RT info:eu-repo/semantics/article
T1 Long-term visual pathway alterations after elemental mercury poisoning: report of a series of 29 cases
A1 Pastor Idoate, Salvador
A1 Coco Martín, Rosa María
A1 Zabalza, Iratxe
A1 Lantigua Dorville, Yrbani
A1 Fernández Martínez, Itziar
A1 Pérez Castrillon, José Luis
A1 Cuadrado Asensio, Rubén
A1 de Lazaro Yague, Jose Alberto
A1 Morejón Lozano, Ángela
A1 Dueñas Laita, Antonio
A1 Pastor Jimeno, José Carlos
K1 Mercury poisoning; Occupational exposure; Retinal toxic effects; Optical coherence tomography (OCT); electroretinogram; visual evoqued potential.
K1 3201.09 Oftalmología
AB ABSTRACT. BACKGROUND: There are few clinical data on retinal involvement after acute exposure to high concentrations mercury and the available reports are based on a small number of patients suffering chronic exposure. The purpose of this paper is to report findings in workers acutely exposed to very high concentrations of mercury vapor with the aim of providing data on a possible direct retinal involvement. METHODS: Twenty-nine patients and 16 controls were evaluated in a comparative case series. Mercury levels in blood and urine samples, visual acuity (VA), contrast sensitivity (CS), visual field (VF), color discrimination and optical coherence tomography (OCT) were recorded. The pattern reversal visual-evoked potentials (PRVEP), full-field and multifocal electroretinography (ffERG/mfERG), pattern electroretinography (PERG), systemic symptoms, presence of erethism, and electromyography (EMG) were also gathered. A descriptive analysis was performed. The correlations between variables also were studied. In addition, electrophysiological data from those patients with deeper VF defects (group 1) were compared with a normal control group. RESULTS: Twenty-six workers exhibited symptoms of erethism. The EMG showed sensorimotor polyneuropathy and multiple mononeuropathy. The VA was slightly affected in 48.27% (n = 14) of subjects. Loss of CS in at least one of four spatial frequencies and color vision alterations occurred in 96.5% (n = 28) and 44.8% (n = 13), respectively. VF alterations were identified in 72.4% (n = 21) patients. No morphologic changes were seen in the OCT scans. Latencies over 100 milliseconds and reduced amplitudes of P100 were found in the PRVEP (p < 0.05). The reduced amplitude of the b wave at the ffERG, of the P50 at the PERG and of the P1 wave at the mfERG results (p < 0.05) suggested that the outer retina was involved. Significant negative correlations among blood mercury levels, VA, and ffERG were observed. CONCLUSIONS: In this case series, showed that acute exposure to mercury vapor had a hazardous effect on the visual system. Although neurologic and visual pathway involvement was clearly demonstrated, the differences found compared to control support the existence of a direct functional retinal damage and participation in impaired vision in mercury poisoning.
PB Springer Nature
SN 1745-6673
YR 2021
FD 2021-11-12
LK https://uvadoc.uva.es/handle/10324/68959
UL https://uvadoc.uva.es/handle/10324/68959
LA eng
NO J Occup Med Toxicol, 12 Nov 2021, vol. 16, n. 1, Article number 49, 11 páginas.
NO Producción Científica
DS UVaDOC
RD 26-jul-2024