나팔꽃 증후군에서 발생한 맥락막신생혈관에서 유리체강내 베바시주맙주입술을 시행한 1예
A Case of Intravitreal Bevacizumab Injection for the Treatment of Choroidal Neovascularization in Morning Glory Syndrome
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
목적: 유리체강내 베바시주맙 주입술을 시행한 나팔꽃 증후군에서 발생한 맥락막신생혈관에 대한 1예를 보고하고자 한다. 증례요약: 51세 남자 환자가 1년 반 전부터 있었던 우안의 시력저하를 주소로 내원하였다. 우안 최대교정시력은 0.1이었으며 안저 검사상 우안에 나팔꽃 증후군의 시신경 소견과 황반하 출혈 및 장액성 망막박리 소견을 보였다. 빛 간섭 안구광학단층촬영과 형광안저혈관조영술 및 인도시아닌그린 혈관조영술에서 우안 망막층간분리 및 망막하액, 맥락막신생혈관이 확인되어 유리체강내 베바시주맙주입술을 시행하였다. 시술 후 망막층간 분리가 없어지고 망막하액의 감소를 보였으나 망막색소상피박리가 발생하고 장액성 망막박리 소견이 지속되어 2개월 후 2차 유리체강내 베바시주맙 주입술을 시행하였다. 첫 번째 유리체강내 베바시주맙 주입술 시행 후 1개월째와 2개월째 시력은 각각 0.4, 0.6이었다. 두 번째 주입술 시행 3개월 후 1.0까지 시력이 향상되었으며 망막하액 감소 소견을 보였다. 6개월 후에도 맥락막신생혈관의 재발 없이 시력이 유지되었다. 결론: 유리체강내 베바시주맙 주입술을 시행하여 나팔꽃 증후군에서 합병된 맥락막신생혈관을 효과적으로 치료할 수 있었다.
Abstract
Purpose: We report a case of intravitreal bevacizumab injection for the treatment of choroidal neovascularization in morning glorysyndrome. Case summary: A 51-year-old male visited our hospital for a 1.5-year visual disturbance in his right eye. The patient’s best-correctedvisual acuity was 0.1 in the right eye. After fundus examination, we found characteristic findings of morning glory syndromewith submacular hemorrhage and serous retinal detachment in the right eye. Optical coherence tomography, fluoresceinangiography and indocyanine green angiography were performed for evaluation. Retinoschisis, subretinal fluid, and choroidalneovascularization were detected, and thus bevacizumab was injected in the right eye. After intravitreal bevacizumab injection,retinoschisis was improved, and subretinal fluid was decreased. However, retinal pigment epithelial detachment was newly detected,and serous retinal detachment persisted. After 2 months, a second bevacizumab injection was performed. After these intravitrealbevacizumab injections at 1 and 2 months, visual acuity was 0.4 and 0.6, respectively. Visual acuity improved to 1.0 after3 months. Visual acuity was maintained for at least 6 months with no relapse of choroidal neovascularization. Conclusions: The choroidal neovascularization in morning glory syndrome was effectively treated with intravitreal bevacizumabinjections.
참고문헌 (10)
- Ryan SJ, "Retina", pp.2013, Elsevier
- Lit ES, "Retinal manifestations of morning glory disc syndrome", Int Ophthalmol Clin, 41, pp.131~138 (2001)
- Chang S, "Retinal detachment associated with optic disc colobomas and morning glory syndrome", Eye(Lond), 26, pp.494~500 (2012)
- Chang S, "Treatment of total retinal detachment in morning glory syndrome", Am J Ophthalmol, 97, pp.596~600 (1984)
- Choudhry N, "Spontaneous resolution of retinal detachment in morning glory disk anomaly", J AAPOS, 13, pp.499~500 (2009)
- Campos CC, "Retinal detachment associated with morning glory syndrome", Arch Soc Esp Oftalmol, 86, pp.295~299 (2011)
- Akamine T, "Morning glory syndrome with peripheral exudative retinal detachment", Retina, 17, pp.73~74 (1997)
- Sobol WM, "Morning glory disk syndrome associated with subretinal neovascular membrane formation", Am J Ophthalmol, 110, pp.93~94 (1990)
- Chuman H, "A case of morning glory syndrome associated with contractile movement of the optic disc and subretinal neovascularization", Nippon Ganka Gakkai Zasshi Sep, 100, pp.705~709 (1996)
- Browning DJ, "Ocular conditions associated with peripapillary subretinal neovascularization, their relative frequencies, and associated outcomes", Ophthalmology, 112, pp.1054~1061 (2005)