Jovanović Predrag, Hentova-Senćanić Paraskeva, Zorić Lepsa, Petrović Maja, Bozinović Marija Trenkić
Klinicki centar, Klinika za ocne bolesti, Nis, Srbija.
Vojnosanit Pregl. 2009 Jun;66(6):487-9. doi: 10.2298/vsp0906487j.
Courmon street name for 3,4-Methylenedioxymethamphetamine (MDMA) is ecstasy. This widely abused "recreational" drug causes both an increased release of monoamine neurotransmitters, including serotonine and dopamine, and an increased reuptake inhibition of serotonin. As a consequence, mydriasis and increased intraocular pressure (IOP) in predisposed patients occur. We present herein a rare case of acute increased IOP after use of ecstasy.
A female patient, aged 38 years, visited doctor complaing of a decreased vision acuity and severe pain in the left eye and in the left part of the head. The initial treatment was urgent antiglaucomatous therapy followed by withdrawal of subjective problems of the patient and improvement of objective finding. History taking procedure revaled that just before the onset of the pain the patient had used ecstasy and had had similar "experience" 6 years ago after cocaine snorting. She had not been to a doctor although she had experienced sporadic migrenous pain. Previous medical records excavation of revealed optic disk (cup-to-dise C/D=06), Bjerum arcuate scotoma and iris plateau with narrow chamber angle (Scheie II-III) so the diagnosis was a rare unilateral iris plateau syndrome of the left eye. Although the patient was given some pieces of information about the dangerous and possible deadly consequences of psychoactive substanace abuse, she has not continue the treatment.
Ecstasy abuse might cause a complete loss of vision, thus medicametous and surgical treatment are abligatory.
3,4-亚甲基二氧甲基苯丙胺（MDMA）的俗称是摇头丸。这种被广泛滥用的“娱乐性”药物会导致单胺类神经递质（包括血清素和多巴胺）释放增加，同时对血清素的再摄取抑制也增强。因此，易感患者会出现瞳孔散大和眼压升高。我们在此报告一例使用摇头丸后急性眼压升高的罕见病例。
一名38岁女性患者因左眼视力下降和左眼及左侧头部剧痛就诊。初始治疗为紧急抗青光眼治疗，随后患者主观症状缓解，客观检查结果改善。病史询问显示，就在疼痛发作前，患者使用了摇头丸，且6年前吸食可卡因后有过类似“经历”。尽管她曾有过散发性偏头痛，但此前未就医。既往病历显示视盘（杯盘比C/D = 0.6）、 Bjerrum弓形暗点以及房角狭窄的虹膜平台（Scheie II - III级），因此诊断为罕见的左眼单侧虹膜平台综合征。尽管已向患者告知精神活性物质滥用的危险及可能的致命后果，但她仍未继续治疗。
滥用摇头丸可能导致完全失明，因此药物治疗和手术治疗必不可少。
