히알우론산나트륨 점안액의 장기 사용으로 인한 독성 각막염 1예
A Case of Toxic Keratitis due to Chronic Use of Sodium Hyaluronate Eyedrops
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목적: 히알우론산나트륨 점안액을 장기간 점안하여 이로 인해 독성각막염이 발생한 증례를 보고하고자 한다. 증례요약: 74세 여자 환자가 양안의 심한 안구통증 및 시력저하를 주소로 내원하였다. 내원 10년 전 양안 굴절교정수술 받았으며 수술후 발생한 건성안 조절을 위하여 히알우론산나트륨 점안액을 장기간 사용하였다. 검안상 양안 각막 중심부 및 하부에 표층각막염소견을 보였고, 이에 과거력과 임상소견으로 독성 각막염을 의심하고 사용하던 점안약제를 중단한 후 자가혈청안약을 처방하고 1개월후 추적 관찰하였을 때 안경교정시력의 호전, 주관적인 불편감의 해소 및 부분적인 각막염의 호전을 관찰하였다. 결론: 장기간 점안하던 히알우론산나트륨 점안액의 사용을 중단한 후 각막염이 회복됨을 관찰하였기에 독성각막염의 가능성이 높다고 생각하며, 본 증례를 통해 히알우론산나트륨 점안제를 장기간 사용하는 경우의 위험성을 일깨우고, 적절한 안과 진료가 동반되어야 한다는 점을 되새겨 볼 수 있겠다.
Abstract
Purpose: To report a case of toxic keratitis due to chronic use of sodium hyaluronate eyedrops. Case summary: A 74-year-old female visited our clinic with severe ocular pain and decreased vision in both eyes. She had receivedrefractive surgeries in both eyes 10 years prior. She had been using sodium hyaluronate eyedrops for the treatment of dryeye symptoms for 10 years. Slit-lamp examination revealed inferior punctate erosions in the inferior part of the cornea in botheyes. With her history of chronic use of sodium hyaluronate and after ophthalmologic examination, we suspected keratitis medicamentosadue to sodium hyaluronate eyedrops. We discontinued the eyedrops she was using and prescribed autologousserum. One month later, ocular discomfort and decreased vision were improved and corneal erosions were decreased. Conclusions: In the present case, toxic keratitis was assumed to be associated with the use of sodium hyaluronate eyedrops andcorneal erosions improved after the eyedrops were discontinued. We suggest sodium hyaluronate eyedrops are potentially hazardousand recommend a regular follow-up should be performed by a qualified ophthalmologist.
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