Copenhagen University Department of Ophthalmology, Rigshospitalet, Copenhagen, Denmark.
Copenhagen University Department of Dermato-Venerology, Bispebjerg Hospital, Copenhagen, Denmark.
Eye (Lond). 2018 Nov;32(11):1688-1696. doi: 10.1038/s41433-018-0137-9. Epub 2018 Jul 4.
To evaluate ophthalmic involvement in a long-term series of patients with en coup de sabre (ECS) close to the eye based on the hypothesis that this is not commonly affected, or simply under-reported.
An observational study of ophthalmological findings in patients from Copenhagen University Dermatology Clinics. A standard eye examination further included exophthalmometry, axial length and keratometry (IOLMaster), and horizontal eye muscle thickness (B-scan ultrasonography).
Thirty-one consecutive patients were included from 2014 to 2015 (25 females, 6 males; median age, 33 years; range, 11-71 years). Twenty-seven patients had undergone ophthalmic evaluation more than once (observation time, 1-31 years; median, 7 years). Most eyes were normal or had currently adapted to eventual adnexal lesions and to insidious changes in eye position and/or motility. However, significant ipsilateral complications had developed related to 8 eyes, where two patients had more than one disorder. The ophthalmic pathologies were: blind eye (n = 2) due to adult age keratopathy/perforation and to Coats-like retinal detachment in childhood; restricted eye motility and diplopia (n = 2); acquired corneal astigmatism (n = 2); and dense cataract with light sense only (n = 1). Two patients had optic neuritis-like presentations, and lacrimal sac pathology occurred in one.
The main ophthalmic focus possibly explained the high proportion of significant lesions in this patient series (in 8 of 31). In addition to the established feature of enophthalmos, the oculometric evidence suggested smaller eye and rectus muscle involvement, interpreted as a secondary (late) negative trophic effect of the overlying skin disorder on eye structures.
根据这一假说，评估靠近眼部的砍头畸形（en coup de sabre，ECS）患者的眼部受累情况，该假说认为眼部通常不受影响，或者只是简单地报道较少。
对哥本哈根大学皮肤科诊所的患者进行眼部发现的观察性研究。标准的眼部检查进一步包括眼球突出度、眼轴和角膜曲率（IOLMaster）以及水平眼外肌厚度（B 型超声检查）。
2014 年至 2015 年连续纳入 31 例患者（25 名女性，6 名男性；中位年龄 33 岁；范围 11-71 岁）。27 例患者接受了不止一次的眼部评估（观察时间 1-31 年；中位数 7 年）。大多数眼睛正常或已经适应了最终的附件病变以及眼位置和/或运动的隐匿性变化。然而，8 只眼睛出现了明显的同侧并发症，其中 2 例患者有不止一种疾病。眼部病变包括：由于成人年龄的角膜病/穿孔和儿童期的类似 Coats 样视网膜脱离而导致的盲眼（n=2）；运动受限和复视（n=2）；获得性角膜散光（n=2）；以及仅光感的致密白内障（n=1）。2 例患者表现为视神经炎样表现，1 例患者发生泪囊病变。
主要的眼部焦点可能解释了该患者系列中高比例的显著病变（31 例中有 8 例）。除了明确的眼球内陷特征外，眼测量证据表明眼球较小和直肌受累，这被解释为上方皮肤疾病对眼部结构的继发性（晚期）负营养作用。
