백내장수술 후 발생한 안와첨증후군
Orbital Apex Syndrome after Uneventful Phacoemulsification
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목적: 백내장 술 후 발생한 안와첨증후군 1예를 경험하였기에 보고하고자 한다. 증례요약: 74세 여성이 좌안의 백내장수술 후 시작된 시력저하, 눈꺼풀처짐, 전방향 눈근육마비, 안구의 통증을 주소로 내원하였다. 영상검사에서 미만성 외안근 비대와 밀집된 안와첨이 관찰되었으며, 형광안저조영술에서 팔망막순환시간과 맥락막충만시간의 지연이 관찰되었다. 이러한 소견을 근거로 안와첨증후군에 동반된 안허혈증후군으로 진단을 하였다. 고용량 스테로이드 치료 후 외안근운동, 동공반사, 눈꺼풀처짐, 안구돌출이 호전되었으나, 시력은 회복되지 않았다. 결론: 점안마취 백내장수술 후 발생한 안와첨증후군을 경험하여 이를 보고하고자 하며, 드물지만 백내장수술 후 이러한 합병증의 연관 가능성에 대하여 인지할 필요가 있을 것으로 사료된다.
Abstract
Purpose: We report a case of orbital apex syndrome associated with ocular ischemic syndrome after unenventful cataract surgery. Case summary: A 74-year-old female came to our clinic with vision loss, ptosis, total ophthalmoplegia and ocular pain in the left eye after cataract surgery. On radiologic examination, diffuse hypertrophy of the extraocular muscles and a crowded orbital apex were observed. Additionally, the arm to retina and choroidal filling times were delayed on fluorescence angiography. Based on these findings, the patient was diagnosed with ocular ischemia complicated by orbital apex syndrome. After prompt pulse steroid therapy, improvement in extraocular muscle and pupil movement, ptosis and proptosis were observed; however, visual acuity failed to return to baseline. Conclusions: We report a rare case of orbital apex syndrome associated with ocular ischemic syndrome after cataract surgery, indicating the orbital apex syndrome may occur in healthy patients after uneventful cataract surgery.
참고문헌 (15)
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