PDF(Pubmed)
Abstract：
BACKGROUND Peracetic acid is among the disinfectants that irritate the upper respiratory tract, skin, and conjunctiva. It can cause symptoms of eye irritation, secondary to an inflammatory process that can lead to various manifestations. Irritation happens due to the high reduction potential of the acid, which causes the consequent release of reactive oxygen species. This fact serves to reinforce the importance of personal protective equipment when handling peracetic acid. CASE REPORT During an accident at work, a 21-year-old patient received a strong jet of disinfectant solution directly into both eyes. The composition of the disinfectant solution was 15% peracetic acid, 15-16% hydrogen peroxide, 22-23% acetic acid, and 16-17% horticultural sanitizers. Twenty-four hours after the incident, eye damage (punctate keratitis and low visual acuity) had occurred, and was treated by washing the eye with ice water and frequently applying lubricating eye drops. The next day, the patient returned with an improvement of irritative symptoms, but with a major complaint of low visual acuity in left eye, secondary to optic neuritis, detected by fundoscopy and confirmed by optical coherence tomography. In the following week, fluorescent angiography indicated the persistence of neuritis in the left eye. This was treated with prednisone, 40 mg/day, which brought about gradual improvement. Two months later, the patient returned with test results showing normal magnetic resonance imaging and negative serologies (for syphilis, HIV, and herpes virus), visual acuity 20/20 in both eyes, and normalization of angiography and optical coherence tomography parameters. CONCLUSIONS Until now, there have been no published studies demonstrating neuritis caused by direct contact of peracetic acid into the eyes. Therefore, this is the first report in the world literature of this manifestation of ocular exposure to peracetic acid. This is a chemical formulation that is widely useful and prevents the growth of various pathogens. Further investigation and studies on the subject should be encouraged to improve its management and use.
摘要：
背景技术过氧乙酸是刺激上呼吸道的消毒剂之一。皮肤,和结膜。它会引起眼睛刺激的症状，继发于炎症过程，可导致各种表现。刺激是由于酸的高还原电位而发生的，从而导致活性氧的释放。这一事实加强了处理过乙酸时个人防护装备的重要性。案例报告在工作事故中，一名21岁的患者接受了强烈的消毒剂直接喷射到双眼。消毒剂溶液的成分是15%过氧乙酸,15-16%过氧化氢,22-23%乙酸,和16-17%的园艺消毒剂。事件发生二十四小时后，发生了眼睛损伤（点状角膜炎和低视力），并通过用冰水清洗眼睛并经常使用润滑眼药水进行治疗。第二天,患者返回时刺激性症状有所改善，但是主要抱怨左眼视力低，继发于视神经炎,通过眼底镜检查并通过光学相干断层扫描确认。在接下来的一周,荧光血管造影显示左眼持续存在神经炎。用泼尼松治疗,40毫克/天，这带来了逐步的改善。两个月后,患者返回时，检查结果显示磁共振成像正常，血清学阴性(梅毒，艾滋病毒,和疱疹病毒），双眼视力20/20，血管造影和光学相干断层扫描参数的归一化。结论直到现在，没有发表的研究证明过氧乙酸直接接触眼睛引起的神经炎。因此,这是世界文献中首次报道过氧乙酸眼部暴露的这种表现。这是一种广泛有用的化学制剂，可防止各种病原体的生长。应鼓励对该主题进行进一步的调查和研究，以改善其管理和使用。
