ÀüüÃþȲ¹Ý¿ø°øÀ» µ¿¹ÝÇÑ ¸Á¸·»ö¼Òº¯¼ºÈ¯ÀÚÀÇ ¼ö¼úÀû Ä¡·á: Áõ·Êº¸°í
Surgical Repair of a Full-thickness Macular Hole in Retinitis Pigmentosa: a Case Report
±è½Â¸ð, ¿©ÁØÇü, ±èÁß°ï,
¼Ò¼Ó »ó¼¼Á¤º¸
±è½Â¸ð ( Kim Seung-Mo )
¿ï»ê´ëÇб³ ÀÇ°ú´ëÇÐ ¼¿ï¾Æ»êº´¿ø ¾È°úÇб³½Ç
¿©ÁØÇü ( Yeo Joon-Hyung )
¿ï»ê´ëÇб³ ÀÇ°ú´ëÇÐ ¼¿ï¾Æ»êº´¿ø ¾È°úÇб³½Ç
±èÁß°ï ( Kim June-Gone )
¿ï»ê´ëÇб³ ÀÇ°ú´ëÇÐ ¼¿ï¾Æ»êº´¿ø ¾È°úÇб³½Ç
Abstract
¸ñÀû: ¸Á¸·»ö¼Òº¯¼ºÈ¯ÀÚ¿¡¼ ¹ß»ýÇÑ ÀüüÃþȲ¹Ý¿ø°ø¿¡ ´ëÇØ ¼ö¼úÀû Ä¡·á ÈÄ Àå±â °á°ú¸¦ º¸°íÇÏ°íÀÚ ÇÑ´Ù.
Áõ·Ê¿ä¾à: 5³â Àü ¸Á¸·»ö¼Òº¯¼ºÀ» Áø´Ü¹ÞÀº 55¼¼ ³²ÀÚ°¡ 6°³¿ù Àü ½ÃÀÛÇÑ Á¾ÈÀÇ ½Ã·ÂÀúÇϸ¦ ÁÖ¼Ò·Î ³»¿øÇÏ¿´´Ù. ³»¿ø ½Ã ÃÖ´ë±³Á¤½Ã·ÂÀº ¿ì¾È 1.0, ÁÂ¾È 0.3À̾ú°í, ¼¼±Øµî°Ë»ç»ó ¾ç¾È ÈĹæÀÇ Àΰø¼öÁ¤Ã¼ ÀÌ¿ÜÀÇ Æ¯ÀÌ ¼Ò°ßÀº ¾ø¾ú´Ù. ¾ÈÀú°Ë»ç»ó ¾ç¾È ¸Á¸· Áß°£ÁÖº¯ºÎ¿¡ ±¤¹üÀ§ÇÑ °ñ¼Òü ¸ð¾çÀÇ »ö¼ÒħÂø ¹× ÁÂ¾È È²¹ÝºÎ¿¡ ½Ã½Å°æ Å©±â 1/3 Á¤µµÀÇ È²¹Ý¿ø°øÀÌ È®ÀεǾú°í, ºû°£¼·´ÜÃþÃÔ¿µ°Ë»ç»ó À¯¸®Ã¼È²¹Ý°ßÀÎÀ» µ¿¹ÝÇÑ ÀüüÃþȲ¹Ý¿ø°ø°ú ¿ø°øµÑ·¹ÀÇ ¸Á¸·³»¾×ÀÌ °üÂûµÇ¾ú´Ù. ÀÌ¿¡ ¼ö¼úÀû Ä¡·á¸¦ °èȹÇÏ¿´À¸¸ç, À¯¸®Ã¼ÀýÁ¦¼ú ¹× Àεµ½Ã¾Æ´Ñ±×¸°À» ÀÌ¿ëÇÑ ³»°æ°è¸·¹þ±è¼ú, °úºÒÈÇÁ·ÎÆÇÀ» ÀÌ¿ëÇÑ ¾È³»°¡½ºÃæÀü¼úÀ» ½ÃÇàÇÏ¿´´Ù. ¼ú ÈÄ 1ÁÖÀÏ¿¡ ½ÃÇàÇÑ ºû°£¼·´ÜÃþÃÔ¿µ°Ë»ç»ó Ȳ¹Ý¿ø°øÀº ÇغÎÇÐÀûÀ¸·Î Æó¼âµÈ °ÍÀÌ È®ÀεǾúÀ¸¸ç, ¼ú ÈÄ 3°³¿ù° ÁÂ¾È ÃÖ´ë±³Á¤½Ã·ÂÀº 0.63±îÁö È£ÀüµÇ¾ú´Ù. ¸¶Áö¸· ¹æ¹®(¼ú ÈÄ 6³â)±îÁö ½Ã·Â°ú Ȳ¹Ý¿ø°øÀÇ Æó¼â´Â ¾ÈÁ¤ÀûÀ¸·Î À¯Áö ÁßÀÌ´Ù.
°á·Ð: ¸Á¸·»ö¼Òº¯¼ºÈ¯ÀÚ¿¡¼ ÀüüÃþȲ¹Ý¿ø°øÀÌ ÇÕº´µÈ °æ¿ì ³»°æ°è¸·¹þ±è¼úÀ» µ¿¹ÝÇÑ À¯¸®Ã¼ÀýÁ¦¼úÀÌ Ä¡·á ¹æ¹ýÀ¸·Î °í·ÁµÉ ¼ö ÀÖ´Ù.
Purpose: To report the long-term outcome after surgical repair of a full-thickness macular hole (FTMH) in a patient with retinitis pigmentosa (RP).
Case summary: A 55-year-old male who had been diagnosed with retinitis pigmentosa in both eyes 5 years earlier presented with decreased visual acuity in his left eye over the last 6 months. On examination, his Snellen best-corrected visual acuity (BCVA) was 1.0 in the right eye and 0.3 in the left eye. Slit-lamp examination of the anterior segment was remarkable only for posterior chamber intraocular lenses in each eye. Fundus examination demonstrated extensive bony spicule-like pigmentation in the mid-peripheral region in both eyes and a FTMH with approximately one-third disc diameter in the left eye. The optical coherence tomography (OCT) findings confirmed a FTMH with a surrounding cuff of intraretinal fluid and vitreomacular traction in the left eye. The patient underwent 23-gauge pars plana vitrectomy (PPV) with indocyanine green-assisted internal limiting membrane peeling and gas tamponade. One week postoperatively, an anatomically well-sealed macular hole was confirmed by OCT. At the 3-month postoperative follow-up, the BCVA improved to 0.63 and the hole remained closed until his last follow-up (postoperative 6 years).
Conclusions: Although macular hole is a rare occurrence in RP patients, it should be considered as a cause of significant visual loss in patients with this disorder. Our case suggested that over the long-term, PPV may be tolerable in the management for FTMH in RP.
Å°¿öµå
Full-thickness macular hole; Retinitis pigmentosa; Vitrectomy
¿ø¹® ¹× ¸µÅ©¾Æ¿ô Á¤º¸
µîÀçÀú³Î Á¤º¸