Object: congenital color vision disorder (color anomalies - H 53.5). Objective: optimization of differential diagnosis of congenital color vision disorders by applying a combined method with a new algorithm for interpretation of color metamerism data, based on spectral optometric technique, polychromatic tables and colorimetric tables, followed by confirmation of objective response of the visual cortex by evoked potentials for achromatic and chromatic patterns. Methods: ophthalmic (visometry, biomicroscopy, refractometry), studies of color recognition function of the visual analyzer - polychromatic Rabkin tables, threshold tables of E.M. Yustova et al., anomaloscope AN-59, study of achromatic and chromatic visual evoked potentials (VEP) by Retiscan electrophysiological computer complex. For the first time, a time increase in conducting a bioelectric signal according to the VEP data in protanopes and deuteranopes is observed - an increase in the latency of the P100 wave on chromatic patterns. The same latency was found for patterns with angular sizes of 1o and 0o15' in normal trichromats (103.6 ms) and by 4.8 ms (4.6%) more in protanopes and deuteranopes (108.4 ms). For the first time the decrease in the amplitude of P100 and N135 waves for achromatic patterns 1o and 0o15' in color-blind dichromats was found to be up to 10.6mcV, which is by 6.6 mcV (38.1%) lower than in normal trichromats. For the first time, the same level of decrease in the bioelectric activity of the visual cortex on the chromatic patterns 1o and 0o15' was found in protanopes and deuteranopes in the P100 and N135 wave amplitude - up to 8.5 mcV, which is by 3 mcV (27%) lower than in normal trichromats. The anomalies studies (test A) on the anomaloscope revealed the following features of color difference: the threshold values of Rayleigh equation were the same for all protanomals and were equal to 22.9±0.57 relative units with an anomaly ratio of 0.47 ± 0.02 relative units; also, in all deuteranomals, the values of Rayleigh equation were the same (51.7 ± 0.58 rel.u) with an anomaly coefficient of 2.9±0.14 rel. units, indicating that it is impossible to determine the degree of anomaly by the Rayleigh anomaly coefficient. There were added data on the differential diagnostic significance of the following 7 Rabkin tables: the sensitivity of the data according to the table No. 7 is 12% higher (81.98%) in protanopes than for deuteranopes (69.95%); data sensitivity according to table No.8 is specific to 50% of protanopes and 4% of deuteranopes; the table No.11 - with sensitivity of 44.6% in protanopes and 59.9% in deutans; the table No.12 - in protanopes, depending on the degree of anomalies, the sensitivity increases from 25% in the mild degree to 90% in protanopes, while in deutans it is equal to 32% in the severe degree; the table No13 is differentially diagnostic only for deuteranopes and abnormalities of the type A in 51.3%; the table No22 is sensitive in 37% in the protanopes of the degree A, B and in cases of color blindness; the table No23 is equally low in 32.2 and 40.6% of protanomals and deutans. According to the tables of Yustova et al. the color weakness of red color receiver of the mild and medium degree is determined in 31% of the type C protanomals, in 85.6% of the type B protanopes, and in 70.3% of the type A protanopes; color weakness of moderate and severe degrees - in protanopes in 100% of cases. The color weakness of the green color receiver of the mild degree is available in the type C deuteranomals of 19.6%; of the mild and moderate degrees - in the B type deuteranomal in 55.5%; of all degrees – deuteranomals of the type A in 85.3% of cases; in deuteranopes, indices of color weakness of various degrees reach 100%, of which of the severe degree - 51.9%. A new algorithm for color perception is proposed, based on the consistent interpretation of the anomaloscope study data, reading of Rabkin tables, determination of color weakness by Yustova threshold et al. tables and analysis of bioelectric activity indices of the visual cortex in protanopes and deuteranopes. Introduction into practice. The main provisions of the thesis were implemented at the department of functional and diagnostic studies and at the department of disorders of binocular vision of the State Institution «Institute of Eye Diseases and Tissue Therapy named after V.P. Filatov of the National Academy of Medical Sciences of Ukraine. Scope: medicine, ophthalmology.
