국소맥락막함몰의 임상양상과 장기 추적관찰 결과
Clinical Presentations of Focal Choroidal Excavation and Results of Long-term Follow-up
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목적: 국소맥락막함몰의 임상양상을 알아보고 동반된 망막 이상이 없었던 경우의 장기 추적관찰 결과를 보고하고자 한다. 대상과 방법: 국소맥락막함몰로 진단된 환자를 대상으로 후향적 의무기록 분석을 시행하였다. 진단 당시 동반된 망막질환을 확인하였으며, 진단 당시 망막질환을 동반하지 않은 특발성 국소맥락막함몰의 경우 경과관찰기간 동안 질환의 발생 여부를 추가적으로 조사하였다. 결과: 전체 45안(45명)을 대상으로 연구를 시행하였다. 16안(35.6%)의 경우 진단 당시 다른 망막질환을 동반하고 있었으며, 나머지 29안의 경우 국소맥락막함몰을 제외한 다른 이상은 확인할 수 없었다. 동반된 질환은 맥락막혈관신생 8안, 중심장액맥락망막병증 4안, 망막앞막 1안, 황반원공 1안, 분지망막정맥폐쇄 1안, 포도막염 1안이었다. 동반된 질환이 없었던 29안 중 22안에서 평균 33.5 ± 18.2개월 동안 경과관찰하였는데 1안에서 59개월에 맥락막혈관신생이 발생하였고, 2안에서는 각각 17개월 및 28개월에 망막하액이 발생하였다. 결론: 국소맥락막함몰로 진단된 35.6%에서 최초 진단 당시 망막질환을 동반하였다. 망막질환을 동반하지 않았던 경우에도 경과관찰과정 중 일부에서는 망막질환이 발생하였는데, 이와 같은 결과는 국소맥락막함몰로 진단된 환자를 대상으로 장기적인 경과관찰이 필요하다는 점을 시사한다.
Abstract
Purpose: To evaluate the clinical presentations of focal choroidal excavation and to report long-term outcomes of cases without retinal disorders at the initial presentation. Methods: A retrospective review of medical records was performed for patients diagnosed with focal choroidal excavation. Concomitant retinal disorders at the initial presentation were identified. In cases without retinal disorders, the development of retinal disorders during follow-up was also evaluated. Results: Forty-five eyes in 45 patients were examined in this study. Focal choroidal excavation was accompanied with retinal disorders in 16 eyes (35.6%). In the remaining 29 eyes, only focal choroidal excavation was noted without any accompanying retinal disorders. The accompanying retinal disorders included choroidal neovascularization (n = 8), central serous chorioretinopathy (n = 4), epiretinal membrane (n = 1), macular hole (n = 1), branch retinal vein occlusion (n = 1), and uveitis (n = 1). Of the 29 eyes without retinal disorders, 22 were followed up for a mean period of 33.5 ± 18.2 months. Consequently, choroidal neovascularization was found to have developed in one eye at 59 months, and subretinal fluid had developed in two eyes at 17 and 28 months, respectively. Conclusions: Focal choroidal excavation was accompanied by retinal disorders in 35.6% of the included patients. In patients without retinal disorders, the development of a retinal disorder was noted in some eyes, suggesting the need for long-term regular follow-up in patients diagnosed with focal choroidal excavation.
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