Occupational exposure to lead decreases macular, choroidal, and retinal nerve fiber layer thickness in industrial battery workers.

PURPOSE: To evaluate the toxic effects of chronic lead (Pb) exposure on retinal nerve fiber layer thickness (RNFLT), macular thickness (MT) and choroidal thickness (CT) in battery industry workers. MATERIALS AND METHODS: Male factory workers (n = 50) and healthy non-employees (n = 20) participated in the study. Group 1 (n = 22) comprised lead workers; Group 2 (n = 16), box makers; Group 3 (n = 12), assistant personnel; and Group 4 (n = 20), healthy non-employees. All participants were given Best-Corrected Visual Acuity (BCVA) tests, full ophthalmologic examinations, and Spectral Domain Optical Coherence Tomography (SD-OCT) of the optic nerve head, RNFL, macula, and choroid. Blood lead levels (BLL) in venous blood samples were determined. The duration of exposure to lead varied, and is expressed in months. RESULTS: Average (mean ± SD) ages of participants were 27.55 ± 4.00, 28.69 ± 3.48, 32.00 ± 3.38, and 29.85 ± 5.48 yrs (Groups 1-4, respectively). BLL were 46.2 ± 2.32, 29.31 ± 3.30, 16.9 ± 1.9, and 2.85 ± 0.98 µg/dL (Groups 1-4, respectively). Durations of exposure to lead were 43.86 ± 10.81, 42.81 ± 4.86, and 49.42 ± 6.14 mo (Groups 1-3, respectively). OCT averages for RNFL were 101.68 ± 5.32, 119.50 ± 13.47, 127.67 ± 8.92, and 130.9 ± 6.63 µm (Groups 1-4, respectively). Although RNFLTs of Group 1 were significantly less than those of for Groups 2-4, and, RNFLTs of Groups 2 and 3 were significantly less than that of Group 4, there were no significant differences between Group 2 and 3. MTs were 94.50 ± 6.78, 105.63 ± 5.43, 111.50 ± 6.74 and 147.95 ± 6.67 µm, (Groups 1-4, respectively). CTs were 176.41 ± 15.39, 222.19 ± 17.79, 239.17 ± 15.64, and 251.50 ± 10.98 µm (Groups 1-4, respectively). Both MTs and CTs displayed significant differences among the four groups. CONCLUSIONS: Ocular changes in individuals who are chronically exposed to lead include decrease in RNFT, MT, and CT, and thus these parameters should be evaluated during ophthalmologic examination of individuals working in lead-based industries.

Peripapillary Retinal Nerve Fibre Layer Thinning Secondary to Nutritional Folic Acid Deficiency.

Folic acid has a fundamental role in central nervous system (CNS) function at all ages, especially the methionine synthase-mediated conversion of homocysteine to methionine, which is essential for nucleotide synthesis and genomic and non-genomic methylation. Folic acid and vitamin B12 may have roles in the prevention of disorders of CNS development, mood disorders, and dementias, including Alzheimer disease and vascular dementia in elderly people. The authors examined the peripapillary retinal nerve fibre layer thickness (RNFLT) in patients with nutritional folic acid deficiency using optical coherence tomography (OCT). Patients were divided into two groups according to blood folic acid levels: blood folic acid <7 nmol/L as Group 1 and >7 nmol/L as Group 2. Peripapillary RNFL measurements were performed. There were significant positive correlations between serum folate levels and RNFLT in all quadrants (p < 0.05), except for the temportal quadrant (p = 0.41).

Optic Atrophy Secondary to Preseptal Cutaneous Anthrax: Case Report.

Bacillus anthracis, the agent of anthrax, is a nonmotile, aerobic gram-positive rod that can form very resistant spores in economically poor environments. Anthrax can manifest as cutaneous, gastrointestinal, or inhalational form. Cutaneous anthrax, caused by direct skin contact, presents with eschar, lymphadenopathy, and a febrile illness. The face and eyelids are most commonly involved in cutaneous anthrax. A 45-year-old man was admitted to our clinic with high fever and swelling of the right eyelid. One day later on re-examination, formation of ulcerous lesions in the right medial canthal region was observed, with general oedema in the upper and lower eyelids. The patient was evaluated as having cutaneous anthrax and medical treatment was continued until the 28th day; he was discharged from the hospital with no loss of vision. He returned for a follow-up examination after 2 months, with decreased visual acuity (

Is there a relationship between sleep apnea and central corneal thickness?

PURPOSE: The objective of this study was to determine the central corneal thickness (CCT) measurements in patients with Sleep Apnea Syndrome (SAS) and the relationship between the severity of SAS and minimal arterial oxygen saturation (min. SpO2) with respect to CCT. MATERIALS AND METHODS: Two hundred and fourteen eyes of 107 patients (58 males, 49 females) who were diagnosed as SAS and 80 eyes of 40 healthy subjects (20 males, 20 females) were included in the study. The SAS patients were divided into subgroups according to their Apnea-Hypopnea Index (AHI) values as: AHI values between 5 and 15 as subgroup 1, between 15 and 30 as subgroup 2, and the values ≥30 as subgroup 3. The CCT was measured by an ultrasonic pachymetric system. Statistical analyses were an analysis of variance test and, for post-hoc analysis, the Dunnett C test. RESULTS: Mean age was 52.5 ± 10.96 years in the study group, and 40.7 ± 10.14 years in the control group. There were 58 (54.2%) males and 49 (45.8%) females in the study group, and 20 (50%) males and 20 (50%) females in the control group. Mean CCT values were 526.65 ± 25.06, 525.26 ± 29.25, 512.93 ± 43.20 and 539.90 ± 17.28 in subgroup 1, subgroup 2, subgroup 3 and the control group, respectively. There were no statistically significant differences between gender and age groups with respect to CCT (p > 0.05). When the mean CCT values of each subgroups were compared with the control group, the differences were statistically significant (p < 0.05). There was a negative correlation between CCT and AHI values and a positive correlation between CCT and min. SpO2 values. CONCLUSIONS: CCT measurements differ significantly in patients with SAS compared with healthy control subjects. It should be taken into consideration that SAS may reduce CCT over time and that CCT should be measured in each ophthalmic examination.