To assess the associations between the prevalence of congenital color vision deficiency (CVD) and genetics and environment, represented by place of origin (ethnic background) and place of birth, respectively.
This is a retrospective study of the computerized database of the northern recruitment center of Israel of 53,895 consecutive male Jewish conscripts 16–19 years old, who completed the medical profiling process between 1988 and 2011. CVD was diagnosed using the 24-pseudo-isochromatic plate Ishihara test. Associations of CVD prevalence with sociodemographic variables, anthropometric indices, refractive errors, and mainly place of origin and place of birth were tested by both univariate analysis and multivariate regression models.
Elevated BMI (obesity) and blood pressure (hypertension), as well as myopia, were all positively associated with congenital CVD. The composition of the study population provides a unique opportunity to investigate the relationship between ethnicity and environment. The prevalence of CVD significantly differs among subpopulations of different ethnic background as well as among those who were born in different geographical locations. Additionally, differences in the prevalence of CVD (1.2–1.6%) were observed among conscripts from the same origin, who were born in Israel, compared to those who were born elsewhere. Both place of origin (p < 0.01) and place of birth (p < 0.05) were associated with the prevalence of CVD in a multivariable regression model.
This study affirms previously established associations of CVD with certain variables and reveals a possible novel association of CVD with environmental factors.
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The datasets generated for this study will not be made publicly available. The IDF Helsinki committee that approved the research has restricted any public approach to the datasets.
Wong B (2011) Color blindness. Nat Methods 8:441. https://doi.org/10.1038/nmeth.1618
Gardner JC, Michaelides M, Holder GE, Kanuga N, Webb TR, Mollon JD, Moore AT, Hardcastle AJ (2009) Blue cone monochromacy: causative mutations and associated phenotypes. Mol Vis 15:876–884
Aboshiha J, Dubis AM, Carroll J, Hardcastle AJ, Michaelides M (2016) The cone dysfunction syndromes. Br J Ophthalmol 100:115–121. https://doi.org/10.1136/bjophthalmol-2014-306505
Neitz J, Neitz M (2011) The genetics of normal and defective color vision. Vision Res 51:633–651. https://doi.org/10.1016/j.visres.2010.12.002
Deeb SS (2005) The molecular basis of variation in human color vision. Clin Genet 67:369–377. https://doi.org/10.1111/j.1399-0004.2004.00343.x
Deeb SS (2004) Molecular genetics of color-vision deficiencies. Vis Neurosci 21:191–196. https://doi.org/10.1017/s0952523804213244
Deeb SS, Kohl S (2003) Genetics of color vision deficiencies. Dev Ophthalmol 37:170–187. https://doi.org/10.1159/000072046
Xie JZ, Tarczy-Hornoch K, Lin J, Cotter SA, Torres M, Varma R, Multi-Ethnic Pediatric Eye Disease Study G (2014) Color vision deficiency in preschool children: the multi-ethnic pediatric eye disease study. Ophthalmology 121:1469–1474. https://doi.org/10.1016/j.ophtha.2014.01.018
Harper PS (2011) Mary Lyon and the hypothesis of random X chromosome inactivation. Hum Genet 130:169–174. https://doi.org/10.1007/s00439-011-1013-x
Simunovic MP (2010) Colour vision deficiency. Eye (Lond) 24:747–755. https://doi.org/10.1038/eye.2009.251
Birch J (2012) Worldwide prevalence of red-green color deficiency. J Opt Soc Am A: 29:313–320. https://doi.org/10.1364/josaa.29.000313
Delpero WT, O’Neill H, Casson E, Hovis J (2005) Aviation-relevent epidemiology of color vision deficiency. Aviat Space Environ Med 76:127–133
Berger A, Findler M, Maymon D, Korach T, Yativ OF, Gronovich Y, Hassidim A (2016) Color vision deficiency and functional disorders among Israeli male adolescents between 2007 and 2013. J Child Neurol 31:1245–1249. https://doi.org/10.1177/0883073816650040
Adam A, Doron D, Modan R (1967) Frequencies of protan and deutan alleles in some Israeli communities and a note on the selection-relaxation hypothesis. Am J Phys Anthropol 26:297–305. https://doi.org/10.1002/ajpa.1330260304
Machluf Y, Fink D, Farkash R, Rotkopf R, Pirogovsky A, Tal O, Shohat T, Weisz G, Ringler E, Dagan D, Chaiter Y (2016) Adolescent BMI at Northern Israel: from trends, to associated variables and comorbidities, and to medical signatures. Medicine (Baltimore) 95:e3022. https://doi.org/10.1097/md.0000000000003022
Machluf Y, Navon N, Yona A, Pirogovsky A, Palma E, Tal O, Ash N, Cohen A, Chaiter Y (2011) From a quality assurance and control system for medical processes, through epidemiological trends of medical conditions, to a nationwide health project Modern Approaches To Quality Control, Dr Ahmed Badr Eldin (Ed). InTech, Rijeka, Croatia, 259–282
Machluf Y, Pirogovsky A, Palma E, Yona A, Navon A, Shohat T, Yitzak A, Tal O, Ash N, Nachman M, Chaiter Y (2012) Coordinated computerized systems aimed at management, control, and quality assurance of medical processes and informatics. Int J Health Care Qual Assur 25:663–681. https://doi.org/10.1108/09526861211270622
Chaiter Y, Machluf Y, Pirogovsky A, Palma E, Yona A, Shohat T, Yitzak A, Tal O, Ash N (2010) Quality control and quality assurance of medical committee performance in the Israel Defense Forces. Int J Health Care Qual Assur 23:507–515. https://doi.org/10.1108/09526861011050538
Chaiter Y, Pirogovsky A, Palma E, Yona A, Machluf Y, Shohat T, Farraj N, Tal O, Campino-Abbebe G, Levy Y (2008) Medical quality control in conscription centers- ten years of activity. Journal of Israeli Military Medicine 5:75–79
Allon G, Machluf Y, Mezer E, Chaiter Y (2019) Screening for myopia-related retinal changes among teenagers. Ophthalmic Surg Lasers Imaging Retina 50:e311–e319. https://doi.org/10.3928/23258160-20191031-19
Shapira Y, Machluf Y, Mimouni M, Chaiter Y, Mezer E (2018) Amblyopia and strabismus: trends in prevalence and risk factors among young adults in Israel. Br J Ophthalmol 102:659–666. https://doi.org/10.1136/bjophthalmol-2017-310364
Shapira Y, Mimouni M, Machluf Y, Chaiter Y, Saab H, Mezer E (2019) The increasing burden of myopia in Israel among young adults over a generation: analysis of predisposing factors. Ophthalmology 126:1617–1626. https://doi.org/10.1016/j.ophtha.2019.06.025
Sloan LL (1961) Evaluation of the Tokyo Medical College color vision test. Am J Ophthalmol 52:650–659. https://doi.org/10.1016/0002-9394(61)90150-7
Hardy LH, Rand G, Rittler MC (1945) Tests for detection and analysis of color blindness; an evaluation of the Ishihara test. Archives of ophthalmology (Chicago, Ill: 1929) 34:295–302. https://doi.org/10.1001/archopht.1945.00890190297005
Fetkenhour CL, Gurney N, Dobbie JG, Choromokos E (1976) Central areolar pigment epithelial dystrophy. Am J Ophthalmol 81:745–753. https://doi.org/10.1016/0002-9394(76)90357-3
Berger A, Findler M, Korach T, Yativ OF, Gronovich Y, Hassidim A (2016) Is male migraine associated with color vision deficiency? Findings among Israeli adolescents between 2007 and 2013. J Child Neurol 31:593–596. https://doi.org/10.1177/0883073815604226
Morton WE (1975) Hypertension and color blindness in young men. Arch Intern Med 135:653–656
Shoji T, Sato H, Chihara E, Sakurai Y (2015) Are middle-age blood pressure levels related to color vision impairment? The Okubo Color Study. Am J Hypertens 28:98–105. https://doi.org/10.1093/ajh/hpu097
Schröder A, Erb C, Falk S, Schwartze G, Radermacher J, Winter R (2002) Color vision defects in patients with arterial hypertension. Ophthalmologe 99:375–379. https://doi.org/10.1007/s00347-001-0558-9
Morton WE, Knudsen JC (1975) Correlates of hypertension among young men. Prev Med 4:258–267. https://doi.org/10.1016/0091-7435(75)90062-6
Nguyen NT, Magno CP, Lane KT, Hinojosa MW, Lane JS (2008) Association of hypertension, diabetes, dyslipidemia, and metabolic syndrome with obesity: findings from the National Health and Nutrition Examination Survey, 1999 to 2004. J Am Coll Surg 207:928–934. https://doi.org/10.1016/j.jamcollsurg.2008.08.022
Hall JE, do Carmo JM, da Silva AA, Wang Z, Hall ME (2015) Obesity-induced hypertension: interaction of neurohumoral and renal mechanisms. Circulation research 116:991–1006. https://doi.org/10.1161/circresaha.116.305697
Qian YS, Chu RY, He JC, Sun XH, Zhou XT, Zhao NQ, Hu DN, Hoffman MR, Dai JH, Qu XM, Pao KE (2009) Incidence of myopia in high school students with and without red-green color vision deficiency. Invest Ophthalmol Vis Sci 50:1598–1605. https://doi.org/10.1167/iovs.07-1362
Ostadimoghaddam H, Yekta AA, Heravian J, Azimi A, Hosseini SM, Vatandoust S, Sharifi F, Abolbashari F (2014) Prevalence of refractive errors in students with and without color vision deficiency. J Ophthalmic Vis Res 9:484–486. https://doi.org/10.4103/2008-322x.150828
Human subjects were not included in this study; rather, it relied on a computerized database in which subjects could not be identified. This study was approved on the basis of participants’ anonymity by an IDF Institutional Review Board (IRB) ethics committee (approval number: #1199–2012), and adhered to the tenets of the Declaration of Helsinki.
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Yoram Chaiter and Eedy Mezer share senior authorship
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Machluf, Y., Allon, G., Sebbag, A. et al. A large population study reveals a novel association between congenital color vision deficiency and environmental factors. Graefes Arch Clin Exp Ophthalmol (2021). https://doi.org/10.1007/s00417-021-05417-4
- Congenital color vision deficiency
- Color blindness
- Place of birth
- Anthropometric indices
- Regression model