유리체내 베바시주맙 주사술 후 발생한 HLA‐B27 양성급성 전방 포도막염 1예
A Case of Acute Anterior Uveitis Associated with HLA-B27 Positivity after Intravitreal Injection of Bevacizumab
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목적: 유리체내 베바시주맙 주사술 후에는 안내염, 출혈 등의 여러 가지 안내 합병증이 병발할 수 있다. 저자들은 유리체내 베바시주맙주사술 후 전방축농을 동반한 HLA‐B27 양성 급성 전방 포도막염 발생을 경험하였기에 이를 보고하고자 한다. 증례요약: 11개월 전 중심정맥 망막 폐쇄 진단을 받은 40세 남자가 4일전 타병원에서 유리체내 베바시주맙 주사술 후 발생한 좌안의충혈과 시력저하를 주소로 내원하였다. 내원 당시 전방 축농, 전방 염증, 홍채 후 유착 등이 관찰되었으며 치료 중 9일 뒤 주사술을시행하지 않은 우안에도 비슷한 양상의 염증 소견이 관찰되었다. 기존의 병력과 전신 검사, 임상양상으로 HLA‐B27 양성 급성 전방포도막염으로 진단하였다. 1% prednisolone acetate 및 0.5% moxifloxacin, 1% atropine 안약 점안 후 6주 후 포도막염이 호전되었다.
Abstract
Purpose: Intravitreal injection of bevacizumab (Avastin®) can lead to several intraocular complications including endophthalmitis,hemorrhage and inflammation. We present one case of acute anterior uveitis with hypopyon in an HLA-B27(+)patient following intravitreal injection of bevacizumab. Case summary: A 40-year-old male with known central retinal vein occlusion presented with redness and decreased visual acuity in the left eye. Symptoms had developed 4 days earlier after the sixth intravitreal injection of bevacizumab in that eye. The patient had a marked anterior chamber reaction with hypopyon and posterior synechiae. Nine days after onset,similar symptoms in the left eye occurred in the uninjected right eye. Through examination and clinical manifestations, we diagnosed acute anterior uveitis associated with HLA-B27 positivity. The patient was treated with 1% prednisolone acetate,0.5% moxifloxacin and 1% atropine in both eyes and all symptoms had resolved after 6 weeks.
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