장액망막박리가 동반된 레버 특발성 성상 신경망막염에서 안내베바시주맙 주사 효과 1예
Intravitreal Bevacizumab Injection for Serous Retinal Detachment Associated with Leber’s Idiopathic Stellate Neuroretinitis
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목적: 장액성 망막박리를 동반한 Leber 특발성 성상 신경망막염 환자에서 유리체강내 베바시주맙 주사 시행 후 호전된 증례 1예를경험하였기에 보고하고자 한다. 증례요약: 특별한 병력이 없는 56세 남자가 3일 전부터 발생한 우안 시야장애로 내원하였다. 우안 최대교정시력 0.5, 상대적 구심성동공운동장애 및 안구이동통, 유리체강의 염증세포, 안저검사상 시신경유두부종 및 출혈, 성상 경성삼출물이 있었다. 색각검사상 전색약, 형광안저촬영상 시신경유두 과형광, 빛간섭단층촬영상 시신경유두부종, 황반부 장액성 망막박리, 시야검사상 하측 수평시야결손을 나타냈다. 유리체강내 베바시주맙 주사치료 및 스테로이드 안약 치료를 하였고, 치료 6일째 증상 호전 및 시신경유두부종의 호전,망막하액의 감소가 관찰되었다. 6주 후 시력 1.0으로 회복되고, 9주 후 시야검사상 비특이적 암점 외 이상소견 보이지 않았다. 결론: 장액성 망막박리를 동반한 Leber 특발성 성상 신경망막염 환자에서 유리체강내 베바시주맙 주입술이 치료로서 사용될 수 있다.
Abstract
Purpose: To report the effectiveness of intravitreal bevacizumab treatment for serous retinal detachment associated withLeber’s idiopathic stellate neuroretinitis. Case summary: A 56-year-old male visited our clinic complaining of visual disturbance for three days in his right eye. His bestcorrected visual acuity was 0.5. Relative afferent pupillary defect and pain when moving eyes were noted in his right eye as wellas inflammatory cells in the vitreous cavity. On funduscopic examination, disc swelling with hemorrhage and stellate-shapedhard exudates were noted at the perifovea. Ishihara color vision test showed anomalous trichromacy in his right eye. Hyperfluorescence around the disc was observed on fundus fluorescein angiography. Optical coherence tomography showeddisc swelling with serous retinal detachment at the fovea. Inferior altitudinal scotoma was noted on visual field examination. Thepatient underwent intravitreal bevacizumab injection and topical steroid medication. After six days, the patient’s symptoms anddisc swelling improved, and decreased subretinal fluid was observed. After six weeks, his best corrected visual acuity was 1.0. Nine weeks later, visual field examination showed nonspecific scotoma. Conclusions: Intravitreal bevacizumab injection is useful for treating serous retinal detachment associated with Leber’s idiopathicstellate neuroretinitis.
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