Shimozono M, Townsend J C, Ilsen P F, Bright D C
Alpine Vision, Orem, Utah, USA.
J Am Optom Assoc. 1998 May;69(5):293-303.
Alcoholism affects about 10% of men and 3% to 5% of women in their lifetime. It is a primary chronic disease with genetic, psychosocial, and environmental factors that influence its development and manifestations.
A 47-year-old alcoholic male manifested mild nutritional optic atrophy, chronic anemia, pancreatitis, and previous gastrojejunostomy and pancreaticojejunostomy. After an acute episode of hypovolemic blood loss from peptic ulceration, there was increased bi-temporal optic nerve head pallor with permanent vision loss, central scotoma, and an acquired red-green color vision defect.
The genetic, psychosocial, and systemic effects of ethanol abuse--including anemia, cardiomyopathy, gastric/duodenal ulceration, pancreatitis, and neurologic deficits--are reviewed. Appropriate treatment and management of ocular manifestations and complications from alcoholism are discussed. Prophylactic topical therapy may be indicated to restore the balance between intraocular tension and optic nerve head perfusion in an attempt to prevent further axonal loss.
Alcohol-induced nutritional optic neuropathy should not be viewed as an isolated ocular entity, but rather as a potentially treatable neurologic problem. An interdisciplinary approach is essential optimal in the management of the alcoholic patient.
酗酒在一生中影响约10%的男性和3%至5%的女性。它是一种原发性慢性疾病，受遗传、心理社会和环境因素影响其发展和表现。
一名47岁的男性酗酒者表现为轻度营养性视神经萎缩、慢性贫血、胰腺炎，既往有胃空肠吻合术和胰空肠吻合术。在因消化性溃疡导致急性低血容量性失血发作后，出现双侧视神经乳头苍白加重，伴有永久性视力丧失、中心暗点和后天性红绿色觉缺陷。
综述了乙醇滥用的遗传、心理社会和全身影响，包括贫血、心肌病、胃/十二指肠溃疡、胰腺炎和神经功能缺损。讨论了酗酒眼部表现和并发症的适当治疗和管理。可能需要预防性局部治疗以恢复眼压与视神经乳头灌注之间的平衡，试图防止进一步的轴突丢失。
酒精性营养性视神经病变不应被视为孤立的眼部疾病，而应被视为一个潜在可治疗的神经问题。跨学科方法对于酗酒患者的最佳管理至关重要。
