Perimetric visual field testing reveals deficits in contrast sensitivity in workers exposed to occupational levels of pesticides.

Purpose: This case-control study investigated whether defects in visual field contrast sensitivity are associated with exposure to occupational levels of pesticides in agricultural workers.

Methods: Twenty-seven individuals exposed to occupational levels of pesticides (exposed group) from 14 agricultural systems and 27 non-exposed individuals (non-exposed group) were measured using standard automated perimetry (30-2 full threshold). Visual sector analysis, targeting regions of the optic nerve head, was performed to examine for potential region-specific sensitivity differences. Participants also underwent comprehensive assessments, including general optometric examinations and demographic surveys. Symptoms and signs of neurotoxicity were assessed using the modified Q16 neurotoxic symptom questionnaire and biological testing for abnormal levels of Substance P in tears (an inflammatory marker associated with chemical exposure) and cholinesterase (which is inhibited by pesticides) in blood samples.

Results: Signs of chemical exposure were found as indicated by significantly higher levels of neurotoxic symptoms, higher concentrations of Substance P and lower levels of cholinesterase in the exposed group. Visual field global indices showed differences in contrast sensitivity between the exposed and non-exposed groups, with the exposed group demonstrating significantly lower means and larger pattern-standard deviations. Notably, visual field sector analysis revealed comparatively lower contrast sensitivity at nasal locations surrounding the optic nerve head in the exposed group.

Conclusion: This study found deficits in visual field contrast sensitivity to be associated with pesticide exposure, and selective loss at nasal locations centred on the optic nerve head may indicate retinal toxicity. These findings suggest the utility of visual field assessment as a potential method to evaluate pesticide-related health implications. The results highlight the need for ongoing monitoring and protective measures for agricultural workers exposed to pesticides to prevent potential visual and neurological damage.