Global prevalence of congenital color vision deficiency among children and adolescents, 1932-2022

Abstract

Purpose: To estimate the prevalence of congenital color vision deficiency (CVD), categorized by geographical region, ethnicity, type (deutan, protan, and tritan), and severity (anomalous trichromacy, dichromacy, and monochromacy).

Design: Systematic review and meta-analysis of the literature.

Participants: A total of 1,703,619 participants, including 31,493 patients from 56 studies across 21 countries and five continents, were included in our analysis.

Methods: We conducted a systematic search of PubMed/MEDLINE, Embase, CINAHL, and Google Scholar databases from 1930 to August 12, 2024. We used strict inclusion criteria, limiting the analysis to studies on children and adolescents in the general population. National and regional prevalence estimates were analyzed, with additional sub-analyses by ethnicity, type, and severity. A random-effects model was utilized to calculate pooled prevalence estimates with 95% confidence intervals (CIs), and heterogeneity was assessed using the I² statistic.

Main outcome measures: Pooled estimates for the prevalence of CVD.

Results: The global prevalence of CVD was estimated at 2.59% (95% CI, 2.20-3.03, I² =99.37), with higher rates observed in males (4.38% [3.93-4.88]) compared to females (0.64% [0.46-0.89]). Among ancestries, individuals of European descent exhibited the highest prevalence (2.77% [2.10-3.64]), closely followed by those of African descent (2.69% [2.21-3.28]). Regionally, Oceania displayed the highest prevalence (4.37% [3.36-5.68]), followed by Africa (2.86% [2.36-3.46]). Across all CVD types and severities, males consistently showed higher prevalence rates than females. In terms of CVD types, the highest prevalence was observed for deutan in both sexes (males: 3.66% [3.02-4.44]; females: 0.46% [0.30-0.69]), followed by protan (males: 1.54% [1.30-1.82]; females: 0.30% [0.21-0.43]) and tritan (males: 0.67% [0.20-2.22]). Regarding severity, males had the highest prevalence of dichromacy (1.59% [1.33-1.90]), followed by anomalous trichromacy (1.17% [0.89-1.55]) and monochromacy (0.36% [0.22-0.61]). For females, anomalous trichromacy had the highest prevalence (0.38% [0.25-0.56]), followed by dichromacy (0.27% [0.19-0.39]) and monochromacy (0.10% [0.04-0.21]).

Conclusions: This study highlights that the prevalence of CVD varies significantly by region and ethnicity.

Keywords: Adolescents; color vision deficiency; deutan defect; protan defect; tritan defect.