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M. Etezad Razavi, M. Mahmoudy, M. Hefazi, M. Balali–Mood; The Immunostatus of Iranian Veterans With Delayed Ocular Complications Following Exposure to Mustard Gas . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2814.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:Sulfur mustard (SM) is an alkylating chemical warfare agent with devastating long–term effects on eyes. One of its most distressing complications is the development of delayed keratitis which usually occurs 15 to 20 years after the initial injury. The aim of this study was to evaluate the possible relationship between ophthalmological and immunological toxic effects of sulfur mustard on severely intoxicated Iranian veterans. Methods:Ophthalmologic examination was performed on all severely SM poisoned veterans in the Khorasan (Iran). The severities of ocular complications were classified into four grades: grade 1 (no signs ± symptoms), grade 2 (conjunctival lesions), grade 3 (limbal lesions) and grade 4 (corneal lesions). Cell blood counts and flowcytometric analyses were performed for the patients as well as for a control group consisted of 35 healthy, age–matched, male subjects. Hematological and flowcytometric parameters were compared between patients and the control group, using Man–Whitney U test. The correlation between these parameters were evaluated, using Spearman's rank correlation test. Results:Forty male patients with confirmed SM poisoning 16 to 20 years ago, were studied. Severity grading of ocular complications were determined as 14 in grade 1, 15 in grade 2, 5 in grade 3, and 6 patients in grade 4. The values for WBC, RBC, and HCT as well as for the percentage of monocytes and CD3+ lymphocytes were significantly higher (p<0.05) and the percentage of CD 16+56 positive cells was significantly lower in patients compared with the control group. Except for the significant positive correlation between Hb level and the severity grades of ocular complications (r=0.341, p=0.031), no other significant correlation was found between hematological and immunological parameters and the severity grades of ocular complications. Conclusions: SM exposure is known to be responsible for several adverse effects on both ocular and immune system. No relationship, however, was found between the severity of ocular complications and either the hematological or immunological complications of SM poisoning.
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