중심망막정맥폐쇄 환자에서 덱사메타손 유리체강내 삽입물 주입 시 발생한 분절화 1예
A Case of Dexamethasone Intravitreal Implant Fragmentation During the Injection Procedure in Central Retinal Vein Occlusion
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목적: 중심망막정맥폐쇄로 인한 황반부종이 있었던 환자에서 덱사메타손 유리체강내 삽입물(OzurdexⓇ; Allergan, Inc.) 주입술 시에약물 분절화 현상을 경험하였기에 이를 보고하고자 한다. 증례요약: 57세 남자가 열흘 전부터 시작된 우안의 시력저하를 주소로 내원하였다. 내원 시 환자의 최대교정시력은 우안 0.02, 좌안1.2였다. 안저 검사에서 황반부종을 동반한 중심망막정맥폐쇄로 진단하여 베바시주맙을 우안에 주입하였으나, 황반부종 호전을 보이지않아 덱사메타손 유리체강내 삽입물을 우안에 주입하였다. 주입술 직후 안저를 확인하여 덱사메타손 유리체강내 삽입물이 세 조각으로 분절화 되어있는 것을 확인하였으며, 특별한 처치 없이 경과관찰 하였다. 주입술 이후 2달째 환자의 최대교정시력은 우안 0.4, 좌안1.0으로 우안의 시력호전이 관찰되었으며 빛간섭 단층촬영에서 황반부종의 감소가 관찰되었다. 결론: 덱사메타손 유리체강내 삽입물 주입술 시에 약물이 분절화되어 방출된 경우는 아직까지 국내에서 보고된 바가 없다. 비록 약물이분절화되어 작용하였지만 합병증 없이 효과를 나타내었던 1예를 보고하고자 한다.
Abstract
Purpose: We report a case of dexamethasone intravitreal implant (Ozurdex®; Allergan, Inc.) fragmentation during the injection procedure in macular edema due to central retinal vein occlusion. Case summary: A 57-year-old man visited our hospital for visual disturbance in his right eye. The patient’s best-corrected visual acuity was 0.02 in the right eye and 1.2 in the left eye. After fundus examination, the patient was diagnosed with central retinal vein occlusion with macular edema, thus bevacizumab was injected in the right eye. However, the macular edema did not improve, and a dexamethasone intravitreal implant was injected in the right eye. Immediately after the dexamethasone intravitreal implant injection, on fundus exam, the drug was observed to be fragmented into 3 pieces without any additional treatment. After 2 months, the patient’s best-corrected visual acuity was 0.4 in the right eye and 1.2 in the left eye. Macular edema decreased according to optical coherence tomography. Conclusions: A case of dexamethasone intravitreal implant fragmentation during an injection procedure has not been previously reported in Korea. Although the drug fragmented, the treatment was effective without complications.
참고문헌 (9)
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