고용량 스테로이드 치료에 반응한 푸르처망막병증 1예

• 영문명: A Case of Purtscher’s Retinopathy Responsive to High-dose Steroid Therapy
• 발행기관: 대한안과학회
• 저자명: 허준·이영창·양성원·김성택·양필중,Jun Heo, M.D., Young Chang Lee, M.D., Sung Won Yang, M.D., Seong Taek Kim, M.D., Pil Joong Yang, M.D.
• 간행물 정보: 『대한안과학회지』Ophthalmological Society,volume49,number3, 509~513쪽, 전체 5쪽
• 주제분류: 의약학 > 기타의약학
• 파일형태: PDF
• 발행일자: 2008.03.31

영문 초록

`Purpose: To report a case of high dose steroid-responsive Purtscher’s retinopathy which was developed after operation for diaphragmatic laceration sustained in motorcycle accident. Case summary: A 68-year-old man came to our hospital with complaining of decreased visual acuity in the right eye after diaphragmatic laceration operation. Best corrected visual acuity was 0.1 in the right eye. Anterior segment was nonspecific. However, afferent pupillary defect was observed. Superficial intraretinal hemorrhage, numerous cotton-wool spots, peripapillary hemorrhage, and macular edema were detected on fundus examination. Fluorescein angiography revealed capillary nonperfusion and fluorescein filling defect due to retinal hemorrhage in arteriovenous phase and fluorescein leakage from the macula and capillary nonperfusion area in the late venous phase. Accordingly, Purtscher’s retinopathy was diagnosed and the patient was observed without specific treatment. After 2 weeks of observation, symptoms and fundus findings were not changed. High-dose steroid therapy was begun with injection of one gram of methylprednisone for three days, switched to oral prednisolone, and then slowly tapered in period of 3 weeks. 7 days after the treatment, visual acuity was improved to 0.2 in the right eye but afferent pupillary defect was still observed. Cotton-wool spots slightly decreased, peripapillary hemorrhage was absorbed but macular edema was remained. 14 days after the treatment, visual acuity greatly improved to 0.63 and afferent pupillary defect was not observed. Cotton-wool spots and macular edema were decreased but fluoroscein leakage from capillary nonperfusion area was remained. Conclusions: In the case of Purtscher’s retinopathy, high-dose steroid therapy can be a useful management method for the improvement of visual acuity and other symptoms. `

키워드

High-dose Steroid Therapy, Purtscher’s Retinopathy