Delayed ocular complications of mustard gas poisoning and the relationship with respiratory and cutaneous complications.
BACKGROUND
This study was aimed to determine the correlation between ocular complications and respiratory or cutaneous complications in a group of 40 Iranian veterans with late complications of sulphur mustard (SM) poisoning.


METHODS
Thorough ophthalmologic examination was performed on all severely SM-poisoned veterans in the province of Khorasan, Iran. Spirometric evaluation of pulmonary function, as well as estimation of the burned skin area, was performed for all the patients. The severities of ocular, respiratory and cutaneous complications were classified into four grades in each patient and were compared with each other, using Spearman's rank correlation test.


RESULTS
Forty male patients (aged 43.8 +/- 9.8 years) with confirmed SM poisoning were studied 16-20 years after their initial exposure. Common symptoms were recorded as itching (42.5%), burning sensation (37.5%), photophobia (30%) and tearing (27.5%). Abnormal conjunctival and limbal findings were chronic conjunctivitis (17.5%), perilimbal hyperpigmentation (17.5%), vascular tortuosity (15%) and limbal ischaemia (12.5%). Abnormal corneal findings were subepithelial opacity (15%), corneal thinning (15%), diffuse corneal opacity (10%), neovascularization (7.5%) and epithelial defects (5%). A significant positive correlation was found between the severity of ocular and respiratory complications (r = 0.322, P = 0.043). Cutaneous complications revealed no significant correlation with either ocular or respiratory complications.


CONCLUSIONS
SM causes delayed destructive lesions in the ocular surface and cornea, leading to progressive visual deterioration and ocular irritation. Late complications of SM poisoning in the eyes, respiratory system and skin are mainly due to SM's local irritant effects.
Etezad-Razavi
Mohammad
M
Ophthalmology Department, Khatamolanbia Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. metezadr2003@yahoo.com
Mahmoudi
Mahmoud
M
Hefazi
Mehrdad
M
Balali-Mood
Mahdi
M
D000328:Adult; D000368:Aged; D002057:Burns, Chemical / Q000209:etiology*; D002619:Chemical Warfare Agents / Q000506:poisoning*; D003229:Conjunctival Diseases / Q000139:chemically induced; D003316:Corneal Diseases / Q000139:chemically induced; D005126:Eye Burns / Q000139:chemically induced; D005128:Eye Diseases / Q000139:chemically induced*; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D009151:Mustard Gas / Q000506:poisoning*; D012129:Respiratory Function Tests; D012140:Respiratory Tract Diseases / Q000139:chemically induced*; D012871:Skin Diseases / Q000139:chemically induced*; D014728:Veterans
D002619:Chemical Warfare Agents; D009151:Mustard Gas