복시환자의 임상양상
Clinical Features for Patients Presenting with Diplopia
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목적: 복시를 주소로 안과를 내원한 환자들을 대상으로 복시의 양상, 원인 및 경과에 대해 알아보고자 하였다. 대상과 방법: 2010년 10월부터 2012년 3월까지 복시를 주소로 내원하여 3개월 이상 경과관찰한 환자들을 대상으로 복시의 양상, 원인및 경과를 후향적으로 분석하였다. 결과: 59명의 환자들이 복시를 주소로 내원하였고 남자 42명, 여자 17명이었으며 평균나이는 50세였다. 양안복시 환자는 54명(92%)이었고 단안복시 환자는 5명(8%)이었다. 양안복시의 원인 중 뇌신경마비가 28명(52%)으로 가장 많았으며 그 중 고혈압 또는 당뇨병을동반한 환자는 14명(50%)이었다. 양안복시 54명 중 3개월 후 35명(65%), 7개월 후 41명(76%)이 호전된 소견을 보였으며 뇌신경마비환자 중 고혈압 또는 당뇨병이 원인인 경우 3개월 후 13명(93%)이 특별한 치료 없이 호전되었다. 결론: 양안 복시의 원인으로는 뇌신경마비가 가장 흔하며 3개월 내 65%가 자연호전 되는 경과를 보였다. 특히 고혈압, 당뇨병이 동반된 뇌신경마비 환자의 경우 93%가 특별한 치료 없이 3개월 내 복시가 호전되는 경과를 보여 복시 발생 초기에는 경과관찰하는 것이좋겠다.
Abstract
Purpose: To evaluate the clinical features, causes and outcomes of patients with diplopia. Methods: All patients presenting with diplopia from October 2010 to March 2012 and followed up for more than 3 months were retrospectively investigated. Results: During the study period, 59 patients with diplopia were identified. There were 42 males and 17 females with an average age of 50 years. Binocular diplopia accounted for 54 cases (92%) and 5 cases (8%) had monocular diplopia. Cranial nerve palsies were the most common cause of binocular diplopia (28 cases, 52%). Within the cranial nerve palsies group, 14 cases (50%) were accompanied by hypertension or diabetes mellitus. Binocular diplopia spontaneously resolved in 35 cases (65%) by 3 months rising to 41 cases (76%) by 7 months. Thirteen (93%) out of 14 cases of cranial nerve palsies with hypertension or diabetes resolved spontaneously by 3 months. Conclusions: Binocular diplopia was caused most commonly by cranial nerve palsy and resolved after 3 months in 65% of patients. A spontaneous recovery from diplopia was observed after 3 months in 93% of patients with cranial nerve palsies and microvascular disease such as hypertension or diabetes. Therefore, the initial observation without additional treatment would be sufficient in these patients.
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