비문증을 주소로 망막열공이 동반된 경우의 위험인자
Risk Factors for Retinal Breaks in Patients with Symptom of Floaters
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목적: 비문증을 주소로 내원한 환자를 대상으로 망막열공의 빈도를 조사하였으며, 또한 망막열공이 진단된 경우 동반된 위험인자에대하여 알아보고자 한다. 대상과 방법: 2012년 7월 1일부터 2012년 10월 30일까지 본원 망막병원에 비문증을 주소로 내원한 환자 1,744명 1,744안을 대상으로망막열공으로 진단받은 환자의 빈도를 조사하였다. 망막열공군과 대조군으로 구분하여 나이, 성별, 증상안, 광시증 유무, 증상기간,-6D 이상의 고도근시, 다수의 비문증 여부에 대하여 조사하였으며, 안저검사상 격자변성, 유리체출혈, 망막출혈 등이 동반된 빈도에대하여 후향적으로 알아보았다. 결과: 비문증 주소로 내원한 환자 1744명 1744안 중, 망막열공으로 진단된 환자는 38안(2.17%)이었으며, 대조군으로 분류된 환자는1706안(97.83%)이었다. 망막열공군과 대조군을 단변량 분석으로 통해 조사한 결과, 망막열공군에서 다수의 비문증, -6D 이상의 고도근시가 있는 경우 대조군에 비하여 망막열공의 위험도가 각각 3.4배, 4.4배 높게 관찰되었으며, 격자변성, 유리체 혹은 망막출혈이동반된 경우, 망막열공 발생의 위험도가 각각 10.8배, 37.5배 높게 관찰되었다. 망막열공으로 레이저 광응고술 후 경과관찰 중, 2안(5.3%)에서 신생 망막열공이 발생하였다. 결론: 망막 혹은 유리체 출혈, 격자변성, 다수의 비문증, 고도근시 등이 동반된 비문증 환자의 경우 망막열공이 발생할 가능성이 크므로 더욱 세밀한 안저검사 및 경과관찰이 필요할 것으로 생각한다.
Abstract
Purpose: To identify the risk factors of retinal breaks in patients with symptoms of floaters and to determine the associations betweenthose risk factors and retinal breaks. Methods: A retrospective chart review of patients who visited with the symptom of vitreous floaters between July 2012 andOctober 2012 was performed. Patient information, such as age, sex, symptoms (e.g., multiple floaters and flashing), duration ofsymptoms, refractive error, and complete eye examination were recorded. The patients were divided into 2 groups: the controlgroup had symptoms of floaters with no retinal breaks and the retinal breaks group had symptoms of floaters with retinal breaks. The chi-square test and univariate logistic regression were used for statistical analysis. Results: A total of 1744 eyes were examined in this study, including 1706 eyes in the control group and 38 eyes in the retinalbreaks group. Univariate analysis revealed that patients with high myopia and multiple floaters showed increased risk of retinalbreaks by 3.4 and 4.4 times, respectively, when compared to patients with a single floater alone. Lattice degeneration and vitreousor retinal hemorrhage increased the risk of retinal breaks by 10.8 and 37.5 times when compared to eyes that did not havelattice degeneration or vitreous or retinal hemorrhage. During the follow-up period after laser photocoagulation, a new retinaltear was found in 2 patients (2/38, 5.3%). Conclusions: Vitreous or retinal hemorrhage, lattice degeneration, multiple floaters, and high myopia are risk factors of retinalbreaks in patients with the symptom of floaters. Therefore, it is important for ophthalmologists to be aware of these risk factorsand the patients at risk should be encouraged to attend follow-up examinations.
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