유리체망막 경계면 질환의 자발호전
Spontaneous Resolution of Vitreoretinal-Iinterface Disorders
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목적: 황반원공, 유리체황반부견인, 망막전막이 자발적으로 호전된 증례들을 분석하여 유리체망막 경계면 질환의 자발적 호전 기전및 임상양상을 알아보고자 한다. 대상과 방법: 2008년 1월부터 2011년 8월까지 황반원공, 유리체황반부견인, 망막전막으로 진단받고 수술적 치료없이 경과 관찰 중 자발적으로 호전된 환자들의 의무기록 및 황반부 빛간섭단층촬영(optical coherence tomography, OCT) 결과를 분석하였다. 결과: 총 10예 중 유리체황반부견인 2안, 특발성 황반원공 3안, 외상성 황반원공 3안(전기화상 1안 포함), 망막전막 2안이었다. 외상성황반원공을 제외하고 회복 후 시력은(0.5) 이상이었다. 특발성 황반원공은 모두 6개월 이내에서 자발적 폐쇄가 일어났으며, 외상성황반원공은 3개월 이내에서 자발적 폐쇄가 일어났다. 10안 중 7안에서 자발호전 과정 중에 완전 후유리체박리가 일어났다. 결론: 일부 유리체망막 경계면 질환은 후유리체박리 등의 기전에 의해 자발 호전이 일어날 수 있으므로 자발 호전에 대한 예측 및선행인자에 대한 연구가 필요할 것으로 판단된다.
Abstract
Purpose: To review the mechanisms and clinical patterns of spontaneous resolution of vitreoretinal interface disorders by analyzing cases and available literature on macular hole (MH), vitreoretinal traction (VMT), and epiretinal membrane (ERM). Methods: Medical records and optical coherence tomography (OCT) images of patients with spontaneous resolution of MH, VMT, and ERM were reviewed. Results: Two eyes with VMT, 3 eyes with idiopathic MH, 3 eyes of traumatic MH (including 1 eye with electrical burn), and 2 eyes with ERM showed spontaneous resolution. All eyes except traumatic MH reached a visual acuity better than 0.5 after resolution. All idiopathic MHs achieved anatomic closure in 6 months, and traumatic MHs in 1 month except for the electrical burn case. Seven out of 10 eyes experienced complete posterior vitreous detachment (PVD) during resolution. Conclusions: Some cases of vitreoretinal interface disorders can resolve spontaneously with complete PVD or other mechanisms. Indicators predicting spontaneous resolution should be considered in patients with vitreoretinal interface disorder.
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