스마트폰을 과다 사용한 급성후천일치내사시 환자의 임상양상 및 치료결과
Clinical Characteristics and Outcomes of Smartphone Overusers with Acute Acquired Comitant Esotropia
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목적: 스마트폰을 과다 사용한 급성후천일치내사시 환자의 임상양상과 치료결과에 대해서 알아보고자 하였다. 대상과 방법: 2011년 5월부터 2016년 1월까지 본원 안과에서 급성후천일치내사시로 진단된 15세 이상 환자 중 스마트폰을 하루 4시간 이상, 1년 이상 사용한 환자들의 의무 기록을 후향적으로 조사하였다. 성별, 사시 발생 시 연령과 내원 전 사시 지속 기간, 굴절력, 내원 시와 최종 내원 시 사시각, 스마트폰 중단 후 경과, 그리고 프리즘안경 착용과 수술 후 결과를 분석하였다. 결과: 13명 중 남자 8명, 여자 5명이었고, 사시 발생 시 평균 연령은 22.7 ± 9.7세였다. 증상 발생 후 평균 28.0 ± 33.0개월에 내원하였고, 16.4 ± 16.4개월간 경과관찰하였다. 내사시각은 원거리에서 평균 21.8 ± 7.0PD, 근거리에서 22.2 ± 7.9PD였다. 근시가 8명, 정시가 5명이었다. 스마트폰 사용 제한으로 내사시가 호전된 경우는 없었다. 13명 중 5명에서 프리즘안경을 4개월 이상 착용하였으나 사시각이 호전된 경우는 없었다. 양안 내직근후전술을 시행한 6명 중 1명만 6개월째 사시각이 정위로 유지되었고 3명은 저교정, 2명은 재발하였다. 결론: 스마트폰을 과다 사용한 경력이 있는 급성후천일치내사시 환자에서 스마트폰 사용 제한과 프리즘 착용 후에도 내사시가 지속되었으며, 내사시 수술 결과가 불량하였다.
Abstract
Purpose: To evaluate the clinical features and treatment outcomes of smartphone overusers with acute acquired comitant esotropia. Methods: We retrospectively reviewed the medical records of patients ≥ 15 years of age who used a smartphone for > 4 hours a day for > 1 year, and who were diagnosed with acute acquired comitant esotropia from May 2011 to January 2016. We analyzed sex, age at the time of manifestation and duration of esotropia, refractive error, deviated angle at the first and final visits, and the results of refraining from smartphone use, use of the Fresnel prism, and surgery for esotropia. Results: A total of 13 patients were studied, including 8 males and 5 females. The mean age at development of esotropia was 22.7 ± 9.7 years. The mean duration of esotropia before the first visit was 28.0 ± 33.0 months, and the mean follow-up period was 16.4 ± 16.4 months. The mean angle of esotropia was 21.8 ± 7.0 prism diopters (PD) at distance and 22.2 ± 7.9 PD at near. There were eight myopic patients; the other patients were emmetropia. The esotropia of all patients did not improve after refraining from smartphone use. There was no improvement in five patients who were wearing the Fresnel prism for ≥ 4 months. A total of six patients were treated with bilateral medial rectus recession; only one patient remained orthotropic at postoperative 6 months, three patients were undercorrected, and two had a recurrence. Conclusions: Esotropia persisted after refraining from smartphone use or wearing a Fresnel prism in acute acquired comitant esotropia patients who were smartphone overusers, and the surgical prognosis of these patients was relatively poor.
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