보그트-고야나기-하라다 병에서의 스펙트럼 영역 빛간섭단층촬영 소견 2예
Spectral-Domain Optical Coherence Tomography Findings of Vogt-Koyanagi-Harada Disease
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목적: 보그트-고야나기-하라다 병에서의 경과에 따른 스펙트럼 영역 빛간섭단층촬영 영상의 특징을 보고하고자 한다. 증례요약: (증례 1) 양안의 시력 감소로 내원한 38세 여자로, 안저검사상 양안의 후극부에 다발성 장액망막박리가 관찰되었다. 스펙트럼 영역 빛간섭단층촬영상 바깥망막에 존재하는 낭포황반부종이 관찰되었고, 낭모양 공간이 일정한 두께의 막구조물로 구획화된 소견이 관찰되었다. 보그트-고야나기-하라다 병 진단하에 고용량 스테로이드 정맥 요법으로 치료한 뒤 망막하액이 감소되었다. (증례2) 양안의 시력 감소로 내원한 58세 남자로, 양안의 후극부에 다발성 장액망막박리가 관찰되었다. 스펙트럼 영역 빛간섭단층촬영상맥락막주름이 관찰되었고, 막구조물은 바깥광수용체층의 타원구역과 연속성을 보여, 바깥광수용체층의 일부로 생각되었다. 고용량스테로이드 정맥 용법으로 치료한 뒤 낭모양 공간은 감소되었다. 결론: 보그트-고야나기-하라다 병에서 스펙트럼 영역 빛간섭단층촬영상 일정한 막구조물로 구획화된 낭모양 공간과, 다발성 장액망막박리 소견이 관찰될 수 있다. 낭모양 공간에서 보이는 막구조물은 바깥광수용체층의 일부로 생각된다.
Abstract
Purpose: To report characteristics of Vogt-Koyanagi-Harada (VKH) disease as observed on spectral-domain optical coherence tomography (SD-OCT) images. Case summary: (Case 1) A 38-year-old female presented with visual impairment in both eyes. On fundus examination, multifocal serous retinal detachment in the posterior pole was observed in both eyes. On enhanced SD-OCT, serous retinal detachment and cystoid macular edema in the outer retina were observed and the intraretinal fluid space was divided by a membranous structure forming an intraretinal compartmentalized cystic space. Under the diagnosis of VKH disease, the patient was treated with intravenous administration of methylprednisolone. After treatment, enhanced SD-OCT images showed decreased serous retinal detachment. (Case 2) A 58-year-old male presented with visual impairment in both eyes. On fundus examination, multifocal serous retinal detachment in the posterior pole was observed in both eyes. On enhanced SD-OCT, choroidal folds were observed and the membranous structure showed continuity with ellipsoid zone, suggesting the membranous structure was part of the outer photoreceptor layer of the adjacent attached retina. The patient was treated with intravenous administration of methylprednisolone. After treatment, enhanced SD-OCT images showed cystic space was decreased. Conclusions: SD-OCT images of VKH disease demonstrated multiple serous retinal detachments and intraretinal compartmentalized cystic space divided by a membranous structure. The membranous structure may be considered a part of the outer photoreceptor layer of the attached retina.
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