Long-term visual pathway alterations after elemental mercury poisoning: report of a series of 29 cases

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...

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Autores principales:	Salvador Pastor-Idoate, Rosa M. Coco-Martin, Iratxe Zabalza, Yrbani Lantigua, Itziar Fernández, Jose L. Pérez-Castrillón, Ruben Cuadrado, Jose A. de Lazaro, Angela Morejon, Antonio Dueñas-Laita, Jose C. Pastor
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Mercury poisoning Mercury vapor Occupational exposure Optical coherence tomography (OCT), ocular Electrofisiology Industrial medicine. Industrial hygiene RC963-969
Acceso en línea:	https://doaj.org/article/091ac08520974590a3579af94b0ee1cb
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spelling	oai:doaj.org-article:091ac08520974590a3579af94b0ee1cb2021-11-14T12:15:00ZLong-term visual pathway alterations after elemental mercury poisoning: report of a series of 29 cases10.1186/s12995-021-00341-z1745-6673https://doaj.org/article/091ac08520974590a3579af94b0ee1cb2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12995-021-00341-zhttps://doaj.org/toc/1745-6673Abstract 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.Salvador Pastor-IdoateRosa M. Coco-MartinIratxe ZabalzaYrbani LantiguaItziar FernándezJose L. Pérez-CastrillónRuben CuadradoJose A. de LazaroAngela MorejonAntonio Dueñas-LaitaJose C. PastorBMCarticleMercury poisoningMercury vaporOccupational exposureOptical coherence tomography (OCT), ocular ElectrofisiologyIndustrial medicine. Industrial hygieneRC963-969ENJournal of Occupational Medicine and Toxicology, Vol 16, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Mercury poisoning Mercury vapor Occupational exposure Optical coherence tomography (OCT), ocular Electrofisiology Industrial medicine. Industrial hygiene RC963-969
spellingShingle	Mercury poisoning Mercury vapor Occupational exposure Optical coherence tomography (OCT), ocular Electrofisiology Industrial medicine. Industrial hygiene RC963-969 Salvador Pastor-Idoate Rosa M. Coco-Martin Iratxe Zabalza Yrbani Lantigua Itziar Fernández Jose L. Pérez-Castrillón Ruben Cuadrado Jose A. de Lazaro Angela Morejon Antonio Dueñas-Laita Jose C. Pastor Long-term visual pathway alterations after elemental mercury poisoning: report of a series of 29 cases
description	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.
format	article
author	Salvador Pastor-Idoate Rosa M. Coco-Martin Iratxe Zabalza Yrbani Lantigua Itziar Fernández Jose L. Pérez-Castrillón Ruben Cuadrado Jose A. de Lazaro Angela Morejon Antonio Dueñas-Laita Jose C. Pastor
author_facet	Salvador Pastor-Idoate Rosa M. Coco-Martin Iratxe Zabalza Yrbani Lantigua Itziar Fernández Jose L. Pérez-Castrillón Ruben Cuadrado Jose A. de Lazaro Angela Morejon Antonio Dueñas-Laita Jose C. Pastor
author_sort	Salvador Pastor-Idoate
title	Long-term visual pathway alterations after elemental mercury poisoning: report of a series of 29 cases
title_short	Long-term visual pathway alterations after elemental mercury poisoning: report of a series of 29 cases
title_full	Long-term visual pathway alterations after elemental mercury poisoning: report of a series of 29 cases
title_fullStr	Long-term visual pathway alterations after elemental mercury poisoning: report of a series of 29 cases
title_full_unstemmed	Long-term visual pathway alterations after elemental mercury poisoning: report of a series of 29 cases
title_sort	long-term visual pathway alterations after elemental mercury poisoning: report of a series of 29 cases
publisher	BMC
publishDate	2021
url	https://doaj.org/article/091ac08520974590a3579af94b0ee1cb
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Long-term visual pathway alterations after elemental mercury poisoning: report of a series of 29 cases

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