망막앞막이 동반된 다발성 망막 모세혈관종에서 시행한 일차유리체절제술 1예
A Case Report of Primary Vitrectomy in Multiple Bilateral Retinal Capillary Hemangiomas Accompanying Epiretinal Membrane
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목적: 망막앞막이 동반된 다발성 망막 모세혈관종의 일차치료로 유리체절제술을 시행하고 좋은 결과를 얻었기에 문헌고찰과 함께 보고하고자 한다. 증례요약: 4일 전부터 발생한 시력저하를 주소로 17세 여자환자가 내원하였다. 초진 시 최대교정시력이 우안은 20/25, 좌안은 20/100이었고, 안저검사, 형광안저혈관조영술 및 빛간섭단층촬영에서 양안의 다발성 망막모세혈관종이 관찰되었으며, 좌안에 망막앞막과황반부종이 동반되어 있었다. 좌안에 6회의 국소 레이저 광응고술을 시행한 후, 황반부종이 감소하면서 최대교정시력도 20/25로 호전되었으나, 초진 3개월 뒤 망막앞막과 황반부종이 다시 악화되면서 최대교정시력이 20/400으로 저하되었다. 유리체절제술을 시행하여 망막앞막이 소실되고 황반부종이 감소하였으며, 술 후 18개월이 지나고 최대교정시력이 20/25으로 회복되었다. 반면에, 우안에도망막앞막이 심해지면서 최대교정시력이 20/40으로 악화되었는데, 좌안의 경험을 토대로 우안에는 유리체절제술을 일차치료로 시행하였고, 망막앞막이 소실되어 술 후 15개월에 최대교정시력이 20/20으로 호전되었으며, 망막은 안정적으로 유지되었다.
Abstract
Purpose: To report the clinical result of pars plana vitrectomy (PPV) as the primary treatment in a patient with multiple bilateralretinal capillary hemangiomas (RCH) accompanying epiretinal membrane (ERM). Case summary: A 17-year-old female patient visited our clinic for decreased bilateral vision 4 days in duration. At the first visit,the vision in her right eye was 20/25 and, 20/100 in her left eye. Bilateral multiple retinal capillary hemangiomas were observedat the peripheral retina in both eyes on fundus examination, fluorescein angiography (FAG) and optical coherence tomography(OCT). ERM and associated macular edema (ME) were noted in her left eye. For her left eye, focal laser photocoagulation (PC)was performed 6 times. ME was decreased and her vision improved to 20/25. However, 3 months after the initial visit, her visiondecreased to 20/400 accompanied with exacerbated ERM and ME. Therefore, PPV was performed in her left eye. ERM and associatedME were decreased and her vision improved to 20/25 after 18 months. PPV was performed in the right eye immediatelyafter her vision worsened (best corrected visual acuity, BCVA 20/40) and ERM occurred. After 15 months later, vision in her righteye improved to 20/20 and ERM was also decreased.
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