Department of Ophthalmology and Visual Sciences.
Department of Neurological Surgery, University of Kentucky College of Medicine, Lexington, Kentucky, U.S.A.
Ophthalmic Plast Reconstr Surg. 2024;40(3):245-253. doi: 10.1097/IOP.0000000000002537. Epub 2023 Dec 19.
To describe a unique case of a fatal self-enucleation and review previously published cases.
The authors describe a unique case of a complete unilateral self-enucleation while under the influence of drugs, which resulted in severe intracranial hemorrhages, right internal carotid artery opacification, and death. A literature review was performed by searching articles published before January 2023 in the Pubmed/MEDLINE database using the keywords "auto-enucleation or self-enucleation." Cases of self-inflicted damage to the globe without severing any connections were excluded.
A literature review identified a total of 54 articles and 75 patients who had self-enucleated at least one globe completely (84.0%). Their average age was 37 years and 50.7% were male. At the time of auto-enucleation, 64.0% of these patients had known psychiatric disorders, and 28.0% were found to be under the influence of illicit drugs or alcohol. Auto-enucleation resulted in intracranial complications in 26.7% of cases. There has been 1 prior case, which, like the authors' case, resulted in death due to intracranial complications. However, this occurred in a patient who partially enucleated one eye after a self-inflicted injury to the fellow eye. The current case is unique as these complications resulted from a complete unilateral auto-enucleation.
The severity of this case's presentation and outcome highlights the importance of prompt neuroimaging and a thorough assessment. Prompt psychiatric assessment and treatment are also required.
描述一例独特的致命性自行眼球摘除病例，并复习既往文献。
作者描述了一例独特的单侧完全自行眼球摘除病例，该例发生于药物影响下，导致严重颅内出血、右侧颈内动脉显影和死亡。通过在 Pubmed/MEDLINE 数据库中使用“auto-enucleation 或 self-enucleation”等关键词，检索 2023 年 1 月前发表的文章，进行文献回顾。排除了所有未切断任何连接而导致的眼球自行损伤的病例。
文献回顾共确定了 54 篇文章和 75 例至少完全自行摘除一只眼球的患者（84.0%）。他们的平均年龄为 37 岁，50.7%为男性。在自行眼球摘除时，这些患者中有 64.0%已知患有精神疾病，28.0%被发现受非法药物或酒精影响。自动眼球摘除导致颅内并发症的比例为 26.7%。此前有 1 例类似病例，因颅内并发症导致死亡，但该例是在对另一只眼造成自我伤害后部分摘除一只眼。本病例的独特之处在于这些并发症是由单侧完全自行眼球摘除引起的。
该病例的表现和结果的严重性强调了及时进行神经影像学检查和全面评估的重要性。还需要及时进行精神病学评估和治疗。
