시삭증후군 환자에서 빛간섭단층촬영의 소견
The Optical Coherence Tomography Findings of Optic Tract Syndrome
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목적: 시삭증후군 환자에서 빛간섭단층촬영을 통한 망막신경섬유층의 소견과 그 의의를 보고하고자 한다. 증례요약: 32세 남자환자가 8개월 전에 교통사고 직후 발생한 양안의 우측 시야결손을 주소로 내원하였다. 양안 시력은 정상이었고우안의 상대구심동공장애가 있었으며 우안 시신경유두에 띠모양위축(band atrophy) 소견이 의심되었고 좌안은 위아래의 궁상신경섬유다발(arcuate bundle)이 얇아진 소견이 의심되었다. 시야검사에서 우측 동명성 반맹을 보였다. 시삭증후군이 의심되었으나 자기공명영상에서 시각경로에 이상소견은 발견되지 않았다. 빛간섭단층촬영(fast RNFL thickness scan)에서 우안은 비측과 이측의, 좌안은상측과 하측의 망막신경섬유층이 얇아져 있었다. 이상의 소견으로 좌측의 시삭증후군을 진단하였다. 결론: 시삭증후군의 특징적인 빛간섭단층촬영 소견을 보고하며 이러한 특징적인 소견은 시삭증후군의 진단에 유용할 것으로 생각한다.
Abstract
Purpose: To report a case of optic tract syndrome in which optical coherence tomography (OCT) demonstrated the specific findings of the retinal nerve fiber layer (RNFL). Case summary: A 32-year-old male patient visited the hospital with right side visual field defect in both eyes that occurred immediately after a traffic accident 8 months prior. The visual acuity of both eyes was normal, and a relative afferent papillary defect was evident in the right eye. In addition, suspicious band atrophy of the right optic disc and thinning of the superior and inferior arcuate bundle were observed in the left eye. On visual field examination, homonymous hemianopia was present. Optic tract syndrome was suspected, although there was no abnormality of the visual tract on MRI. On fast RNFL thickness 3.4 scan, a thinning of RNFL in the nasal and temporal segments in the right eye and superior and inferior segments in the left eye were observed. Based on the findings, optic tract syndrome was diagnosed in the left eye. Conclusions: We report specific OCT findings which can be useful when making a diagnosis of optic tract syndrome.
참고문헌 (7)
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