Visual field defects in epidemic dropsy.
Epidemic dropsy is a multi-system disease involving the cardiovascular, hepatic, renal, ocular and other systems. It is a toxic disease caused by the unintentional ingestion of Argemone mexicana (prickly yellow poppy) seeds as an adulterant of wheat flour or more commonly of cooking oil such as mustard oil.


OBJECTIVE
To investigate the occurrence of visual field defects in patients suffering from epidemic dropsy glaucoma.


METHODS
Visual field analysis was performed to ascertain the field defects, in patients suffering from epidemic dropsy. Group I consisted of 35 patients (69 eyes) whose intraocular pressure (IOP) was > or = 22 mmHg. Ten dropsy patients (20 eyes) with normal IOP (<22 mm Hg) formed Group II. Ten healthy unexposed volunteers (20 eyes) constituted Group III. All the patients were tested using the Armaly full field glaucoma screening test on the Humphrey field analyzer.


RESULTS
Forty seven of the 69 eyes (68%) suffering from epidemic dropsy glaucoma, and 18 out of 20 (90%) eyes in dropsy patients with normal IOP, showed field defects. In the control group, 15% eyes had only nasal field defects. The difference between Group I and II was not significant (p = 0.054), though the field defects were significantly more frequent in dropsy patients as compared to the controls (p < 0.01 in either case). The results suggest that visual field defects in epidemic dropsy occur independently of the rise in intraocular pressure. Field defects were detected more frequently in patients who underwent visual field analysis early in the course of disease, as compared to those who underwent screening later on in the disease course.


CONCLUSIONS
In epidemic dropsy, acute visual field defects occur independent of rise of intraocular pressure and more frequently in the early stage of the disease.
Singh
Kirti
K
Department of Ophthalmology, Guru Nanak Eye Center, Maulana Azad Medical College, New Delhi, India. the.singhs@vsnl.com
Singh
Mandeep Jot
MJ
Das
Jaya Chander
JC
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004487:Edema / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D005901:Glaucoma / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D007194:India / Q000453:epidemiology; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009149:Mustard Plant / Q000506:poisoning; D010938:Plant Oils / Q000506:poisoning; D011041:Poisoning / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D011446:Prospective Studies; D012164:Retinal Diseases / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D014794:Visual Fields / Q000502:physiology*
D010938:Plant Oils; C027793:mustard oil