다양한 원인에 의한 황반하 출혈에서 유리체강내 가스 주입술 여부에 따른 임상양상의 비교
Clinical Course of Submacular Hemorrhage Due to Various Chorioretinal Diseases According to Pneumatic Displacement
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목적: 황반하 출혈에서 유리체강내 가스 주입술 시행 여부에 따른 임상경과를 비교하고 시력예후에 영향을 미치는 인자들에 대해 알아보고자 한다. 대상과 방법: 황반하 출혈로 유리체강내 가스 주입술을 시행 받은 12안(1군)과 시행 받지 않은 14안(2군)의 의무기록을 후향적으로 분석하였다. 진단 시, 1개월, 3개월, 6개월 및 최종 내원 시 최대교정시력(logMAR)을 비교하였고, 최종시력과 다양한 인자들의 연관성을분석하였다. 결과: 1군의 시력은 진단 시 1.22 ± 0.66에서 시술 후 6개월경 0.77 ± 0.57로 유의하게 호전되었고(p=0.045), 최종 내원 시 6안(50%)에서 2줄 이상의 시력호전을 보였다. 2군의 시력은 진단 시 1.29 ± 0.70에서 1개월경부터 1.06 ± 0.84로 유의하게 호전되었고(p=0.045), 최종 내원 시 10안(71.4%)에서 2줄 이상의 시력 호전을 보였다. 1군에서 최종시력과 유의하게 연관된 인자는 없었으며,2군에서는 나이와 진단 시 시력이 최종시력과 유의한 연관성을 보였다. 결론: 황반하 출혈 환자에서 유리체강내 가스 주입술 등 적극적인 치료를 시행할 수 없는 경우 보존적 치료만으로도 시력의 호전을기대할 수 있다.
Abstract
Purpose: To assess the clinical course of submacular hemorrhage (SMH) due to various chorioretinal diseases with or without pneumatic displacement and the factors related with the final visual outcome. Methods: The authors of the present study retrospectively reviewed the charts of 12 eyes (group 1) which underwent pneumatic displacement for SMH and the charts of 14 eyes (group 2) which did not receive pneumatic displacement. Best-corrected visual acuity (BCVA) at baseline was compared with the BCVA at 1, 3, and 6 months and on the final visit. Association between final BCVA and other clinical features was analyzed including age, baseline BCVA, duration of symptoms,and size of SMH. Results: In group 1, log MAR BCVA was 1.22 ± 0.66 at baseline and there was a significant BCVA improvement of 0.77 ±0.57 at 6 months compared with baseline (p = 0.045). On the final visit, 6 eyes (50%) had gained 2 Snellen lines or more. In group 2, BCVA was significantly improved from 1.29 ± 0.70 at baseline to 1.06 ± 0.84 at 1 month (p = 0.045). Ten eyes (71.4%) had gained 2 Snellen lines or more on the final visit. In group 1, there were no factors correlated with final BCVA (p > 0.05), while the final BCVA was significantly correlated with age and baseline BCVA in group 2. Conclusions: Clinicians may expect conservative treatment to lead to significant improvement of BCVA in patients with SMH due to various chorioretinal diseases who did not undergo any procedures to displace the hemorrhage.
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