Armentano Marta, Alisi Ludovico, Visioli Giacomo, Saturno Maria Carmela, Barba Arianna, Speranzini Alessio, Albanese Giuseppe Maria, Gharbiya Magda, Iannetti Ludovico
Department of Sense Organs, Medicine and Dentistry Faculty, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy.
Ophthalmology Unit, Head and Neck Department, Policlinico Umberto I University Hospital, 00161 Rome, Italy.
J Clin Med. 2024 Dec 22;13(24):7838. doi: 10.3390/jcm13247838.
This comprehensive review examines the ocular vascular complications of cocaine use, focusing on its effects on retinal vasculature and inflammation. A rare case of bilateral frosted branch angiitis (FBA) in a 48-year-old man with a history of intranasal cocaine abuse is presented as an illustrative example to stimulate discussion. The case highlights severe retinal ischemia and vascular sheathing, with no identifiable infectious or autoimmune cause, ultimately complicated by systemic vascular events. Integrating this case with a review of the literature, we discuss cocaine's vasoconstrictive and immunomodulatory effects and their role in retinal pathology, including vasculitis, vascular occlusions, hemorrhages, and optic neuropathy. Although often a diagnosis of exclusion, and with rare and poorly understood consequences, this review underscores the importance of considering cocaine abuse in the differential diagnosis of complex retinal presentations.
这篇综述全面审视了使用可卡因引发的眼部血管并发症，重点关注其对视网膜血管系统和炎症的影响。文中呈现了一例罕见病例，一名48岁有鼻内滥用可卡因病史的男性患双侧霜样树枝状视网膜血管炎（FBA），以此作为实例引发讨论。该病例突出显示了严重的视网膜缺血和血管鞘形成，且未发现可识别的感染或自身免疫病因，最终并发全身性血管事件。结合此病例及文献综述，我们讨论了可卡因的血管收缩和免疫调节作用及其在视网膜病变中的作用，包括血管炎、血管阻塞、出血和视神经病变。尽管通常是排除性诊断，且后果罕见且了解甚少，但本综述强调了在复杂视网膜表现的鉴别诊断中考虑可卡因滥用的重要性。
