Nagpal Agnieszka G, Brodie Scott E
Mount Sinai School of Medicine, New York, USA.
Doc Ophthalmol. 2009 Apr;118(2):163-6. doi: 10.1007/s10633-008-9144-7. Epub 2008 Aug 15.
To report a case of lead exposure in a 10-year-old girl which resulted in a supranormal ERG and clinical findings of decreased visual acuity, color vision, and stereopsis.
Case report.
A 10-year-old girl was exposed to unknown levels of lead, with peak recorded blood levels of 19 mcg/dl 5 years prior to presentation. Lead levels had since normalized. Uncorrected visual acuity was 20/200-OU, improving to 20/80-OU with a refractive correction of +1.50 + 0.75 x 90 degrees OD, +2.50 sphere OS. Color vision was tested with Ishihara plates, and appeared markedly impaired. Stereopsis was grossly impaired, as the patient could not perceive stereoscopic depth with the Titmus "fly" target. Her cognitive function appeared to be slowed and her reaction time also delayed. ERG waveforms were supranormal under photopic and scotopic conditions. Implicit times were normal.
Lead toxicity with significant visual and cognitive dysfunction, and supranormal ERG, can persist at lead levels below those recognized for lead poisoning.
报告一例10岁女孩铅暴露病例，该病例导致视网膜电图（ERG）超常，以及视力下降、色觉和立体视觉的临床症状。
病例报告。
一名10岁女孩曾暴露于未知水平的铅中，就诊前5年记录的血铅峰值水平为19微克/分升。此后铅水平已恢复正常。裸眼视力为双眼20/200，右眼通过+1.50 + 0.75×90度的屈光矫正、左眼通过+2.50球镜矫正后提高到双眼20/80。使用石原氏色盲测试图测试色觉，结果显示明显受损。立体视觉严重受损，因为患者无法通过Titmus“苍蝇”视标感知立体深度。她的认知功能似乎减慢，反应时间也延迟。在明视和暗视条件下，ERG波形超常。潜伏时间正常。
铅毒性伴明显视觉和认知功能障碍以及超常ERG，可在低于铅中毒公认水平的铅含量时持续存在。
