유리체강내 베바시주맙 주입술을 이용한 당뇨병유두병증의 치료 1예
Intravitreal Bevacizumab Injection in Diabetic Papillopathy
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목적: 제2형 당뇨병환자에서 발생한 당뇨병유두병증을 유리체강내 베바시주맙 주입술을 이용하여 효과적으로 치료하였기에 이를 보고하고자 한다. 증례요약: 47세 남자가 당뇨망막병증 검사를 위하여 내원하였다. 10년 전부터 제2형 당뇨병으로 치료받고 있었으며 내원 당시 최대교정시력은 우안 20/20, 좌안 20/30이었고 시력저하, 시야결손 등의 자각증상은 없었다. 안저검사상 좌안의 시신경유두부종과 신생혈관이 있어 범망막광응고술을 시행하였다. 10일 후 환자는 좌안의 무통성 시력저하를 호소하였고 최대교정시력 좌안 20/80, 안저검사상시신경유두부종과 모세혈관의 충혈이 현저히 증가한 소견을 보였다. 유리체강내 베바시주맙 주입술을 1회 시행하였고 2달 후 최대교정시력은 좌안 20/30으로 호전되었으며 시신경유두부종과 모세혈관충혈이 감소하였다. 결론: 당뇨병유두병증에서 유리체강내 베바시주맙 주입술이 시력회복에 도움이 될 것으로 생각한다.
Abstract
Purpose: To report a case where intravitreal bevacizumab injection was an effective treatment for diabetic papillopathy in a type 2 diabetic patient. Case summary: A 47-year-old male with a 10-year history of diabetes mellitus type 2 presented to our clinic for evaluation of diabetic retinopathy. There were no subjective symptoms including blurred vision or visual defect, and best corrected visual acuity (BCVA) was 20/20 in the right eye and 20/30 in the left eye. Fundus examination showed hyperemic optic disc swelling with telangiectatic new vessels, and fluorescein angiography leakage from the optic disc with neovascularization. The patient underwent fractionated panretinal photocoagulation. Ten days later, he complained of painless blurred vision with significant optic nerve head swelling and BCVA was 20/80 in the left eye. Intravitreal bevacizumab injection was administered,optic disc swelling was significantly decreased and BCVA improved to 20/30 after two months. Conclusions: Diabetic papillopathy with severe decreased visual acuity can be treated with intravitreal bevacizumab injection.
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