Retinal Nerve Fiber Layer Defects and Microtalc Retinopathy Second Ary to Free-Basing “Crack” Cocaine

Rofsky, Jay E.; Townsend, John C.; Ilsen, Pauline F.; Bright, David C.

doi:10.1097/00006324-199412001-00230

Cited by 2 publications

(4 citation statements)

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“…Interestingly, in addition to corneal nerve abnormalities, the patient also presented with focal asymmetries in the retinal nerve fiber layer between eyes, as measured by OCT. This finding is in concert with a study performed in the mid-nineties that analyzed 60 crack cocaine addicts and demonstrated significant retinopathy and retinal nerve fiber changes ( 8 ). Electron microscopic studies of the optic nerve in response to cocaine exposure in neonatal rats demonstrated that the number of axons was not altered ( 10 ).…”

Section: Discussionsupporting

confidence: 82%

“…It has also been suggested that patients who use crack cocaine have an increased likelihood for glaucoma-like retinal nerve fiber defects (8). A recent study reported on the effects of cocaine snorting on ocular surface damage (5).…”

Section: Introductionmentioning

confidence: 99%

“…Prior studies have also shown that patients who use crack cocaine have an increased likelihood of optic neuropathy, retinopathy, retinal artery occlusion, intraretinal hemorrhages and transient mononuclear blindness ( 5 , 7 ). It has also been suggested that patients who use crack cocaine have an increased likelihood for glaucoma-like retinal nerve fiber defects ( 8 ). A recent study reported on the effects of cocaine snorting on ocular surface damage ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

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Alterations in corneal nerves following crack cocaine use mimic diabetes-induced nerve damage

Stuard

Gallerson

Robertson

2017

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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SummaryThe use of in vivo confocal microscopy (IVCM) is rapidly emerging as an important clinical tool to evaluate changes in corneal sensory nerves as a surrogate measure for diabetic peripheral neuropathy. Commonly used metrics to document and grade the severity of diabetes and risk for diabetic peripheral neuropathy include nerve fiber length, density, branching and tortuosity. In addition to corneal nerves, thinning of the retinal fiber layer has been shown to correlate with the severity of diabetic disease. Here, we present a case report on a pre-diabetic 60-year-old native American woman with abnormal corneal nerve morphology and retinal nerve fiber layer thinning. Her past medical history was positive for illicit substance abuse. IVCM showed a decrease in nerve fiber density and length, in addition to abnormally high levels of tortuosity. OCT revealed focal areas of reduced retinal nerve fiber layer thickness that were asymmetric between eyes. This is the first report of abnormally high levels of tortuosity in the corneal sub-basal nerve plexus in a patient with a past history of cocaine abuse. It also demonstrates, for the first time, that illicit substance abuse can have long-term adverse effects on ocular nerves for years following discontinued use of the drug. Studies using IVCM to evaluate changes in corneal nerve morphology in patients with diabetes need to consider a past history of illicit drug use as an exclusionary measure.Learning points:Multiple ocular and systemic factors can impede accurate assessment of the corneal sub-basal nerve plexus by IVCM in diabetes.Although current history was negative for illicit substance abuse, past history can have longstanding effects on corneal nerves and the retinal nerve fiber layer.Illicit drug use must be considered an exclusionary measure when evaluating diabetes-induced changes in corneal nerve morphology and the retinal nerve fiber layer.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Alterations in corneal nerves following crack cocaine use mimic diabetes-induced nerve damage

Stuard

Gallerson

Robertson

2017

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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“…[64][65][66][67] Studies using OCT have commonly reported the thinning of superior, inferior and nasal retinal nerve fibre layers, 68 or a thinning of the superior retinal nerve fibre layer, which may mimic glaucoma. 69 Other occasional reports include a case of vascular headache secondary to consumption of cocaine that led to blurry vision, a case of transient monocular blindness following intranasal consumption and a case of chorioretinal ischaemia associated with a profound loss of vision. [70][71][72]…”

Section: Cocainementioning

confidence: 99%

Drugs of abuse and ocular effects

Proulx

Tousignant

2021

Clinical and Experimental Optometry

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Illicit drugs and substances of abuse are increasingly used by adults and teenagers, with novel substances constantly becoming available. Many substances can cause ocular effects or visually threatening conditions. Current literature informing eye-care practitioners on these effects is scant. The present scoping review reports the ocular effects of most commonly used drugs and substances of abuse in the teenage and adult populations of North America. Ovid MEDLINE and Ovid EMBASE databases were searched for publications from 1980 to 2019 regarding ocular effects of drug use. The selected papers regarded human subjects, in either teenage or adult population and included all types of studies, including case reports. Publications in English or in French were included. Exclusion criteria were publications about the use of prescriptions drugs, drug withdrawal, and publications about the use of alcohol, tobacco, or cannabis. Some 241 papers were retained and analysed. The use of various drugs and substances can lead to damage to structures throughout the eye, including but not limited to corneal conditions, glaucoma and other optic neuropathies, maculopathies and endophthalmitis. The data presented in this review may help guide clinicians in their diagnosis and treatment of certain ocular conditions, which could otherwise not be linked to drug use.

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Retinal Nerve Fiber Layer Defects and Microtalc Retinopathy Second Ary to Free-Basing “Crack” Cocaine

Cited by 2 publications

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Alterations in corneal nerves following crack cocaine use mimic diabetes-induced nerve damage

Alterations in corneal nerves following crack cocaine use mimic diabetes-induced nerve damage

Drugs of abuse and ocular effects

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