녹내장 여과 수술 후 발생한 중심장액성 맥락망막병증 1예
A Case of Central Serous Chorioretinopathy after Glaucoma Filtering Surgery
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목적: 단안의 중심장액성 맥락망막병증의 과거력이 있는 환자에서, 반대안의 녹내장 여과 수술 후 발생한 중심장액성 맥락망막병증을경험하여 이를 보고하고자 한다. 증례요약: 양안의 만성 포도막염의 과거력이 있는 46세 남자 환자가 6개월간 지속된 좌안의 안압 상승을 주소로 내원하였다. 좌안의안압은 34 mmHg였으며, 우안은 1달 전 진단된 중심장액성 맥락망막병증이 관찰되었고, 좌안은 시신경 유두 창백 외에 망막의 특이이상 소견은 없었다. 좌안의 이차성 녹내장 진단하에 mytomicin-C를 이용한 섬유주 절제술 및 주변홍채 절제술을 시행하였다. 수술후 염증 조절의 목적으로 트리암시놀론 8 mg을 4일간 복용하였다. 수술 후 4일째 안압은 7 mmHg로 유지되었으나, 기존에 관찰되지않았던 중심장액성 맥락망막병증이 발견되었다. 이후 경과 관찰 시 좌안의 안압은 7-10 mmHg로 잘 유지되었으며, 중심장액성 맥락망막병증은 서서히 감소하여 수술 후 7개월째 시행한 검사상 완전히 소실된 소견을 보였다. 결론: 반대안의 중심장액성 맥락망막병증의 과거력이 있는 환자에서 안과적 시술을 시행할 때에는 본 환자처럼 중심장액성 맥락망막병증의 발생 가능성이 있음을 염두에 두고 주의해야 할 필요가 있다.
Abstract
Purpose: To report a case of central serous chorioretinopathy development after glaucoma filtering surgery and spontaneousresolution in a patient with a history of central serous chorioretinopathy in the contralateral eye. Case summary: A 46-year-old male with a history of chronic uveitis in both eyes presented with uncontrolled intraocular pressure(IOP) in his left eye. Initial IOP was 34 mm Hg in his left eye. On preoperative evaluation, central serous chorioretinopathy, whichwas diagnosed in another clinic 1 month prior, was observed in his right eye. Slightly pale optic disc and retinal nerve fiber layerdefects were noted in the left eye. However, macular abnormalities were not observed in the left eye. Trabeculectomy and peripheraliridectomy using mitomycin C were performed in the left eye. The patient was prescribed triamcinolone 8 mg daily for 4days to reduce the post-surgical inflammation. On postoperative day 4, IOP in the left eye was 7 mm Hg and newly developedcentral serous chorioretinopathy was noted. On follow-up, IOP was maintained at 7-10 mm Hg and central serous chorioretinopathydisappeared 7 months postoperatively. Conclusions: When clinicians consider performing an ophthalmological procedure in a patient with a history of central serouschorioretinopathy in the contralateral eye, careful observation of central serous chorioretinopathy development is recommended.
참고문헌 (18)
- Yannuzzi LA, "Type A behavior and central serous chorioretinopathy", Retina, 32(1), pp.709~ (2012)
- Marmor MF, "New hypotheses on the pathogenesis and treatment of serous retinal detachment", Graefes Arch Clin Exp Ophthalmol, 226, pp.548~552 (1988)
- Simmons-Rear A, "Characterization of serous retinal detachments in uveitis patients with optical coherence tomography", J Ophthalmic Inflamm Infect, 2, pp.191~197 (2012)
- Lavin M, "Serous retinal detachment following glaucoma filtering surgery", Arch Ophthalmol, 108, pp.1553~1555 (1990)
- Roe R, "Hypotony maculopathy in a patient with HLA-B27-associated uveitis", Ocul Immunol Inflamm, 16, pp.107~108 (2008)
- Roe RM, "Hormonal regulation of metamorphosis and reproduction in ticks", Front Biosci, 13, pp.7250~7268 (2008)
- Lin JM, "Retinal pigment epithelial detachment in the fellow eye of a patient with unilateral central serous chorioretinopathy treated with steroid", Retina, 21, pp.377~379 (2001)
- Bouzas EA, "Central serous chorioretinopathy and glucocorticoids", Surv Ophthalmol, 47, pp.431~448 (2002)
- Carvalho-Recchia CA, "Corticosteroids and central serous chorioretinopathy", Ophthalmology, 109, pp.1834~1837 (2002)
- Haimovici R, "Endocrine abnormalities in patients with central serous chorioretinopathy", Ophthalmology, 110, pp.698~703 (2003)
- Khairallah M, "Central serous chorioretinopathy, corticosteroids, and uveitis", Ocul Immunol Inflamm, 20, pp.76~85 (2012)
- Jampol LM, "Involvement of corticosteroids and catecholamines in the pathogenesis of central serous chorioretinopathy: a rationale for new treatment strategies", Ophthalmology, 109, pp.1765~1766 (2002)
- Arndt C, "Electrophysiological effects of corticosteroids on the retinal pigment epithelium", Invest Ophthalmol Vis Sci, 42, pp.472~475 (2001)
- Sibayan SA, "Epinephrine, but not dexamethasone, induces apoptosis in retinal pigment epithelium cells in vitro: possible implications on the pathogenesis of central serous chorioretinopathy", Graefes Arch Clin Exp Ophthalmol, 238, pp.515~519 (2000)
- Hardy P, "Nitric oxide in retinal and choroidal blood flow autoregulation in newborn pigs: interactions with prostaglandins", Pediatr Res, 39, pp.487~493 (1996)
- Mann RM, "Nitric oxide and choroidal blood flow regulation", Invest Ophthalmol Vis Sci, 36, pp.925~930 (1995)
- Hardy P, "Free radicals in retinal and choroidal blood flow autoregulation in the piglet: interaction with prostaglandins", Invest Ophthalmol Vis Sci, 35, pp.580~591 (1994)
- Guyer DR, "Digital indocyanine green videoangiography of central serous chorioretinopathy", Arch Ophthalmol, 112, pp.1057~1062 (1994)