased in magnitude with increasing seve rity of macular edema. Impaired color vision should be considered in the ev aluation and counseling of patients with diabetic retinopathy. (C) 1999 by Elsevier Science Inc. All rights reserved.