目标:快克可卡因的使用和相关的医疗并发症在全球持续存在。医学文献中的一些报道描述了通常称为“裂眼”或“裂眼综合症”的视力威胁状况。这篇综述的目的是描述从同行评审文献中的病例报告中对裂眼的了解。
方法:在MEDLINE中完成了结构化搜索,TOXLINE,EMBASE,PsychInfo,Scopus和BiomedCentral,收集归因于可卡因吸烟的角膜并发症的病例报告和病例系列。
结果:在筛选的111篇文章中,11包含病例报告或系列。报告了30例“裂眼”。大多数(63%)病例双侧受累;所有微生物培养结果的病例中有83%患有角膜感染。积极的治疗使所有病例的95%得到改善,所有病例的23%失去了随访。在那些接受与快克可卡因相关的角膜并发症治疗的人中,22%的人在受影响的眼睛中仍然存在明显的视力障碍(仅手部运动)。
结论:临床医生应考虑在没有已知诱发因素的情况下出现角膜疾病的患者中涉及可卡因,并引发全面的药物史,以防止视力下降。
结论:可卡因吸烟的角膜并发症是由多种协同因素引起的,包括可卡因蒸气对表面细胞的直接毒性,神经源性支持对角膜上皮完整性的损害,由于眨眼反射减少,眼睛表面干燥,低水平的化学烧伤和表面细胞的机械剥蚀通过眼睛摩擦。
Use of crack cocaine and associated medical complications persists globally. Some reports in medical literature describe a sight-threatening condition commonly referred to as \'crack eye\' or \'crack eye syndrome\'. The purpose of this
review is to describe what is known about crack eye from case reports in peer-reviewed literature.
A structured search was completed in MEDLINE, TOXLINE, EMBASE, PsychInfo, Scopus and Biomed Central, to collect case reports and case series on corneal complications attributed to crack cocaine smoking.
Of 111 articles screened, 11 contained case reports or series. Thirty individual cases of \'crack eye\' were reported. The majority (63%) of cases had bilateral involvement; 83% of all cases with microbial culture results had corneal infections. Aggressive treatment caused an improvement in 95% of all cases and 23% of all cases were lost to follow up. Of those who received treatment for corneal complications associated with crack cocaine, 22% remained with significant visual impairment (hand motions only) in the affected eye.
Clinicians should consider crack cocaine involvement in patients presenting with corneal disease without known predisposing factors, and elicit comprehensive drug histories to prevent a reduction in visual acuity.
Corneal complications of crack cocaine smoking are caused by a number of synergistic factors, including direct toxicity of crack cocaine vapours to surface cells, impairment of neurogenic support to corneal epithelial integrity, desiccation of the eye surface due to diminished blinking reflex, low level chemical burns and mechanical denudement of surface cells through eye rubbing.