眼睛,月经和子宫内膜异位症

IF 1.7 Q3 OBSTETRICS & GYNECOLOGY Facts Views and Vision in ObGyn Pub Date : 2023-06-01 DOI:10.52054/15.2.074
S Rahman, Y Youssef, G Maroun, D Inaty, M.H. Kheil, G Moawad
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引用次数: 0

摘要

代月经是指月经周期中子宫腔外的周期性出血。泪血症是一种罕见的医学现象,可能与月经或子宫内膜异位症有关。子宫内膜异位症的定义是子宫外部位存在子宫内膜样组织,大约10%的育龄妇女受到影响;眼部系统是它可以存在的最罕见的部位之一。子宫内膜异位症通常需要活检诊断,而获得眼部系统活检的解剖学困难使得眼部子宫内膜异位症的诊断更加模糊。然而,文献中很少有病例被描述,由于血漏对患者的心理、身体和社会影响,治疗是至关重要的。我们回顾了眼部子宫内膜异位症和眼代月经的文献,目的是讨论临床表现,必要的检查和各种治疗方法,同时也揭示了眼睛和子宫内膜异位症之间的联系。据推测,子宫内膜细胞可以通过淋巴或造血方式传播,并沉积子宫外子宫内膜异位症病变,这些病变在月经周期中因激素变化而出血。此外,结膜血管系统由于雌激素和孕激素受体的存在而对激素变化有反应,导致相应部位出血,即使没有子宫内膜异位症病变。血漏与月经周期的临床相关性足以诊断代行性月经,从而为患者提供对症治疗提供可能性。
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Eyes, Menstruation and Endometriosis
Vicarious menstruation refers to cyclical bleeding outside the uterine cavity during the menstrual cycle. Haemolacria, or blood in tears, is a rare medical phenomenon that can occur with menstruation or in association with endometriosis. Endometriosis, defined by the presence of endometrial-like tissue in extra-uterine sites, affects around 10% of fertile women; the ocular system is one of the rarest sites it can be present in. Endometriosis usually requires a biopsy for diagnosis, and the anatomic difficulty of obtaining a biopsy of the ocular system makes ocular endometriosis diagnosis more obscure. However, few cases have been described in the literature and due to the psychological, physical, and social implications of haemolacria on the patient, treatment is of utmost importance. We reviewed the literature on ocular endometriosis and ocular vicarious menstruation with the aim to discuss the clinical presentation, necessary workup and various treatment modalities, while also shedding light on the connection between the eyes and endometriosis in general. It is hypothesised that uterine endometrial cells can travel lymphatically or haematogenously and deposit extra-uterine endometriotic lesions that bleed in response to hormonal changes in the menstrual cycle. Additionally, the conjunctival vasculature has been found to be responsive to hormonal changes due to the presence of oestrogen and progesterone receptors, causing bleeding at the corresponding sites, even without endometriotic lesions. Clinical correlation of the haemolacria with the menstrual cycle can suffice for a diagnosis of vicarious menstruation, and thus opens the possibility of treatment to provide symptomatic treatment for the patient.
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Facts Views and Vision in ObGyn
Facts Views and Vision in ObGyn OBSTETRICS & GYNECOLOGY-
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