한 눈 안면화염혈관종 녹내장 환아에서 무증상 반대 눈 안압과 유두함몰비에 대한 고찰
Clinical Features of the Fellow Eyes of Children with Unilateral Facial Port-Wine Stains and Ipsilateral Glaucoma
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목적: 편측 안면화염혈관종과 동측 녹내장이 있는 환아에서 무증상 반대 눈의 안압과 유두함몰비에 대해 고찰하고자 한다. 대상과 방법: 1996년 9월부터 2020년 5월까지 본원 소아안과에서 한쪽 눈 안면화염혈관종 녹내장을 진단받은 35명의 의무기록을 후향적으로 분석하였다. 무증상 반대 눈의 임상특성(즉, 안압과 유두함몰비)을 안면화염혈관종과 녹내장이 모두 없는 대조군(35명 35안)과 비교하였다. 결과: 한쪽 눈 안면화염혈관종 녹내장군의 녹내장 진단 시 평균 연령은 0.56 ± 0.99세(범위, 0.08-4세)였다. 녹내장 진단 시 반대 눈의 평균 안압은 16.68 ± 5.73 mmHg (범위, 9-22.9)였고, 유두함몰비는 0.37 ± 0.14 (범위, 0.15-0.80)였다. 마지막 진료 시(평균 연령, 11.2 ± 7.5세) 평균 안압은 14.14 ± 6.29 mmHg (범위, 8.1-26.7)였고, 유두함몰비는 0.37 ± 0.12 (범위, 0.26-0.82)였다. 대조군(평균 연령, 11.2 ± 7.4세)과 비교했을 때 평균 안압에는 유의한 차이가 없었으나(14.14 ± 6.29 mmHg vs. 14.57 ± 2.49 mmHg, p=0.712) 유두함몰비는 대조군에 비해 유의하게 컸다(0.37 ± 0.12 vs. 0.30 ± 0.08, p=0.014). 결론: 한쪽 눈 안면화염혈관종 녹내장을 진단받은 환아에서 무증상 반대 눈의 유두함몰비가 대조군에 비해 증가되어 있었다. 안면화염혈관종 녹내장이 한쪽 눈에서 진단된 경우 반대 눈에 녹내장 발생 위험이 증가하는지에 대한 후속 연구가 필요하다.
Abstract
Purpose: To investigate the clinical features of non-affected fellow eyes in patients with unilateral facial port-wine stain (PWS) and ipsilateral secondary glaucoma. Methods: We performed a retrospective analysis of the medical records of 35 patients with unilateral facial PWS glaucoma and those of controls (35 subjects without both facial PWS and glaucoma) between September 1996 and May 2020. We noted patients’ age at the glaucoma diagnosis (for unilateral facial PWS glaucoma patients) or at the initial examination (for controls), cup-to-disc ratio (CDR), and intraocular pressure (IOP). We compared the clinical features between the glaucoma-free eyes in patients with unilateral facial PWS glaucoma and the controls. Results: The mean age at the glaucoma diagnosis for unilateral facial PWS glaucoma patients was 0.56 ± 0.99 years (range, 0.08-4). The mean IOP of the glaucoma-free eyes was 16.68 ± 5.73 mmHg (range, 9-22.9), and the mean CDR was 0.37 ± 0.14 (range, 0.15-0.80) at glaucoma diagnosis. The mean IOP of the glaucoma-free eyes was 14.14 ± 6.29 mmHg (range, 8.1-26.7), and the mean CDR was 0.37 ± 0.12 (range, 0.26-0.82) at final examination. When comparing glaucoma-free eyes of the unilateral facial PWS glaucoma patients with the control group (mean age, 11.2 ± 7.4 years), the mean CDR was significantly greater (0.37 ± 0.12 vs. 0.30 ± 0.08; p = 0.014) but there was no significant difference in the mean IOP (14.14 ± 6.29 mmHg vs. 14.57 ± 2.49 mmHg; p = 0.712). Conclusions: The glaucoma-free eyes of unilateral facial PWS glaucoma patients showed greater CDR compared to the non-facial PWS and non-glaucoma controls. Additional longitudinal studies are needed to investigate the clinical course of those eyes, whether the risk of developing glaucoma is increased.
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