![]() Mercury is a toxic metal that exists in three forms with different toxicological properties, as elemental or metallic mercury (mercury liquid and mercury vapor) or as inorganic (mercury salts) and organic compounds (methylmercury and ethylmercury) when combined with other elements ( Park and Zheng, 2012 Fowler and Zalups, 2022), and it is considered by the World Health Organization (WHO) as one of the top 10 chemicals or groups of chemicals of major public health concern ( World Health Organization, 2017). This review aims to summarize the published structural and functional alterations found in the visual system of patients suffering from mercury intoxication. Despite the use of some imaging techniques such as in vivo confocal microscopy of the cornea, optical coherence tomography (OCT) of the retina and optic nerve, and functional tests such as electroretinography has helped to solve in part this debate, further studies incorporating other imaging modalities such as autofluorescence, OCT angiography or adaptive optics retinal imaging are needed. ![]() Nevertheless, there is still controversy about whether visual manifestations occur secondary to brain damage or as a direct affectation, and which ocular structure is primarily affected. Additionally, visual function alterations regarding central visual acuity, color discrimination, contrast sensitivity, visual field and electroretinogram responses have also been described widely. Although, there are many pathways for poisoning depending on the mercury form, it has been suggested that tissue distribution does not differ in experimental animals when administered as mercury vapor, organic mercury, or inorganic mercury. Ophthalmic involvement includes impaired function of the extraocular muscles and the eyelids, as well as structural changes in the ocular surface, lens, retina, and optic nerve causing a potential irreversible damage to the visual system. Human intoxication after mercury exposure is a rare condition that can cause severe damage to the central nervous, respiratory, cardiovascular, renal, gastrointestinal, skin, and visual systems and represents a major public health concern. 3CIBER-BBN, Carlos III National Institute of Health, Madrid, Spain.Junta de Castilla y León, Valladolid, Spain 2Centro en Red de Medicina Regenerativa y Terapia Celular.1Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain.Carlos Pastor 1,2 Margarita Calonge 1,2,3
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