유리체절제술 후 망막표면에 남은 트리암시놀론 아세토나이드에 의해 발생한 망막출혈

• 영문명: Retinal Hemorrhage Induced by Triamcinolone Acetonide Left After Vitrectomy for Macular Epiretinal Membrane
• 발행기관: 대한안과학회
• 저자명: 이승준,Seung Jun Lee, MD
• 간행물 정보: 『대한안과학회지』Ophthalmological Society,volume50,number11, 1745~1750쪽, 전체 6쪽
• 주제분류: 의약학 > 기타의약학
• 파일형태: PDF
• 발행일자: 2009.11.15

영문 초록

Purpose: To report retinal hemorrhage and retinal edema induced by the remaining triamcinolone acetonide (TA) used in vitrectomy for dyeing of vitreous and epiretinal membranes. Case summary: The authors performed 23 gauze vitrectomies for macular epiretinal membranes. TA was used during the operation to enhance visualization of the vitreous and epiretinal membrane. At the end of the surgery, an amount of TA was left on the retinal surface. One day after the operation, the patient was maintained a semi-sitting position because of the floating TA particles in the vitreous cavity. The following day, the TA settled onto the inferior retina and retinal edema and hemorrhage occurred unexpectedly in the inferior retina. Vitrectomy was performed again and the fluid of the vitreous cavity was replaced with a fresh balanced salt solution and the settled TA was removed from retinal surface. Finally, argon laser photocoagulation was performed at the area where the retinal edema and hemorrhage had occurred. The retinal edema and hemorrhage disappeared after a few days, normal visual acuity was recovered in seven days, and a normal condition with no further ocular complications was maintained at six months. Conclusions: When a TA vehicle, such as benzyl alcohol, and TA particles contained in the vehicle are left in the vitreous cavity and contact the retinal surface of a vitrectomized eye, retinal toxicity can be induced due to retinal edema and hemorrhage. The safest use of TA in vitrectomy would involve at least two rounds of sedimentation or filtration through a micofilter needle. J Korean Ophthalmol Soc 2009;50(11):1745-1750

키워드

Macular epiretinal membrane, Retinal hemorrhage, Triamcinolone acetonide