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碘酸钾中毒性视网膜病变:5例报告

Potassium iodate toxic retinopathy: a report of five cases.

作者信息

Singalavanija A, Ruangvaravate N, Dulayajinda D

机构信息

Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

出版信息

Retina. 2000;20(4):378-83.

Abstract

BACKGROUND

Potassium iodate (KIO3) is an iodized salt used for iodine supplementation in areas endemic for goiter. KIO3 overdose in humans is rare. The authors report unusual cases of retinal toxicity from KIO3 overdose that caused acute vision loss.

METHODS

The clinical manifestations, toxic dosage of iodate, and ocular changes in five patients who had taken a KIO3 overdose were analyzed. Electroretinography, visual evoked potential (VEP), and fundus fluorescein angiography (FA) were performed to study retinal function and changes.

RESULTS

Two men and three women (age 22-65 years) ingested KIO3 solution at a concentration between 187 and 470 mg/kg body weight. Visual acuity ranged from light perception with projection to counting fingers and decreased from 2 to 12 hours after ingestion. Fundus FA showed bilateral extensive areas of retinal pigment epithelial (RPE) window defects, and electroretinography and VEP showed marked impairment of retinal function. Visual acuity improved from counting fingers to 20/80 in 3 months.

CONCLUSION

Potassium iodate can produce retinal toxicity that damages RPE and photoreceptor cells. The recovery of retinal function depends on the amount of chemical absorption, the regeneration of RPE, and the recovery function of photoreceptor cells.

摘要

背景

碘酸钾(KIO₃)是一种加碘盐,用于在甲状腺肿流行地区补充碘。人类碘酸钾过量情况罕见。作者报告了因碘酸钾过量导致急性视力丧失的视网膜毒性异常病例。

方法

分析了5例碘酸钾过量患者的临床表现、碘酸盐中毒剂量及眼部变化。进行了视网膜电图、视觉诱发电位(VEP)和眼底荧光血管造影(FA)以研究视网膜功能及变化。

结果

2名男性和3名女性(年龄22 - 65岁)摄入了浓度为187至470毫克/千克体重的碘酸钾溶液。视力范围从有光感及可判断方向到能数指,摄入后2至12小时视力下降。眼底FA显示双侧视网膜色素上皮(RPE)广泛区域出现窗样缺损,视网膜电图和VEP显示视网膜功能明显受损。3个月内视力从能数指提高到20/80。

结论

碘酸钾可产生视网膜毒性,损害视网膜色素上皮和光感受器细胞。视网膜功能的恢复取决于化学物质的吸收量、视网膜色素上皮的再生以及光感受器细胞的恢复功能。

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