Pujari Amar, Behera Aswini, Mukhija Ritika, Chawla Rohan, Yadav Suresh, Sharma Namrata
a Dr. Rajendra Prasad Centre for Ophthalmic Sciences , All India Institute of Medical Sciences , New Delhi , India.
Cutan Ocul Toxicol. 2019 Mar;38(1):1-4. doi: 10.1080/15569527.2018.1495225. Epub 2018 Sep 10.
To correlate the anatomical extent of ocular surface toxicity due to colours using anterior segment optical coherence tomography (ASOCT) with the clinical findings.
Patients presenting to our emergency department with ocular colour toxicity during the Holi festival celebrations from March 2 2018 to March 5 2018 were assessed for any adnexal, conjunctival, corneal, and anterior chamber findings, as well as findings on anterior segment optical coherence tomography.
A total of 21 patients were observed. The average age was 23 years with 16 patients being male (76.19%). Bilateral ocular involvement was more common (13 patients, 61.90%). Clinically, the corneal changes included localized punctate epitheliopathy (type I) in 12 patients (57.14%) and diffuse punctate epitheliopathy admixed with a variable sized epithelial defect (type II) in the other 9 patients (42.85%). The visual acuity among the former group varied from 6/6 to 6/9, whereas for the latter, it ranged from 6/12 to 6/24. On ASOCT in both the types, the superficial stromal involvement was noted up to 60 microns. Interestingly in two patients with type II corneal involvement, anterior segment involvement was noted in the form of staining of the lens capsule and dense anterior chamber inflammation.
Ocular toxicity due to colours used during Holi mainly involves the surface epithelium and the superficial stroma. This was observed clinically and also confirmed on ASOCT. The colour can rarely diffuse into the anterior chamber causing an inflammatory reaction and staining of the lens capsule. However, if managed appropriately, vision-threatening complications can be averted.
使用眼前节光学相干断层扫描（ASOCT）将因颜色导致的眼表毒性的解剖范围与临床发现相关联。
对2018年3月2日至2018年3月5日胡里节庆祝活动期间到我们急诊科就诊的有眼部颜色毒性的患者进行评估，检查任何附属器、结膜、角膜和前房的情况，以及眼前节光学相干断层扫描的结果。
共观察了21例患者。平均年龄为23岁，男性16例（76.19%）。双眼受累更为常见（13例，61.90%）。临床上，角膜变化包括12例患者（57.14%）出现局限性点状上皮病变（I型），另外9例患者（42.85%）出现弥漫性点状上皮病变并伴有大小不一的上皮缺损（II型）。前一组患者的视力从6/6到6/9不等，而后一组患者的视力范围为6/12到6/24。在两种类型的ASOCT检查中，均发现浅层基质受累达60微米。有趣的是，在2例II型角膜受累患者中，发现眼前节受累表现为晶状体囊染色和前房密集炎症。
胡里节期间使用的颜色导致的眼毒性主要累及表面上皮和浅层基质。这在临床上得到了观察，并在ASOCT上得到了证实。颜色很少会扩散到前房，引起炎症反应和晶状体囊染色。然而，如果处理得当，可以避免威胁视力的并发症。
