한국인 안허혈증후군환자의 초기 임상양상
Initial Clinical Manifestations of Ocular Ischemic Syndrome in Koreans
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목적: 한국인 안허혈증후군환자의 초기 임상양상에 대해 알아보고자 한다. 대상과 방법: 2010년에서 2017년 사이 본원 안과에서 형광안저혈관조영을 포함한 안과검사에서 안허혈증후군으로 추정되고 영상학검사를 통해 경동맥 협착이 확인된 환자의 의무기록을 후향적으로 분석하였다. 결과: 22명 27안이 포함되었다. 20명은 남성이었고, 나이의 평균은 64.2세였다. 당뇨와 고혈압이 각각 15명에서 동반되었다. 21명에서 갑작스럽게 발생한 시력저하가 주 증상이었다. 최대교정시력은 logMAR 0.89 ± 0.65였고, 안압의 평균은 16.1 ± 6.9 mmHg였다. 21 mmHg 이상의 안압상승은 5안에서 확인되었다. 홍채신생혈관이 가장 흔한 전안부 소견이었고(13안, 48.1%), 망막출혈(23안, 85.2%)이 가장 흔한 안저검사 소견이었다. 빛간섭단층촬영을 통해 측정된 중심망막두께의 평균은 255.0 μm로 유리체황반견인이 동반된 1안을 제외하고는 황반부종은 없었다. 결론: 안허혈증후군환자의 90.9%는 50세 이상 남성이었고, 가장 흔한 임상 소견은 급격한 시력장애였다. 빛간섭단층촬영에서 황반부종이 나타나지 않는 것이 특징적이다.
Abstract
Purpose: To evaluate the clinical features of ocular ischemic syndrome in Koreans. Methods: The medical records of patients who were presumed to have ocular ischemic syndrome by ophthalmic examination, and confirmed by carotid artery imaging, were retrospectively reviewed from 2010 to 2017. Results: A total of 22 patients and 27 eyes were included in the study. Twenty patients were male. The average age was 64.2 years. Fifteen patients had hypertension and fifteen patients had diabetes mellitus. Twenty-one patients presented with acute visual impairment at the initial visit. The average best-corrected visual acuity (BCVA) was a LogMAR of 0.89 ± 0.65, with an average IOP of 16.1 ± 6.9 mmHg. Elevated IOP > 21 mmHg was noted in five eyes (18.5%). Iris neovascularization was the most common (13 eyes, 48.1%) feature in the anterior segment. Retinal hemorrhage was the most common feature in the fundus examination (23 eyes, 85.2%). The average central submacular thickness was 255.0 μm, and there was no macular edema except for one case with vitreomacular traction syndrome on optical coherent tomography. Conclusions: A total of 90.9% of patients with ocular ischemic syndrome were males > 50 years of age. Most patients presented with acute visual impairment. There was no macular edema on optical coherent tomography of all eyes.
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