Sato Tomoko, Sugioka Koji, Kodama-Takahashi Aya, Fukuda Masahiko, Mishima Hiroshi, Shimomura Yoshikazu
Department of Ophthalmology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan.
Case Rep Ophthalmol. 2018 Feb 16;9(1):114-118. doi: 10.1159/000485965. eCollection 2018 Jan-Apr.
To report a case of neurotrophic keratopathy associated with nasopharyngeal carcinoma.
A 59-year-old man who had been diagnosed with a nasopharyngeal carcinoma was referred to the authors because of visual disturbance and pain in his right eye. Slit-lamp examination revealed a corneal epithelial defect and corneal stromal edema surrounding the epithelial defect area in his right eye. Magnetic resonance imaging showed a mass in his cavernous sinus, which was identified as nasopharyngeal carcinoma (NPC). We diagnosed neurotrophic keratopathy associated with NPC and initiated treatment with preservative-free artificial tears, antibiotic eye drops, fibronectin, a therapeutic contact lens, and amniotic membrane transplantation. However, the persistent corneal epithelial defect was unresponsive to these treatments.
Neurotrophic keratopathy secondary to NPC is thought to be rare. We presented a case of neurotrophic keratopathy associated with cavernous sinus metastasis of an NPC. The development of new and more effective treatments for this refractory disease is anticipated.
报告一例与鼻咽癌相关的神经营养性角膜病变病例。
一名59岁男性，已被诊断为鼻咽癌，因右眼视力障碍和疼痛转诊至作者处。裂隙灯检查发现其右眼角膜上皮缺损，上皮缺损区域周围角膜基质水肿。磁共振成像显示其海绵窦有肿物，确诊为鼻咽癌（NPC）。我们诊断为与NPC相关的神经营养性角膜病变，并开始使用不含防腐剂的人工泪液、抗生素眼药水、纤连蛋白、治疗性隐形眼镜和羊膜移植进行治疗。然而，持续的角膜上皮缺损对这些治疗无反应。
继发于NPC的神经营养性角膜病变被认为很罕见。我们报告了一例与NPC海绵窦转移相关的神经营养性角膜病变病例。期待针对这种难治性疾病开发新的、更有效的治疗方法。
