포스너-슐로스만 증후군의 임상양상과 녹내장성 변화의 위험 인자
Clinical Features and Risk Factors of Glaucomatous Change in Posner-Schlossman Syndrome
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목적: 포스너-슐로스만 증후군의 임상양상을 알아보고 녹내장 발생의 위험인자를 규명하고자 하였다. 대상과 방법: 포스너-슐로스만 증후군으로 진단 받은 환자 51명 51안을 대상으로 분석하였다. 녹내장성 변화를 보이는 군과 보이지않는 군으로 나누어 첫 발작 시의 나이, 발작 시의 최고 안압, 유병 기간, 발작 횟수, 그리고 재발 간격을 조사하여 녹내장성 변화의발생에 대한 위험인자를 분석하였다. 결과: 첫 발작 시의 나이는 34.73 ± 10.77세, 발작 시 최고 안압은 47.75 ± 9.43 mmHg, 유병 기간은 62.06 ± 69.84개월, 발작횟수는 6.20 ± 7.73회, 재발 간격은 12.65 ± 8.95개월이었다. 51명 51안 중 녹내장성 변화를 보인 경우는 12명 12안(23.5%)이었다. 녹내장성 변화를 보인 군에서 발작 시의 최고 안압이 52.81 ± 7.87 mmHg, 발작 횟수가 11.91 ± 10.63회, 그리고 재발 간격이 8.07 ± 3.97개월로 녹내장성 변화를 보이지 않은 군에서 각각 46.19 ± 9.14 mmHg, 4.59 ± 5.94회, 14.59 ± 9.79개월인 것에 비하여발작 시의 최고 안압이 더 높았고 발작 횟수가 많았으며 재발 간격이 짧았다(p＝0.025, p＝0.001, p＝0.028). 결론: 포스너-슐로스만 증후군 환자들 중 상당수가 녹내장성 변화를 보이며, 발작 시 안압이 높고 발작 횟수가 많으며 재발 간격이짧은 환자들에서는 녹내장이 발생할 가능성이 높기에 주의 깊은 경과관찰과 적극적인 치료가 필요할 것으로 보인다.
Abstract
Purpose: To analyze the clinical features and determine the factors that affect glaucomatous change of patients with Posner- Schlossman syndrome (PSS). Methods: A retrospective analysis of 51 eyes of 51 patients diagnosed with PSS was performed. We analyzed the factors including age of first attack, highest intraocular pressure (IOP), duration of the disease, number of the attacks and interval between attacks among the patients who developed glaucoma and those who did not and compared the 2 groups. Results: The age of first attack was 34.73 ± 10.77 years, and highest IOP was 47.75 ± 9.43 mm Hg. Duration of the disease was 62.06 ± 69.84 months, number of the attacks was 6.20 ± 7.73 times, and interval between attacks was 12.65 ± 8.95 months. Of 51 eyes of 51 patients, 12 eyes (23.5%) of 12 patients showed significant glaucomatous change. In the glaucoma group, highest IOP was 52.81 ± 7.87 mm Hg, number of attacks was 11.91 ± 10.63 times, and interval between attacks was 8.07 ± 3.97 months. In the non-glaucomatous group highest IOP was 46.19 ± 9.14 mm Hg, number of attacks was 4.59 ± 5.94 times, and interval between attacks was 14.59 ± 9.79 months, respectively. Highest IOP was significantly greater, number of attacks was higher, and interval was shorter with statistical significance in the glaucoma group (p = 0.025, p = 0.001, p = 0.028). Conclusions: A significant number of patients with PSS tend to show glaucomatous change over time. Patients with high IOP during attacks and those having frequent attacks with short intervals should be closely monitored and evaluation for glaucomatous damage is recommended.
참고문헌 (25)
- Posner A., "Syndrome of unilateral recurrent attacks of glaucoma with cyclitic symptoms", Arch Ophthal, 39, pp.517~535 (1948)
- Posner A., "Further observations on the syndrome of glaucomatocyclitic crises", Trans Am Acad Ophthalmol Otolaryngol, 57, pp.531~536 (1953)
- Masuda K., "Prostaglandins and glaucomatocyclitic crisis", Jpn J Ophthalmol, 19, pp.368~375 (1975)
- Raitta C., "Glaucomatocyclitic crisis", Arch Ophthalmol, 95, pp.608~612 (1977)
- Yamamoto S., "Possible role of herpes simplex virus in the origin of Posner-Schlossman syndrome", Am J Ophthalmol, 119, pp.796~798 (1995)
- Bloch-Michel E., "Possible role of cytomegalovirus infection in the etiology of the Posner-Schlossmann syndrome", Int Ophthalmol, 11, pp.95~96 (1987)
- Teoh SB., "Cytomegalovirus in aetiology of Posner-Schlossman syndrome : evidence from quantitative polymerase chain reaction", Eye(Lond), 19, pp.1338~1340 (2005)
- Spivey BE., "Tonographic findings in glaucomatocyclitic crises", Am J Ophthalmol, 55, pp.47~51 (1963)
- Hung PT., "Treatment of glaucomatocyclitic crises", Am J Ophthalmol, 77, pp.169~172 (1974)
- Kass MA., "Glaucomatocyclitic crisis and primary open-angle glaucoma", Am J Ophthalmol, 75, pp.668~673 (1973)
- Jap A., "Is Posner Schlossman syndrome benign?", Ophthalmology, 108, pp.913~918 (2001)
- 박원호, "포스너-슐로스만 증후군 환자에서 녹내장 발생의 임상 요인", 대한안과학회지, 46(4), pp.671~675 (2005), 대한안과학회
- Caprioli J., "Correlation of structure and function in glaucoma. Quantitative measurements of disc and field", Ophthalmology, 95, pp.723~727 (1988)
- Sommer A., "Optic disc parameters and onset of glaucomatous field loss. II. Static screening criteria", Arch Ophthalmol, 97, pp.1449~1454 (1979)
- Pederson JE., "The mode of progressive disc cupping in ocular hypertension and glaucoma", Arch Ophthalmol, 98, pp.490~495 (1980)
- Zeyen TG., "Progression of disc and field damage in early glaucoma", Arch Ophthalmol, 111, pp.62~65 (1993)
- Yamada N., "Probability maps of sequential glaucoma-scope images help identify significant change", J Glaucoma, 6, pp.279~287 (1997)
- Darchuk V., "Optic nerve head behavior in Posner-Schlossman syndrome", Int Ophthalmol, 23, pp.373~379 (2001)
- 김태협, "Optic Disc Atrophy in Patient with Posner-Schlossman Syndrome", Korean Journal of Ophthalmology, 26(6), pp.473~477 (2012), 대한안과학회
- Mitchell P., "Prevalence of open-angle glaucoma in Australia. The Blue Mountains Eye Study", Ophthalmology, 103, pp.1661~1669 (1996)
- Dielemans I., "The prevalence of primary open-angle glaucoma in a population-based study in The Netherlands. The Rotterdam Study", Ophthalmology, 101, pp.1851~1855 (1994)
- Coleman AL., "Risk factors for glaucoma onset and progression", Surv Ophthalmol, 53(Suppl1), pp.S3~S10 (2008)
- Suzuki Y., "Risk factors for open-angle glaucoma in a Japanese population : the Tajimi Study", Ophthalmology, 113, pp.1613~1617 (2006)
- Leske MC., "Risk factors for incident open-angle glaucoma : the Barbados Eye Studies", Ophthalmology, 115, pp.85~93 (2008)
- Kim M., "Risk factors for primary open-angle glaucoma in South Korea : the Namil study", Jpn J Ophthalmol, 56, pp.324~329 (2012)