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 5 continents, were included in our analysis.

Methods: We conducted a systematic search of PubMed/MEDLINE, Embase, CINAHL, and Google Scholar databases from 1930 through August 12, 2024. We used strict inclusion criteria, limiting the analysis to studies of children and adolescents in the general population. National and regional prevalence estimates were analyzed, with additional subanalyses by ethnicity, type, and severity.

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

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

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

Financial disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Keywords: Adolescents; Color vision deficiency; Deutan defect; Protan defect; Tritan defect.