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角膜黄蜂蜇伤后视网膜和脉络膜脱离:一例报告及文献综述

Retinal and choroidal detachment following corneal wasp sting: a case report and literature review.

作者信息

Xue Shaofei, Yao Jiang, Scotland Daniel Hillarion, Qi Yuanyuan

机构信息

The Third People's Hospital of Dalian, Dalian, China.

Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Dalian, China.

出版信息

J Ophthalmic Inflamm Infect. 2025 Jul 15;15(1):53. doi: 10.1186/s12348-025-00510-9.

DOI:10.1186/s12348-025-00510-9
PMID:40663202
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12263537/
Abstract

PURPOSE

Ocular injuries caused by wasp stings are rare but potentially devastating. This report describes a case of severe retinal and choroidal detachment secondary to corneal wasp envenomation, with a focus on pathogenesis and management challenges.

CASE PRESENTATION

A 63-year-old female sustained a left corneal wasp sting, progressing to corneal edema, hypopyon, retinal-choroidal detachment, and eventual light perception loss. Despite medical therapy (topical corticosteroids, antibiotics), the patient declined surgical intervention, ultimately resulting in evisceration.

CONCLUSION

Wasp venom triggers synergistic neurotoxic and immune-mediated damage, emphasizing the necessity of individualized management. Clinicians should prioritize multimodal approaches to mitigate irreversible vision loss in such cases.

摘要

目的

黄蜂蜇伤导致的眼部损伤虽罕见但可能具有毁灭性。本报告描述了一例因角膜黄蜂蜇伤继发严重视网膜和脉络膜脱离的病例,重点关注发病机制和管理挑战。

病例介绍

一名63岁女性左眼被黄蜂蜇伤,进展为角膜水肿、前房积脓、视网膜 - 脉络膜脱离,最终丧失光感。尽管进行了药物治疗(局部使用皮质类固醇、抗生素),但患者拒绝手术干预,最终导致眼球摘除。

结论

黄蜂毒液引发协同性神经毒性和免疫介导的损伤,强调了个体化管理的必要性。在此类病例中,临床医生应优先采用多模式方法以减轻不可逆的视力丧失。

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本文引用的文献

1
Analysis of risk factors for acute kidney injury in children with severe wasp stings.分析儿童严重黄蜂蜇伤后急性肾损伤的危险因素。
Pediatr Nephrol. 2024 Jun;39(6):1927-1935. doi: 10.1007/s00467-023-06265-6. Epub 2024 Jan 10.
2
Endothelial dysfunction of the cornea after exposure to sprayed venom from hornets.暴露于胡蜂喷射毒液后角膜的内皮功能障碍。
Cutan Ocul Toxicol. 2023 Dec;42(4):185-189. doi: 10.1080/15569527.2023.2227902. Epub 2023 Jun 30.
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Making a bee-line for the eye: a limbal sting and retained honey bee.
Clin Exp Optom. 2021 May;104(4):538-540. doi: 10.1080/08164622.2021.1878837. Epub 2021 Feb 10.
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Commentary: Corneal bee sting injury.评论:角膜蜂蜇伤
Indian J Ophthalmol. 2021 Feb;69(2):426-427. doi: 10.4103/ijo.IJO_2484_20.
5
Endoscopic visualization-assisted corneal bee sting removal.内镜可视化辅助角膜蜜蜂蜇伤取出术。
Indian J Ophthalmol. 2021 Feb;69(2):423-425. doi: 10.4103/ijo.IJO_1161_20.
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Corneal Bee Sting.
N Engl J Med. 2020 Dec 3;383(23):2274. doi: 10.1056/NEJMicm2024132. Epub 2020 Nov 28.
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Management of Secondary Keratouveitis in a Wasp Sting Patient in a Jungle Region of Peru.秘鲁丛林地区一名黄蜂蜇伤患者继发性角膜葡萄膜炎的管理
Int Med Case Rep J. 2020 Nov 20;13:663-666. doi: 10.2147/IMCRJ.S284184. eCollection 2020.
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Ocular Lesions Other Than Stings Following Yellow-Legged Hornet (Vespa velutina nigrithorax) Projections, as Reported to French Poison Control Centers.法国中毒控制中心报告的黄脚胡蜂(Vespa velutina nigrithorax)蜇伤以外的眼部病变
JAMA Ophthalmol. 2021 Jan 1;139(1):105-108. doi: 10.1001/jamaophthalmol.2020.4877.
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Bee Updated: Current Knowledge on Bee Venom and Bee Envenoming Therapy.蜂更新:当前关于蜂毒液和蜂螫伤治疗的知识。
Front Immunol. 2019 Sep 6;10:2090. doi: 10.3389/fimmu.2019.02090. eCollection 2019.
10
A Case of Conjunctival Bee Sting Injury with Review of the Literature on Ocular Bee Stings.一例结膜蜂蜇伤病例并文献复习:眼部蜂蜇伤
Am J Case Rep. 2019 Aug 31;20:1284-1289. doi: 10.12659/AJCR.917592.