일시적인 시력저하로 발견된 모야모야병
Moyamoya Disease Initially Presenting Transient Visual Loss
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목적: 건강한 젊은 성인에게 갑자기 발생한 일시적인 시력저하로 인해 발견된 모야모야병의 증례를 보고하고자 한다. 증례요약: 특별한 질병 및 외상의 과거력이 없는 20세 남성이 갑자기 발생한 우안의 시력저하를 주소로 안과에 내원하였다. 시력저하를제외한 두통, 간질, 마비, 감각이상 등의 증상은 없었다. 내원 당시 최대교정시력은 우안 안전수동, 좌안 1.0이었고 전안부에는 특별한이상이 없었다. 안저검사에서 우안 후극부 창백 소견이 보였고 형광안저혈관조영술에서 우안 후극부 맥락막과 망막동맥에 충만지연소견이 보였다. 환자의 우안 시력저하는 발생 2시간 후에 저절로 호전되기 시작하여 발생 1일 후에는 교정시력 1.0으로 회복되었다. 원인질환 감별을 위해 시행한 자기공명 뇌혈관조영과 경동맥 뇌혈관조영술에서 내경동맥 및 중뇌동맥의 협착과 우회혈관망이 발견되어 모야모야병으로 진단되었다. 결론: 건강한 젊은 성인에게 발생한 일시적인 시력저하의 원인으로 모야모야병의 가능성을 고려해야 할 것이다.
Abstract
Purpose: To report a case of moyamoya disease initially presenting transient visual loss in a healthy young subject. Case summary: A 20-year-old male with no history of systemic disease or trauma visited our clinic due to sudden onset visual loss in the right eye. There were no accompanying symptoms, including headache, seizure, paresis, or paresthesia. Best corrected visual acuity at the first visit was hand movement in the right eye and 20/20 in the left eye. No abnormal finding was revealed in the anterior segment. On fundus examination, whitening at post pole was found in the right eye. In fluorescein angiography, a choroidal and retinal artery filling delay in the posterior pole was noted. The patient’s visual acuity began to improve gradually and was recovered to 20/20 by the next day. Moyamoya disease was diagnosed based on magnetic resonance angiography of the brain and transfemoral cerebral angiography as well as stenosis of the internal carotid artery and middle cerebral artery with collateral vessel networks. Conclusions: Moyamoya disease should be considered as a possible cause of transient visual loss in healthy young subjects.
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