Severe Cocaine-Induced Midline Destructive Lesions (CIMDL) Leading to Orbital Apex Syndrome and Peripheral Ulcerative Keratitis

Ortiz-Seller, Amparo; Hernández-Pons, Antonio; Pascual, Elia Valls; Comín-Pérez, Alberto; Gaitón, Raquel Dolz; Albert-Fort, Mara

doi:10.1080/09273948.2021.1906913

Cited by 3 publications

(2 citation statements)

References 31 publications

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“…Consequently, adverse effects within the nasal tract from intense local vasoconstriction are common, and long-term abuse can potentially lead to chronic osteolytic sinusitis, mucoperichondrial ischemia, necrosis, nasal septum perforation, and saddle nose deformity. [14][15][16][17][18] Although CIMDL occurs in only a small minority of cocaine users, it has been well documented in the literature; pathogenesis is believed to involve inflammatory, infective, proapoptotic, and autoimmune mechanisms. 13,19 Vasoconstriction of the small vessels, chemical irritation by adulterants in inhaled cocaine, and repeated mechanical trauma likely play a role.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Subperiosteal Orbital Hematoma Associated With Cocaine-Induced Midline Destructive Lesion

Kinde

Clauss

et al. 2023

Ophthalmic Plastic &Amp; Reconstructive Surgery

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The authors present a case of a non-traumatic, spontaneous subperiosteal orbital hematoma in a woman with a history of chronic pansinusitis and absence of midline nasal cavity structures due to chronic inhalational cocaine use. The patient underwent left orbitotomy and drainage of the lesion, showing mostly blood with a small amount of purulence that grew methicillin-resistant Staphylococcus aureus when cultured. The patient received 4 weeks of intravenous antibiotics in addition to functional endoscopic sinus surgery. At 1 month after surgery, her vision had returned to baseline, and proptosis was resolved. Fewer than 20 cases of subperiosteal orbital hematomas associated with chronic sinusitis have been reported. To the authors’ knowledge, this is the first reported case of a subperiosteal orbital hematoma associated with cocaine-induced midline destructive lesions. Patient consent to obtain photographs was obtained and archived. All collection and evaluation of patient health information were compliant with the Health Insurance Portability and Accountability Act, and this report adheres to the Declaration of Helsinki.

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Section: Discussionmentioning

confidence: 99%

Spontaneous Subperiosteal Orbital Hematoma Associated With Cocaine-Induced Midline Destructive Lesion

Kinde

Clauss

et al. 2023

Ophthalmic Plastic &Amp; Reconstructive Surgery

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“…Furthermore, despite the global COVID-19 pandemic, European authorities have intercepted at seaports growing amounts of cocaine in 2020 [5]. All the while, case reports detailing the harmful consequences of cocaine use abound [7][8][9][10][11][12][13][14][15][16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Cocaine: An Updated Overview on Chemistry, Detection, Biokinetics, and Pharmacotoxicological Aspects including Abuse Pattern

Bravo

Faria

Brito-da-Costa

et al. 2022

Toxins

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Cocaine is one of the most consumed stimulants throughout the world, as official sources report. It is a naturally occurring sympathomimetic tropane alkaloid derived from the leaves of Erythroxylon coca, which has been used by South American locals for millennia. Cocaine can usually be found in two forms, cocaine hydrochloride, a white powder, or ‘crack’ cocaine, the free base. While the first is commonly administered by insufflation (‘snorting’) or intravenously, the second is adapted for inhalation (smoking). Cocaine can exert local anaesthetic action by inhibiting voltage-gated sodium channels, thus halting electrical impulse propagation; cocaine also impacts neurotransmission by hindering monoamine reuptake, particularly dopamine, from the synaptic cleft. The excess of available dopamine for postsynaptic activation mediates the pleasurable effects reported by users and contributes to the addictive potential and toxic effects of the drug. Cocaine is metabolised (mostly hepatically) into two main metabolites, ecgonine methyl ester and benzoylecgonine. Other metabolites include, for example, norcocaine and cocaethylene, both displaying pharmacological action, and the last one constituting a biomarker for co-consumption of cocaine with alcohol. This review provides a brief overview of cocaine’s prevalence and patterns of use, its physical-chemical properties and methods for analysis, pharmacokinetics, pharmacodynamics, and multi-level toxicity.

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Medication-associated orbital inflammation: A systematic review

Ang,

Chaggar,

Tong

et al. 2024

Survey of Ophthalmology

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Severe Cocaine-Induced Midline Destructive Lesions (CIMDL) Leading to Orbital Apex Syndrome and Peripheral Ulcerative Keratitis

Cited by 3 publications

References 31 publications

Spontaneous Subperiosteal Orbital Hematoma Associated With Cocaine-Induced Midline Destructive Lesion

Spontaneous Subperiosteal Orbital Hematoma Associated With Cocaine-Induced Midline Destructive Lesion

Cocaine: An Updated Overview on Chemistry, Detection, Biokinetics, and Pharmacotoxicological Aspects including Abuse Pattern

Medication-associated orbital inflammation: A systematic review

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