실리콘기름 제거로 인한 저안압황반병증 환자에서 유리체강내가스주입술로 치료한 1예
Treatment of Hypotony Maculopathy Caused by Silicone Oil Removal With Gas Tamponade
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목적: 유리체내 실리콘기름 주입상태에서 실리콘기름 제거 후 발생한 저안압황반병증 환자에서 가스주입술로 치료한 1예를 보고하고자 한다. 증례요약: 35세 여자 환자가 2주 전 발생한 우안의 시력 감소를 주소로 내원하였다. 환자 우안 망막 주변부에 망막 열공을 동반한망막박리 소견 보여 수정체제거술, 실리콘기름 주입술과 안내 레이저술을 병행한 유리체절제술을 시행하였다. 술 후 2개월째 시력향상을 위해 실리콘기름제거술을 시행하였다. 제거 후 1개월 동안 시력은 안전수동으로 감소, 안압은 3 mmHg 이하로 측정 되었으며 안저에서 지속적인 맥락망막주름이 관찰되었다. 이 후 2개월에 걸쳐 안압 회복을 위해 3차례의 유리체강내 가스주입술을 시행하였다. 3차례 가스주입술 후 안압은 점차 상승하였으며, 안저에서 맥락망막주름의 점차적인 소실이 관찰되었다. 가스주입술 후 18개월간의 경과관찰 기간 동안 안압은 8-10 mmHg를 유지하였고 시력은 0.2까지 호전되었다. 결론: 실리콘기름 제거 후 발생한 저안압황반변증 환자에서 간단하고 안전한 유리체강내가스주입술은 효과적인 치료법이 될 수 있다.
Abstract
Purpose: To report a case of hypotony maculopathy after silicon oil removal treated by intravitreal gas injection. Case summary: A 35-year-old women presented with decreased visual acuity of the right eye for two weeks. Retinal detachment with peripheral retinal tears was observed in the patient’s right eye. Pars plana vitrectomy including lensectomy, endolaser photo-coagulation and silicone oil injection was performed. Silicone oil removal was performed to improve patient’s visual acuity two months after the operation. After the silicone oil removal, visual acuity was decreased to hand motion, and intraocular pressure was decreased below 3 mmHg while observing chorioretinal folding in fundus for two months. Intraviteal C3F8 gas injections were performed three times in the two months after silicone oil removal. After three gas injections, gradual reduction of chorioretinal folding was observed. Visual acuity was improved to 0.2 and IOP was maintained at 8 to 10 mmHg for 18 months after the last gas injection. Conclusions: Intravitreal gas injection offers a safe and effective method for treating hypotony retinopathy after silicon oil removal.
참고문헌 (14)
- Federman JL, "Complications associated with the use of silicon oil in 150 eyes after retina-vitreous surgery", Ophthalmology, 95, pp.870~876 (1988)
- Van Meurs JC, "Five-year results of vitrectomy and silicone oil in patients with proliferative vitreoretinopathy", Retina, 13, pp.285~289 (1993)
- The Silicone Study Group, "Vitrectomy with silicone oil or sulfur hexafluoride in eyes with severe proliferative vitreoretinopathy:result of randomized clinical trial: Silicone study report 1", Arch Ophthalmol, 110, pp.770~779 (1992)
- Costa VP, "Hypotony maculopathy", Acta Ophthalmol Scand, 85, pp.586~597 (2007)
- Gass JDM, "Hypotony maculopathy. Contemporary ophthalmology", pp.343~366 (1972), Williams & Wilkins
- Cairns JD, "Combined vitrectomy, intraocular microsurgery and liquid silicone in the treatment of proliferative vitreoretinopathy", Aust J Ophthalmol, 12, pp.133~138 (1984)
- Hutton WL, "The effects of silicone oil removal. Silicone study report 6", Arch Ophthalmol, 112, pp.778~785 (1994)
- Kampik A, "Problems and timing in the removal of silicone oil", Retina, 12, pp.11~16 (1992)
- Lesnoni G, "Long-term prognosis after removal of silicone oil", Eur J Ophthalmol, 10, pp.60~65 (2000)
- Casswell AG, "Silicone oil removal. II. Operative and postoperative complications", Br J Ophtalmol, 71, pp.898~902 (1987)
- Pavlovic S, "Long-term outcome after silicone oil removal", Ophthalmologe, 92, pp.672~676 (1995)
- Gonvers M, "Temporary silicon oil tamponade in the management of retinal detachment with proliferative vitreoretinopathy", Am J Ophthalmol, 100, pp.239~245 (1985)
- Weinberger D, "Intravitreal gas injection for hypotony after cataract surgery", J Cataract Refract Surg, 24, pp.1490~1492 (1998)
- 문현승, "유리체강내 가스주입술로 치유된 모양체해리를 동반한 저안압 망막병증", 대한안과학회지, 47(2), pp.319~322 (2006), 대한안과학회