한국인 시신경염 환자의 임상 양상 및 고용량 스테로이드 치료 효과
Clinical Features and the Effect of High-Dose Steroid Therapy in Korean Optic Neuritis Patients
0
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
목적: 한국인 시신경염 환자들의 임상 양상과 고용량 스테로이드 치료 후 시력의 회복 양상을 알아보고자 하였다. 대상과 방법: 2005년 1월부터 2008년 12월까지 서울대학교병원에 내원하여 시신경염으로 진단 받고 고용량 스테로이드 치료를 받은 후3개월 이상 추적 관찰된 13명을 대상으로 임상 양상과 스테로이드 치료 후 시력 호전양상을 의무 기록을 통해 후향적으로 조사하였다. 결과: 시신경염으로 진단된 13명 중 8명(61%)에서 안구운동 시 통증과 시신경유두의 부종이 관찰되었다. 고용량 스테로이드 치료 후10명(77%)에서 0.5 이상으로 시력이 호전되었다. 1달 이내 시력이 호전된 환자들은 스테로이드 치료 시작시점과 상관 없이 발병시점으로부터 평균 18일이 지난 후 시력이 회복되었다. 결론: 한국인 시신경염 환자들의 임상양상은 서양에서와 달리 안구운동 시 통증이 적고 시신경유두부종이 많이 관찰되었다. 고용량스테로이드의 치료 시작시점은 발병시점을 기준으로 한 시신경염의 회복 시기에 영향을 끼치지 않았다.
Abstract
Purpose: To investigate the clinical manifestation and response to high-dose steroid therapy in Korean optic neuritis patients. Methods: We retrospectively reviewed the medical records of 13 patients diagnosed with optic neuritis who were treated with high-dose steroid and who were followed-up for more than three months in Seoul National University Hospital between January 2005 and December 2008. Results: Pain on extraocular movement (EOM) and disc swelling were observed in 61% (8/13) patients diagnosed with optic neuritis. Visual acuity (VA) improved to more than 20/40 in 77% (10/13) of patients after high-dose steroid therapy. The patients who resolved within one month recovered VA a mean of 18 days after onset. The recovery period had nothing to do with the initial time of high-dose steroid therapy. Conclusions: Pain on EOM was less frequently observed and disc swelling was more frequent in Korean patients than have been reported in Caucacian patients. The recovery period of optic neuritis was not influenced by the initial time of high-dose steroid therapy.
참고문헌 (21)
- Optic Neuritis Study Group, "Multiple sclerosis risk after optic neuritis: final optic neuritis treatment trial follow-up", Arch Neurol, 65, pp.727~732 (2008)
- Beck RW, "Visual function more than 10 years after optic neuritis: experience of the optic neuritis treatment trial", Am J Ophthalmol, 137, pp.77~83 (2004)
- The Optic Neuritis Study Group, "Visual function 5 years after optic neuritis: experience of the Optic Neuritis Treatment Trial", Arch Ophthalmol, 115, pp.1545~1552 (1997)
- Rizzo JF 3rd, "Risk of developing multiple sclerosis after uncomplicated optic neuritis: a long-term prospective study", Neurology, 38, pp.185~90 (1988)
- Beck RW, "Optic neuritis treatment trial. One-year follow- up results", Arch Ophthalmol, 111, pp.773~775 (1993)
- Confavreux C, "Relapses and progression of disability in multiple sclerosis", N Engl J Med, 43, pp.1430~1438 (2000)
- Kira J, "Multiple sclerosis in the Japanese population", Lancet Neurol, 2, pp.117~127 (2003)
- Isayama Y, "Acute optic neuritis and multiple sclerosis", Neurology, 32, pp.73~76 (1982)
- Lin YC, "Low conversion rate to multiple sclerosis in idiopathic optic neuritis patients in Taiwan", Jpn J Ophthalmol, 50, pp.170~175 (2006)
- Wang JC, "The presentation, aetiology, management and outcome of optic neuritis in an Asian population", Clin Experiment Ophthalmol, 29, pp.312~315 (2001)
- Lim SA, "Optic neuritis in Singapore", Singapore Med J, 49, pp.667~671 (2008)
- Wakakura M, "Baseline features of idiopathic optic neuritis as determined by a multicenter treatment trial in Japan. Optic", Jpn J Ophthalmol, 43, pp.127~132 (1999), Neuritis Treatment Trial Multicenter Cooperative Research Group
- Lee YJ, "Clinical manifestation of optic neuritis", J Korean Ophthalmol Soc, 38, pp.1969~1974 (1997)
- Ahn BC, "Clinical profile of the optic neuritis in Korea", J Korean Ophthalmol Soc, 38, pp.1827~1833 (1997)
- Beck RW, "A randomized, controlled trial of corticosteroids in the treatment of acute optic neuritis", N Engl J Me, 326, pp.581~588 (1992), The Optic Neuritis Study Group.
- Beck RW, "High- and low-risk profiles for the development of multiple sclerosis within 10 years after optic neuritis: experience of the optic neuritis treatment trial", Arch Ophthalmol, 121, pp.944~949 (2003)
- Wakakura M, "Multicenter clinical trial for evaluating methylprednisolone pulse treatment of idiopathic optic neuritis in Japan", Jpn J Ophthalmol, 43, pp.133~138 (1999), Optic Neuritis Treatment Trial Multicenter Cooperative Research Group
- Neuritis Study Group, "The clinical profile of optic neuritis. Experience of the Optic Neuritis Treatment Trial", Arch Ophthalmol, 109, pp.1673~1678 (1991), Neuritis Study Group
- Chan CK, "Optic neuritis treatment trial:10-year follow- up results", Am J Ophthalmol, 138, pp.695~ (2004)
- Boomer JA, "Optic neuritis in adults and children", Semin Ophthalmol, 18, pp.174~180 (2003)
- de la Cruz J, "Clinical profile of simultaneous bilateral optic neuritis in adults", Br J Ophthalmol, 90, pp.551~554 (2006)