Siemerink Martin J, Freling Nicole J M, Saeed Peerooz
a Orbital and Ocular Adnexal Center, Department of Ophthalmology , Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands.
b Department of Radiology , Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands.
Orbit. 2017 Oct;36(5):350-355. doi: 10.1080/01676830.2017.1337178. Epub 2017 Aug 16.
Orbital inflammatory disease and secondary optic neuropathy is a rare but devastating complication of long-term intranasal cocaine abuse. We describe 2 patients with a history of intranasal cocaine consumption who presented with subacute onset of unilateral vision loss from optic neuropathy and limitation of abduction in the affected eye. Magnetic resonance imaging findings included an orbital mass in combination with absent nasal septum and partial destruction of the paranasal sinuses. Biopsies and histopathologic examination of the nasal cavity and the orbital mass revealed chronic inflammation. Both patients were treated with oral corticosteroids, ocular movements completely normalized but no improvement of visual acuity was noted. Intranasal cocaine abuse can cause orbital complications from chronic sinonasal inflammatory disease and these patients are at risk to develop optic neuropathy. Optic neuropathy may be caused by compression, infiltration, or ischaemia.
眼眶炎性疾病和继发性视神经病变是长期鼻内滥用可卡因罕见但极具破坏性的并发症。我们描述了2例有鼻内使用可卡因病史的患者，他们表现为因视神经病变导致的单侧视力丧失亚急性发作，以及患眼外展受限。磁共振成像结果包括眼眶肿块合并鼻中隔缺失和鼻窦部分破坏。鼻腔和眼眶肿块的活检及组织病理学检查显示为慢性炎症。两名患者均接受了口服糖皮质激素治疗，眼球运动完全恢复正常，但视力没有改善。鼻内滥用可卡因可导致慢性鼻-鼻窦炎引起的眼眶并发症，这些患者有发生视神经病变的风险。视神经病变可能由压迫、浸润或缺血引起。
