안허혈증후군 환자에게 유리체강내 베바시주맙 주입 후 발생한 급격한 시력저하
Acute Visual Loss after Intravitreal Bevacizumab Injection in a Patient with Ocular Ischemic Syndrome
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목적: 안허혈증후군 환자에게 유리체강내 베바시주맙 주입 후 급격한 시력저하가 발생한 1예를 경험하였기에 이를 보고하고자 한다. 증례요약: 70세 남자 환자가 점진적으로 진행하는 우안의 시력 저하를 주소로 내원하였다. 내원 당시 우안의 교정시력은 0.1이었다. 우안의 안허혈증후군이 의심되었으며, 범망막광응고술 시행 후에도 여전히 우안의 매우 심한 홍채혈관신생이 관찰되어 신생혈관 퇴행을 목적으로 유리체강내 베바시주맙 주입술을 시행하였다. 시술 하루 뒤 검사상 우안의 홍채혈관신생은 많이 호전되었으나, 시력은안전수지변별까지 급격하게 저하된 것이 관찰되었다. 결론: 안허혈증후군에서 홍채혈관신생 퇴행을 위해 유리체강내 베바시주맙 주입술을 시행하는 경우 급격한 시력저하가 발생할 가능성이 있음에 유의해야 할 것으로 생각한다.
Abstract
Purpose: To report a patient with ocular ischemic syndrome who suffered from sudden decrease in visual acuity after bevacizumab injection. Case summary: A 70-year-old patient visited the Department of Ophthalmology due to progressively decreasing visual acuity in the right eye. Corrected visual acuity in his right eye was 0.1 on the first visit; ocular ischemic syndrome was suspected. Despite panretinal photocoagulation, severe iris neovascularization was still present in the right eye. Intravitreal bevacizumab injection was performed to regress the iris neovascularization. One day after injection, iris neovascularization regressed significantly, however, visual acuity was decreased to finger counting. Conclusions: In ocular ischemic syndrome, bevacizumab injection for reduction of iris neovascularization should be carefully considered due to possibility of acute visual loss.
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