Huang Ye, Chundury Rao V, Timperley Brent D, Terp Patricia A, Krueger Ronald R, Yeh Steven
Truhlsen Eye Institute, Department of Ophthalmology and Visual Sciences, University of Nebraska Medical Center, Omaha, NE, USA.
Department of Epidemiology, University of Nebraska Medical Center College of Public Health, Omaha, NE, USA.
Am J Ophthalmol Case Rep. 2022 Mar 1;26:101464. doi: 10.1016/j.ajoc.2022.101464. eCollection 2022 Jun.
To describe the devastating ophthalmic sequelae of methamphetamine use disorder in two patients who developed vision loss from ocular complications, including keratitis and endophthalmitis.
Case 1 is a 26-year-old male with hepatitis C, poorly controlled type 1 diabetes, and chronic methamphetamine use who presented with a corneal ulcer in the left eye. Corneal culture grew and , prompting antibiotic therapy. Follow-up exam showed peripheral corneal ulceration OD and diffusely vascularized and scarred cornea OS, although nonadherence was reported. Vision eventually worsened to hand motions OD and light perception OS.Case 2 is a 44-year-old woman with hepatitis C, acute myeloid leukemia, dry eye syndrome secondary to chronic graft-versus-host disease (GVHD), and chronic methamphetamine use who presented with a diffuse corneal infiltrate and hypopyon. She underwent emergent corneal transplantation, vitrectomy, and broad-spectrum intravitreal and intravenous antibiotics. Vitreous cultures were positive for . However, progressive disease eventually required enucleation despite initial globe salvaging measures.
These two patient cases highlight the risk of vision loss or blindness due to the detrimental effects of chronic methamphetamine use on the eye, including the potential for keratitis and endophthalmitis. Given the increasing prevalence of methamphetamine use disorder in the United States, further understanding of these toxicities and preventive strategies are needed.
描述两名因眼部并发症（包括角膜炎和眼内炎）导致视力丧失的甲基苯丙胺使用障碍患者所出现的严重眼部后遗症。
病例1是一名26岁男性，患有丙型肝炎、1型糖尿病控制不佳且长期使用甲基苯丙胺，因左眼角膜溃疡前来就诊。角膜培养物培养出[具体菌种1]和[具体菌种2]，遂开始抗生素治疗。随访检查显示右眼周边角膜溃疡，左眼角膜弥漫性血管化并形成瘢痕，尽管患者存在不遵医嘱情况。最终视力恶化至右眼仅能感知手动，左眼仅能感知光感。病例2是一名44岁女性，患有丙型肝炎、急性髓系白血病、慢性移植物抗宿主病（GVHD）继发的干眼综合征且长期使用甲基苯丙胺，因角膜弥漫性浸润和前房积脓前来就诊。她接受了紧急角膜移植、玻璃体切除术以及广谱玻璃体内和静脉抗生素治疗。玻璃体培养物[具体菌种3]呈阳性。然而，尽管最初采取了挽救眼球的措施，但疾病进展最终仍需眼球摘除。
这两例患者突出了长期使用甲基苯丙胺对眼睛的有害影响所导致的视力丧失或失明风险，包括角膜炎和眼内炎的可能性。鉴于美国甲基苯丙胺使用障碍的患病率不断上升，需要进一步了解这些毒性及预防策略。
