Pellegrini Francesco, Interlandi Emanuela, Cuna Alessandra, Mandarà Erika, Lee Andrew G
Department of Ophthalmology, Conegliano Hospital, Conegliano, Italy.
Department of Ophthalmology, "Ospedale Del Mare", Naples, Italy.
Neuroophthalmology. 2019 Apr 8;44(1):54-58. doi: 10.1080/01658107.2019.1602147. eCollection 2020 Feb.
A 47-year-old man with Wallenberg syndrome after a stroke in the territory of the left vertebrobasilar artery and posterior inferior cerebellar artery, presented a week later complaining of visual loss in the left eye. Examination showed corneal anaesthesia associated with a neurotrophic corneal epithelial defect. Corneal involvement secondary to trigeminal neuropathy in Wallenberg syndrome is not frequently reported and may lead to epithelial erosion and neurotrophic keratopathy. Clinicians should be aware that visual loss can occur from a neurogenic basis (e.g., Wallenberg syndrome) due to neurotrophic keratopathy. The use of cocaine, a potential cause of neurotrophic keratopathy, should also be suspected in the appropriate clinical scenario.
一名47岁男性,在左椎基底动脉和小脑后下动脉区域中风后出现延髓背外侧综合征,一周后前来就诊,主诉左眼视力丧失。检查发现角膜麻醉伴有神经营养性角膜上皮缺损。延髓背外侧综合征继发于三叉神经病变的角膜受累情况并不常见,可能导致上皮糜烂和神经营养性角膜病变。临床医生应意识到,神经营养性角膜病变可导致神经源性视力丧失(如延髓背外侧综合征)。在适当的临床情况下,还应怀疑使用可卡因这一神经营养性角膜病变的潜在病因。