순수소안구증에 동반된 급성폐쇄각녹내장 1예
A Case of Acute Angle-Closure Glaucoma in a Nanophthalmos Patient
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목적: 순수소안구증 환자에게 발생한 급성폐쇄각녹내장 1예를 경험하였기에 이를 보고하고자 한다. 증례요약: 28세 여자 환자가 내원 2시간 전에 시작된 좌안 통증을 주소로 내원하였다. 양안에 작은 안와골과 좁은 눈꺼풀틈새 소견을보였으며 좌안 안압은 58 mmHg이었고 세극등검사상 양안의 얕은 전방과 전방각경검사상 좌안에서 전방각 폐쇄 소견을 보였다. 각막의 직경은 양안 모두 11 mm였고, 안구 장축길이는 우안 19.7 mm, 좌안 19.6 mm, 전방의 깊이는 우안 1.51 mm, 좌안 1.82 mm, 수정체의두께는 우안 4.28 mm, 좌안 4.31 mm로 측정되었다. 양안 순수소안구증 환자에서 생긴 좌안 급성폐쇄각녹내장으로 진단하고, 점안약및 경구투여제로 좌안의 안압을 낮춘 후 양안 상비측 레이저홍채절개술을 시행하였다. 결론: 레이저홍채절개술 시행 후 약 1년간의 경과관찰 동안 안압 상승, 맥락막삼출 등의 합병증은 발병하지 않았다. 순수소안구증에합병된 급성폐쇄각녹내장에서 레이저홍채절개술은 효과적인 치료가 될 수 있을 것으로 생각된다.
Abstract
Purpose: To present a case of acute angle-closure glaucoma in a nanophthalmos patient. Case summary: A 28-year-old woman visited the hospital for a sudden pain in the left eye, she had a small orbital bone and narrow palpebral fissurea in both eyes. Her intraocular pressure (IOP) was 58 mmHg in the left eye. The slit lamp examination showed shallow anterior chambers in both eyes, and the gonioscopic examination showed a closed angle in the left eye. The diameters of the corneas were 11 mm , and the axial lengths were 19.7 mm in the right eye and 19.6 mm in the left eye. The depths of the anterior chambers were 1.51 mm in the right eye and 1.82 mm in the left eye. The disease was diagnosed as acute angle-closure glaucoma in the left eye of the patient with nanophthalmos, and thus the IOP of the left eye was lowered using ophthalmic drugs and medications. Laser iridotomy was performed on both eyes. Conclusions: For around a year of follow-up after laser iridotomy, complications such as the rise of intraocular pressure and choroidal effusion were not observed. This suggests that laser iridotomy can be an effective treatment for acute angle-closure glaucoma accompanying nanophthalmos.
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