Ocular injury by mustard gas

Solberg, Yoram; Alcalay, M.; Belkin, Michael

doi:10.1016/s0039-6257(97)00021-0

Cited by 135 publications

(192 citation statements)

References 31 publications

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“…Mustard agents act as alkylating agent that induce structural Use of amphoteric rinsing solution for treatment of ocular tissues exposed to nitrogen mustard (Solberg et al 1997;Safarinejad et al 2001). Currently, there is no known antidote to mustard gas, so washing of the external eye surface after exposure is the mainstay of therapy and of paramount importance (Murray & Volans 1991).…”

Section: Introductionmentioning

confidence: 99%

Use of amphoteric rinsing solution for treatment of ocular tissues exposed to nitrogen mustard

Goldich¹,

Barkana²,

Zadok³

et al. 2012

Acta Ophthalmologica

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ABSTRACT.Purpose: Ocular exposure to mustard agents may cause severe and prolonged injury to the anterior segment tissues. Effective decontamination of the external eye surface after exposure is of paramount importance. The purpose of the present study was to assess the effectiveness of Diphoterine rinsing solution (DRS) in reducing ocular damage after exposure to nitrogen mustard (NM) and to compare it with normal saline solution. Methods: One eye of 16 New Zealand albino rabbits was exposed to 2% NM. Immediate thorough irrigation was performed with either 500 ml of DRS (treated group) or with 500 ml of normal saline (control group). The magnitude of ocular injury and response to treatment were assessed by examiners masked to the treatment assignment during 22 days following the exposure. Results: Immediate ocular irrigation with DRS was more effective compared with saline in reducing corneal, iris and anterior chamber injury. In the DRStreated group, the corneal opacity and corneal neovascularization were less severe, and development of iris atrophy was delayed. Intraocular pressure (mmHg) was better maintained when compared to the control group (day 7 24.3 versus 14.8, p = 0.003; day 12 28 versus 15, p = 0.003; day 22 33.5 versus 21.8, p = 0.014, respectively). Systemic oxidative stress associated with exposure to NM was significantly higher in the saline-treated group than in DRS-treated group (p < 0.011). Conclusions: The findings of this study indicate the effectiveness of DRS in reducing of NM-induced ocular injuries. Its use should be considered as an immediate treatment modality following exposure to mustard agents to reduce potential ocular injury.

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Section: Introductionmentioning

confidence: 99%

Use of amphoteric rinsing solution for treatment of ocular tissues exposed to nitrogen mustard

Goldich¹,

Barkana²,

Zadok³

et al. 2012

Acta Ophthalmologica

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“…1 Mustard gas, as a poisonous chemical agent, acts both locally, on the eyes, skin and respiratory tract, and systemically, on the heart, nervous system and digestive tract. [2][3][4]6 Both acute and chronic ocular injuries from mustard gas have been reported, 2,5, 7,8 but as yet there is no published cytologic report on this subject. In this study we assessed the use of scrape cytology to detect the effects of mustard gas on conjunctival cells.…”

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confidence: 99%

Conjunctival Dysplasia in Soldiers Exposed to Mustard Gas During the Iraq-Iran War

Safaei

Saluti

Kumar³

2001

Acta Cytologica

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“…3,6 Both the corneal thinning and the peripheral scar observed in our patient were located inferiorly, which is consistent with protection of the upper cornea by the eyelid. 1 An asymmetry, indicated by the scarring and significant conjunctival staining in the left eye, is also a common finding. 3 Furthermore, the patient reported reduced ocular discomfort in colder climates, a finding also previously noted.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 Mild and moderate cases of exposure usually resolve after several weeks to months. Severe cases of exposure may resolve or can lead to either chronic inflammation or a delayed-onset keratitis, the latter occurring after a latent asymptomatic period ranging from 1 to 40 years.…”

Section: Introductionmentioning

confidence: 99%

“…Severe cases of exposure may resolve or can lead to either chronic inflammation or a delayed-onset keratitis, the latter occurring after a latent asymptomatic period ranging from 1 to 40 years. 1,[3][4][5] While the delayed course occurs in less than 1% of all cases, it can be particularly distressing, with degenerative changes, recurrent and worsening pain and inflammation, ulceration, and progressive loss of vision. 1,3 The pathophysiologic processes underlying this delayed form of keratitis are not well understood.…”

Section: Introductionmentioning

confidence: 99%

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Delayed Mustard Gas Keratitis: Clinical Course and In Vivo Confocal Microscopy Findings

Lagali

2009

Cornea

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Purpose:To report the detailed clinical and in-vivo confocal microscopic findings in a patient with delayed-onset mustard gas keratitis observed 20 years after initial exposure. Methods:Case report. A 38-year-old man who was exposed to mustard gas in Iraq at the age of 19 was examined after presenting with ocular symptoms 17 years after initial recovery from the exposure. Slit-lamp biomicroscopy, corneal topography and in-vivo confocal microscopy was performed on both corneas. Results:The clinical symptoms were consistent with a delayed-form of mustard gas keratitis, although the patient had clear central corneas and good visual acuity. Confocal microscopic findings included evidence of epithelial abnormalities, necrotic changes in the anterior stroma, subbasal and anterior stromal nerve proliferation, and deep stromal keratocyte activation. Conclusions:In-vivo confocal microscopy revealed persistent morphologic abnormalities in the anterior stroma of both corneas 20 years after initial exposure to mustard gas. The detection of a population of dendritic cell bodies in the central epithelium and evidence of keratocyte activation and migration in the deep stroma indicated the presence of ongoing sub-clinical processes.

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Ocular injury by mustard gas

Cited by 135 publications

References 31 publications

Use of amphoteric rinsing solution for treatment of ocular tissues exposed to nitrogen mustard

Use of amphoteric rinsing solution for treatment of ocular tissues exposed to nitrogen mustard

Conjunctival Dysplasia in Soldiers Exposed to Mustard Gas During the Iraq-Iran War

Delayed Mustard Gas Keratitis: Clinical Course and In Vivo Confocal Microscopy Findings

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