Use of amphoteric rinsing solution for treatment of ocular tissues exposed to nitrogen mustard

Acta Ophthalmol. 2013 Feb;91(1):e35-40. doi: 10.1111/j.1755-3768.2012.02533.x. Epub 2012 Oct 5.

Abstract

Purpose: Ocular exposure to mustard agents may cause severe and prolonged injury to the anterior segment tissues. Effective decontamination of the external eye surface after exposure is of paramount importance. The purpose of the present study was to assess the effectiveness of Diphoterine rinsing solution (DRS) in reducing ocular damage after exposure to nitrogen mustard (NM) and to compare it with normal saline solution.

Methods: One eye of 16 New Zealand albino rabbits was exposed to 2% NM. Immediate thorough irrigation was performed with either 500 ml of DRS (treated group) or with 500 ml of normal saline (control group). The magnitude of ocular injury and response to treatment were assessed by examiners masked to the treatment assignment during 22 days following the exposure.

Results: Immediate ocular irrigation with DRS was more effective compared with saline in reducing corneal, iris and anterior chamber injury. In the DRS-treated group, the corneal opacity and corneal neovascularization were less severe, and development of iris atrophy was delayed. Intraocular pressure (mmHg) was better maintained when compared to the control group (day 7 24.3 versus 14.8, p = 0.003; day 12 28 versus 15, p = 0.003; day 22 33.5 versus 21.8, p = 0.014, respectively). Systemic oxidative stress associated with exposure to NM was significantly higher in the saline-treated group than in DRS-treated group (p < 0.011).

Conclusions: The findings of this study indicate the effectiveness of DRS in reducing of NM-induced ocular injuries. Its use should be considered as an immediate treatment modality following exposure to mustard agents to reduce potential ocular injury.

Publication types

  • Comparative Study

MeSH terms

  • Animals
  • Atrophy / drug therapy
  • Burns, Chemical / drug therapy*
  • Burns, Chemical / etiology
  • Burns, Chemical / pathology
  • Chemical Warfare Agents / toxicity*
  • Corneal Diseases / chemically induced
  • Corneal Diseases / drug therapy*
  • Corneal Neovascularization / chemically induced
  • Corneal Neovascularization / drug therapy
  • Corneal Neovascularization / pathology
  • Corneal Opacity / chemically induced
  • Corneal Opacity / drug therapy
  • Corneal Opacity / pathology
  • Disease Models, Animal
  • Eye Burns / chemically induced*
  • Intraocular Pressure / drug effects
  • Iris / pathology
  • Mechlorethamine / toxicity*
  • Ophthalmic Solutions / therapeutic use*
  • Organic Chemicals / therapeutic use
  • Oxidative Stress / drug effects
  • Rabbits
  • Sodium Chloride / therapeutic use
  • Therapeutic Irrigation
  • Treatment Outcome
  • Wound Healing / drug effects

Substances

  • Chemical Warfare Agents
  • Ophthalmic Solutions
  • Organic Chemicals
  • diphoterine
  • Sodium Chloride
  • Mechlorethamine