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Fulltext Colour vision deficiency among failed candidates for driving license in Sabah. [Abstract]

Azmi N, Yahya AN, Gilong HCS, Anne SJ, Ting RHY, Amil Bangsa NH, et al.

Borneo Journal of Medical Sciences, 2020;3(101):11-12.
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Introduction: Good visual acuity (VA) coupled with the ability to discriminate colours and having a sufficiently wide field of view are factors needed for safe driving. This study aimed to determine the types of colour vision deficiency (CVD) among failed candidates for driving license and to identify the accuracy of the Road transport Department (RTD) screening tests in detecting those who have poor VA and CVD in Sabah.
Methods: A cross-sectional study on the patient’s records of all failed candidates for the driving license that were referred for further assessment by an optometrist. This study was conducted at eight hospitals in Sabah from March to June 2019. Basic demographic data, distance VA, Ishihara test and Farnsworth-Munsell D15 test were collected. Descriptive statistics were used to summarise the results. All subjects referred with best-corrected visual acuity (BCVA) 0.3 LogMAR were included.
Results: A total of 73 subjects (79% males and 21% females), age range from 16 to 61 years (mean 29±13 years) were recruited. Bajau, Dusun, Bugis and Kadazan were the major ethnic among the subjects. Mean VA on attendance was 0.1 ± 0.19 LogMAR, while BCVA was 0.0 ± 0.07 LogMAR. Thirty-six subjects (49%) were found to have CVD. The prevalence of CVD was more in males than females (45% vs 4%). Most of the CVD were deutans (25%) followed by protans (22%), no findings of tritan CVD In this study, 37 subjects (51%) passed the Ishihara test. These were the false-positive error of the RTD screening tests.
Conclusions: Hereditary red-green perceptive disorder was the commonest CVD in Sabah. The severity of CVD was not been evaluated in this study because it is best evaluated using Hardy Rand and Rittler (HRR) test. The false-positive results might be because of technical error or unfamiliar of using computerized colour vision test, especially among elderly candidates. Visual field screening might be considered in the future to ensure safe driving.
Keywords:visual acuity (VA), colour vision deficiency (CVD), driving license
NMRR Research ID: NMRR-19-1785-48811
Total Protein Concentration and Tumor Necrosis Factor α in Tears of Nonproliferative Diabetic Retinopathy

Amil-Bangsa NH, Mohd-Ali B, Ishak B, Abdul-Aziz CNN, Ngah NF, Hashim H, et al.

Optom Vis Sci, 2019 12;96(12):934-939.
PMID: 31834153 DOI: 10.1097/OPX.0000000000001456

SIGNIFICANCE: Total protein concentration (TPC) and tumor necrosis factor α (TNF-α) concentration in tears are correlated with severity of retinopathy. However, minimal data are available in the literature for investigating tear TPC and TNF-α concentrations in Asian individuals with different severity of nonproliferative diabetic retinopathy (NPDR).
PURPOSE: This study evaluated differences of TPC and TNF-α concentrations in tears at different severity of NPDR among participants with diabetes in comparison with normal participants.
METHODS: A total of 75 participants were categorized based on Early Treatment for Diabetic Retinopathy Study scale, with 15 participants representing each group, namely, normal, diabetes without retinopathy, mild NPDR, moderate NPDR, and severe NPDR. All participants were screened using McMonnies questionnaire. Refraction was conducted subjectively. Visual acuity was measured using a LogMAR chart. Twenty-five microliters of basal tears was collected using glass capillary tubes. Total protein concentration and TNF-α concentrations were determined using Bradford assay and enzyme-linked immunosorbent assay, respectively.
RESULTS: Mean ± SD age of participants (n = 75) was 57.88 ± 4.71 years, and participants scored equally in McMonnies questionnaire (P = .90). Mean visual acuity was significantly different in severe NPDR (P = .003). Mean tear TPC was significantly lower, and mean tear TNF-α concentration was significantly higher in moderate and severe NPDR (P < .001). Mean ± SD tear TPC and TNF-α concentrations for normal were 7.10 ± 1.53 and 1.39 ± 0.24 pg/mL; for diabetes without retinopathy, 6.37 ± 1.65 and 1.53 ± 0.27 pg/mL; for mild NPDR, 6.32 ± 2.05 and 1.60 ± 0.21 pg/mL; for moderate NPDR, 3.88 ± 1.38 and 1.99 ± 0.05 pg/mL; and for severe NPDR, 3.64 ± 1.26 and 2.21 ± 0.04 pg/mL, respectively. Tear TPC and TNF-α concentrations were significantly correlated (r = -0.50, P < .0001). Visual acuity was significantly correlated with tear TPC (r = -0.236, P = .04) and TNF-α concentrations (r = 0.432, P < .0001).
CONCLUSIONS: This cross-sectional study identified differences in tear TPC and TNF-α concentrations with increasing severity of NPDR.

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