알코올성 간경화에서 발생한 망막출혈 2예
Two Cases of Retinal Hemorrhage in Alcoholic Cirrhosis
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목적: 알코올성 간경화에서 발생한 빈혈과 혈소판감소증으로 망막출혈 2예를 경험하였기에 이를 보고하고자 한다. 증례요약: (증례 1) 알코올성 간경화로 소화기내과에 입원 치료 중 양안의 시력저하가 발생한 45세 여자로, 안저검사상 양안의 황반부를 포함하는 다수의 망막전출혈 및 망막하출혈이 관찰되었다. 혈액학적 검사상 심한 빈혈과 혈소판감소증이 관찰되었다. 수혈로 혈액학적 이상을 교정하였고, 증상 발생 후 1개월째 시력은 호전되고, 망막출혈은 감소되었다. (증례 2) 알코올성 간경화로 간 이식을 시행받은 후 3일 뒤 호소한 좌안 시력저하로 의뢰된 47세 남자 환자로, 안저검사상 좌안 황반부를 포함하는 다수의 망막전출혈이 양안에서 관찰되었다. 간 이식 당시 심한 빈혈과 혈소판감소증이 관찰되어 수혈로 이를 교정하였다. 증상 발생 후 3개월째 좌안 시력이 호전되었고, 망막출혈은 대부분 흡수되었다. 결론: 알코올성 간경화로 인해 발생하는 혈액학적 이상으로 망막출혈이 발생할 수 있다. 정기적인 경과관찰로 망막출혈의 감소와 시력의 회복을 확인하였다.
Abstract
Purpose: To report 2 cases of retinal hemorrhage due to anemia and thrombocytopenia in patients with alcoholic cirrhosis. Case summary: (Case 1) A 45-year-old female with alcoholic cirrhosis who was treated in the gastroenterology department presented with reduced vision in both eyes. Fundus examination showed multiple preretinal and subretinal hemorrhages with macular involvement in both eyes. Hematological findings revealed severe anemia and thrombocytopenia. One month after the transfusion treatment her visual acuity was improved and retinal hemorrhages resolved. (Case 2) A 47-year-old male presented with painless loss of vision in the left eye 3 days after orthotopic liver transplantation for the treatment of alcoholic cirrhosis. Fundus examination showed preretinal hemorrhages in both eyes with macular involvement in the left eye. During the transplantation, hematological findings revealed severe anemia and thrombocytopenia. Three months after the transfusion treatment his visual acuity was improved and retinal hemorrhages nearly completely resolved. Conclusions: Hematological abnormalities due to alcoholic cirrhosis can cause retinal hemorrhage. In the present cases the retinal hemorrhages were resorbed and the visual acuity recovered.
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