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Inicio Archivos de la Sociedad Española de Oftalmología (English Edition) Optical neuropathy due to inhaled cocaine, causality or chance
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Vol. 95. Issue 8.
Pages 411-414 (August 2020)
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Vol. 95. Issue 8.
Pages 411-414 (August 2020)
Short communication
Optical neuropathy due to inhaled cocaine, causality or chance
Neuropatía óptica secundaria a consumo de cocaína inhalada. Causalidad o casualidad
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J. Escolano-Serrano
Corresponding author
, C.E. Monera-Lucas, I.M. Moreno-Escudero, D. Romero-Valero, C. Fernández-Martínez, J.J. Martínez-Toldos
Servicio de Oftalmología, Hospital General Universitario de Elche, Alicante, Spain
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Abstract

A 44-year-old man, active cocaine consumer, who refered decrease in visual acuity in the right eye in 24 h of evolution, being 0,05 in that eye and 1 in the left eye. The examination showed a relative afferent pupil defect and a swelling head of optic nerve. The systemic studies performed were normal, except the nuclear magnetic resonance of the brain that showed a thickening of the maxillary and frontal sinus mucosa, compatible with sinusitis. Hospital admission and the start of intravenous corticosteroid treatment were decided, with a favorable evolution, a visual acuity of unity in both eyes and an anatomical improvement of the optic nerve head. Due to the medical history of the patient and the assessment of other plausible alternative diagnoses, we establilshed the diagnosis of optical neuropathy due to inhaled cocaine abuse.

Keywords:
Neuritis
Papillitis
Sinusitis
Cocaine
Resumen

Varón de 44 años, consumidor activo de cocaína, que consultó por disminución de agudeza visual en el ojo derecho de 24 h de evolución, siendo de 0,05 en dicho ojo y de 1 en el ojo izquierdo. La exploración reveló la presencia de un defecto pupilar aferente relativo y una papila edematizada en el ojo derecho. Los estudios sistémicos realizados se encontraban dentro de la normalidad salvo la resonancia magnética nuclear encefálica que mostró un engrosamiento de la mucosa de los senos maxilares y frontales compatibles con una sinusitis. Se decidió ingreso hospitalario e inicio de tratamiento corticoideo intravenoso, presentando una evolución favorable, una agudeza visual de unidad en ambos ojos y una mejoría anatómica de la cabeza del nervio óptico. Dados los antecedentes del paciente y tras valorar otros diagnósticos alternativos plausibles se planteó el diagnóstico de Neuropatía óptica secundaria al consumo de cocaína inhalada.

Palabras clave:
Neuritis
Papilitis
Sinusitis
Cocaína

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