마이토마이신 씨를 이용한 공막절개술로 치료한 단순소안구성포도막삼출 1예
Scleral Window Surgery with Mitomycin C for Nanophthalmic Uveal Effusion: Case Report
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
목적: 단순소안구증에 동반된 포도막삼출을 마이토마이신 씨를 이용한 공막절개술로 치험한 증례를 보고하고자 한다. 증례요약: 36세 여자 환자가 3개월 전부터 시작된 양안 시력저하와 시야흐림을 주소로 내원하였다. 양안 교정시력은 우안 0.2, 좌안0.02였으며, 안압은 우안 21 mmHg, 좌안 23 mmHg로 측정되었다. 안저 검사상 삼출성 맥락막 박리와 망막 박리가 관찰되었고 초음파검사상 비후된 공막벽도 관찰할 수 있었다. 양안의 안축장 길이는 우안 15.5 mm, 좌안 13.86 mm로 측정되어 단순소안구증에 동반된포도막삼출로 진단하였다. 경과 관찰 중 좌안의 포도막삼출의 진행 소견을 보여 마이토마이신 씨를 사용하여 부분층 공막절편하 공막절제술을 시행하였으며, 수술 후 좌안의 포도막삼출이 흡수되었으며 교정시력도 0.15로 회복되었다. 이후 3년여의 경과 관찰 동안 포도막 삼출의 재발 및 시력저하는 관찰되지 않았다. 결론: 단순소안구증에 동반된 포도막삼출을 마이토마이신 씨를 이용한 공막절개술로 치료하여 장기간의 경과 관찰동안 재발하지 않은증례를 보고하고자 한다.
Abstract
Purpose: To report the case of a 36-year-old patient with nanophthalmic uveal effusion was treated with scleral window surgery and topical administration of mitomycin C (MMC). Case summary: A 36-year-old woman presented with decreased visual acuity and blurred vision in the both eyes during 3months. Fundus examination revealed choroidal effusion and retinal detachment with thickend sclera wall and short axial lengh. Partial-thickness sclera flap with deep sclerostomy was performed and topical MMC was administered to one quadrant of the equatorial sclera. The subretinal fluid resorbed gradually and visual acuity improved. Conclusions: Scleral window surgery and topical mitomycin C might relieve the blocked transscleral outflow of intraocular fluid in the small area of a sclerostomy in young patient with nanophthlamos.
참고문헌 (23)
- Singh OS, "Anomalies in the size of the eye, In System of Ophthalmology. Vol 3", pp.488~495 (1963), CV Mosby
- Serrano JC, "The nanophthalmic macula", Br J Ophthalmol, 82, pp.276~279 (1998)
- Cross HE, "Familial nanophthalmos", Am J Ophthalmol, 81, pp.300~306 (1976)
- Hirsch SE, "Bilateral nanophthalmos", Arch Ophthalmol, 89, pp.353~ (1973)
- Vingolo EM, "Autosomal dominant simple microphthalmos", J Med Genet, 31, pp.721~725 (1994)
- Singh OS, "Nanophthalmos: a perspective on identification and therapy", Ophthalmology, 89, pp.1006~1012 (1982)
- Kimbrough RL, "Angle-closure glaucoma in nanophthalmos", Am J Ophthalmol, 88(3 Pt 2), pp.572~579 (1979)
- Brockhurst RJ., "Nanophthalmos with uveal effusion. A new clinical entity", Arch Ophthalmol, 93, pp.1989~1999 (1975)
- Yue BY, "Nanophthalmic sclera. Morphologic and tissue culture studies", Ophthalmology, 93, pp.534~541 (1986)
- Brockhurst RJ, "Vortex vein decompression for nanophthalmic uveal effusion", Arch Ophthalmol, 98, pp.1987~1990 (1980)
- Song SW, "A case of nanophthalmos", J Korean Ophthalmol Soc, 37, pp.692~696 (1996)
- Jong Hyun Lee, "Two Cases of Uveal Effusion Syndrome", Korean Journal of Ophthalmology, 20(2), pp.124~127 (2006), 대한안과학회
- Sabrosa NA, "Scleral punch method with topical mitomycin C for safe revision of failed deep sclerectomy in nanophthalmic uveal effusion syndrome", Graefes Arch Clin Exp Ophthalmol, 247, pp.999~1001 (2009)
- Warburg M, "Microphthalmos and colobomata among mentally retarded individuals", Acta Ophthalmol (Copenh), 59, pp.665~673 (1981)
- Khairallah M, "Posterior segment changes associated with posterior microphthalmos", Ophthalmology, 109, pp.569~574 (2002)
- Auffarth GU, "Relative anterior microphthalmos: morphometric analysis and its implications for cataract surgery", Ophthalmology, 107, pp.1555~1560 (2000)
- Burgoyne C, "Nanophthalmia and chronic angle- closure glaucoma", J Glaucoma, 11, pp.525~528 (2002)
- Calhoun FP Jr, "The management of glaucoma in nanophthalmos", Trans Am Ophthalmol Soc, 73, pp.97~122 (1975)
- Neelakantan A, "Familial nanophthalmos: management and complications", Indian J Ophthalmol, 42, pp.139~143 (1994)
- Johnson MW, "Surgical management of the idiopathic uveal effusion syndrome", Ophthalmology, 97, pp.778~785 (1990)
- Morita H, "Recurrence of nanophthalmic uveal effusion", Ophthalmologica, 207, pp.30~36 (1993)
- Suzuki Y, "Scleral window surgery and topical mitomycin C for nanophthalmic uveal effusion complicated by renal failure: case report", Graefes Arch Clin Exp Ophthalmol, 245, pp.755~757 (2007)
- Akduman L, "Nanophthalmic uveal effusion managed with scleral windows and topical mitomycin-C", Ophthalmic Surg Lasers, 28, pp.325~327 (1997)