Download fulltext HTML
1.
Abri Aghdam K, Zand A, Soltan Sanjari M. Bilateral Optic Disc Edema in a Patient with Lead Poisoning. JOVR [Internet]. 2019Oct.24 [cited 2024Apr.25];14(4):513–517. Available from: https://knepublishing.com/index.php/JOVR/article/view/5465

https://doi.org/10.18502/jovr.v14i4.5465

statistics

  • 791 Abstract Views
  • 377 PDF Views
  • 0 HTML Views
  • Cited by 5 articles

authors

  • Kaveh Abri Aghdam

    Kaveh Abri Aghdam

    Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
  • Amin Zand

    Amin Zand

    Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
    https://orcid.org/0000-0003-4423-4979
  • Mostafa Soltan Sanjari

    Mostafa Soltan Sanjari

    Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran

Published Date

  • Oct 24, 2019
This journal is publishing all the articles under Creative Commons Attribution License CC BY 4.0.

Bilateral Optic Disc Edema in a Patient with Lead Poisoning

Journal of Ophthalmic and Vision Research (JOVR) / October–December 2019, Volume 14, Issue 4 / Pages 513–517

Abstract

Purpose: Heavy metals, such as lead can cause optic neuropathy. Optic disc neuropathy due to lead intoxication has previously been reported. We report a rare case of lead toxicity-induced optic neuropathy presenting with bilateral hemorrhagic optic disc swelling.


Case Report: The patient was a 42-year-old man with a history of chronic oral opium use, who had a gradually progressing blurred vision in both eyes over 40 days, with ataxia, paresthesia, and a toxic level of serum lead. He had been treated with lead chelators for lead poisoning. His color vision was impaired in both eyes. Humphrey’s visual field test revealed double arcuate scotoma with enlargement of the blind spot. Funduscopy revealed bilateral optic disc swelling, which was confirmed on optical coherence tomography and fluorescein angiography.


Conclusion: In cases of optic disc edema, a comprehensive history should be taken to detect the cause. Further, in cases of chronic oral opium use, lead toxicity should be considered.

Keywords:

Lead Poisoning, Opium Dependence, Optic Disc Edema, Paresthesia

References
1. Jung JJ, Baek S-H, Kim US. Analysis of the causes of optic disc swelling. Korean J Ophthalmol 2011;25:33–36.

2. Sharma P, Sharma R. Toxic optic neuropathy. Indian J Ophthalmol 2011;59:137–141.

3. Report on carcinogens, fourteenth edition: lead and lead compounds [Internet]. National Toxicology Program, Department of Health and Human Services; 2004. Available from: https://ntp.niehs.nih.gov/ntp/roc/content/profiles/lead.pdf

4. Baghdassarian SA. Optic neuropathy due to lead poisoning: report of a case. Arch Ophthalmol 1968;80:721–723.

5. Fintak DR. Wills Eye Resident Case Series: review of ophthalmology. U.S.: Wills Eye Hospital; 2007 Jan 30. Available from: https://www.reviewofophthalmology.com/ article/wills-eye-resident-case-series-24966

6. Gilhotra JS, Lany HV, Sharp DM. Retinal lead toxicity. Indian J Ophthalmol 2007;55:152–154.

7. Sobieniecki A, Gutowska I, Machalińska A, Chlubek D. Retinal degeneration following lead exposure – functional aspects. Postepy Hig Med Dosw (online) 2015;69:1251–1258.

8. Salehi H, Sayadi AR, Tashakori M, Yazdandoost R, Soltanpoor N, Sadeghi H, et al. Comparison of serum lead level in oral opium addicts with healthy control group. Arch Iran Med 2009;12:555–558.

9. Gilhotra JS, Von Lany H, Sharp DM. Retinal lead toxicity. Indian J Ophthalmol 2007;55:152–154.

10. Wasinska-Borowiec W, Aghdam KA, Saari JM, Grzybowski A. An updated review on the most common agents causing toxic optic neuropathies. Curr Pharm Des 2017;23:586–595.

11. Ekinci M, Ceylan E, Cağatay HH, Keleş S, Altınkaynak H, Kartal B, et al. Occupational exposure to lead decreases macular, choroidal, and retinal nerve fiber layer thickness in industrial battery workers. Curr Eye Res 2014;39:853– 858.

12. Fox DA, Campbell ML, Blocker YS. Functional alterations and apoptotic cell death in the retina following developmental or adult lead exposure. Neurotoxicology 1997;18:645–664.