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Color vision tests to identify elevated digoxin levels.

J M LeSage, M A Chuman

Research in Nursing & Health

|June 1, 1986

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Color vision screening, using tests like Ishihara and Sahlgren's Saturation Test (SST), can help identify patients with high digoxin levels. This method may aid in routine monitoring for digoxin toxicity.

Area of Science:

Clinical Chemistry
Ophthalmology
Pharmacology

Background:

Digoxin is a cardiac glycoside used to treat heart failure and arrhythmias.
Elevated digoxin levels can lead to toxicity, necessitating careful patient monitoring.
Early identification of potential digoxin toxicity is crucial for patient safety.

Purpose of the Study:

To evaluate the efficacy of color vision screening in detecting elevated serum digoxin concentrations.
To determine if specific color vision tests can serve as a bedside tool for monitoring digoxin therapy.

Main Methods:

Color vision was assessed using the Ishihara test and Sahlgren's Saturation Test (SST).
Measurements were taken on 56 patients with elevated digoxin levels (≥2.0 ng/ml) and 93 control subjects.

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Test-retest reliability and score changes were analyzed in relation to digoxin levels and duration of therapy.

Main Results:

The Ishihara and SST tests identified digoxin levels of 2.9 ng/ml or higher.
Patients with elevated digoxin levels (≥2.7 ng/ml) for over 4 days showed significant improvements in retest color vision scores.
Control subjects exhibited a low percentage of improved retest scores, indicating specificity.

Conclusions:

Bedside color vision tests, including Ishihara and SST, show promise for monitoring patients on digoxin.
These tests may be particularly useful for high-risk patients susceptible to digoxin toxicity.
Color vision screening offers a potential non-invasive method for routine digoxin level assessment.