포도막수막증후군 2예
Two Cases of Uveo-meningeal Syndrome
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목적: 바이러스뇌수막염 이후 양안에 망막, 포도막, 시신경을 침범한 포도막수막증후군 2예를 보고하고자 한다. 증례요약: 16세 여자환자가 소아과에서 바이러스뇌수막염 진단하에 치료 후 양안 시력저하로 내원하였다. 최대교정시력은 우안 1.0, 좌안 1.0, 안압 정상이었다. 양안은 세극등현미경검사상 전방 내 염증이 심하였고, 안저검사상 시신경유두부종 소견, 망막 주변부의 다발성 황백색의 병변도 보였다. 항생제 정맥 주사, 스테로이드 안약 치료 후 전방 내 염증, 시신경유두부종, 망막의 황백색병변이 호전되었다. 27세 남자환자가 신경과에서 바이러스뇌수막염 진단하에 치료 후 양안 흐리게 보여 내원하였다. 최대교정시력 우안 0.7, 좌안 0.6, 안압 정상이었다. 양안은 세극등현미경검사상 전방 내 염증 소견, 안저검사상 시신경유두부종, 망막출혈 및 망막염 소견을 보였다. 헤르페스바이러스 감염의 가능성이 높아 경구 아시클로버, 스테로이드 안약 치료 후 전방 내 염증, 망막 출혈 및 망막염 소견이 호전되었다. 결론: 뇌수막염을 진단받은 환자가 양안 흐림을 호소 시 포도막, 망막, 시신경에 염증을 일으키는 포도막수막증후군의 가능성을 고려해야 한다.
Abstract
Purpose: We report two cases of uveo-meningeal syndrome involving the retina, uvea, and optic disc in both eyes after viral meningitis. Case summary: A 16-year-old female was referred to our department with blurred vision in both eyes. She was hospitalized in the pediatric ward with viral meningitis. She showed a norma best-corrected visual acuity (BCVA) and normal intraocular pressure in both eyes, but had severe inflammation in the anterior chamber on slit lamp examination, and optic disc edema and multiple whitish lesions on fundus examination. She was treated with intravenous antibiotic injections and steroid eye drops. After close observation, inflammation in the anterior chamber, optic disc edema, and the multiple whitish lesions in the retina were improved. A 27-year-old male who was treated for viral meningitis at the neurology department was referred to us with blurred vision in both eyes. His BCVAs were 0.7 (right eye) and 0.6 (left eye). The intraocular pressure was normal in both eyes. Slit lamp examination revealed inflammation in the anterior chamber and optic disc edema, and a fundus examination revealed multiple infiltrations. He received treatment for presumed herpes virus infection. After close observation, inflammation in the anterior chamber, optic disc edema, and multiple infiltrations with hemorrhage in the retina were improved. Conclusions: Clinicians should consider the possibility of uveo-meningeal syndrome, which can cause inflammation in the uvea, retina, and optic disc simultaneous with viral meningitis accompanying blurred vision.
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