Color vision in an elderly patient with protanopic genotype and successfully treated unilateral age-related macular degeneration

Int Ophthalmol. 2011 Dec;31(6):471-5. doi: 10.1007/s10792-011-9479-z. Epub 2011 Nov 11.

Abstract

We investigated differences in color discrimination between the fellow eye and the affected eye successfully treated for unilateral age-related macular degeneration (AMD) in a 69-year-old male patient with protanopia. His best-corrected visual acuity (BCVA) was 1.2 in the right eye (RE) and 0.2 in the left eye (LE). Fundus and angiographic findings showed classic choroidal neovascularization (CNV) secondary to AMD in the LE. BCVA of the LE improved to 0.4, and CNV resolved by 15 months after initiating combined anti-vascular endothelial growth factor and photodynamic therapies. After CNV closure, the Farnsworth dichotomous was performed, showing confusion patterns of the protan axis in either eye. The Farnsworth-Munsell 100-hue test showed a total error score of 520 in the LE, much higher than the score of 348 in the RE. Complete genotypes of the long-wavelength-sensitive (L-) cone and middle-wavelength-sensitive (M-) cone opsin genes were determined by polymerase chain reaction, revealing that the patient had a single 5' L-M 3' hybrid gene (encoding an M-cone opsin), with this genotype responsible for protanopia (the L-cone opsin gene was non-functional), instead of the L-cone and M-cone opsin gene arrays. Poorer color vision discrimination in the LE than the RE remained present despite closure of CNV. The presence and type of congenital color vision defect can be confirmed using molecular genetic testing even if complications of acquired retinal diseases such as AMD are identified.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Choroidal Neovascularization / complications
  • Choroidal Neovascularization / genetics*
  • Choroidal Neovascularization / therapy*
  • Color Vision Defects / complications
  • Color Vision Defects / genetics*
  • Color Vision*
  • Genotype
  • Humans
  • Macular Degeneration / complications
  • Macular Degeneration / genetics*
  • Macular Degeneration / therapy*
  • Male
  • Visual Acuity