급성 폐쇄각 녹내장 환자에서 발생한 비동맥염성 앞허혈성시신경병증 1예

• 영문명: A Case of Nonarteritic Anterior Ischemic Optic Neuropathy Following Acute Angle-Closure Glaucoma
• 발행기관: 대한안과학회
• 저자명: 신종훈 이지웅 최희영,Jong Hoon Shin, MD, Ji Woong Lee, MD, Hee Young Choi, MD, PhD
• 간행물 정보: 『대한안과학회지』Ophthalmological Society,volume52,number6, 753~758쪽, 전체 6쪽
• 주제분류: 의약학 > 기타의약학
• 파일형태: PDF
• 발행일자: 2011.06.15

영문 초록

Purpose: Nonarteritic anterior ischemic optic neuropathy (NAION) is believed to result from inadequate blood supply to the posterior ciliary arteries. To date, NAION in a patient with acute angle-closure glaucoma (AACG) has been reported in only two studies in the English literature. Thus, the authors report a case of NAION following AACG in a Korean patient. Case summary: A 59-year-old woman presented with a three-day history of acute ocular pain and decreased vision in her right eye; visual acuity was hand movement and the intraocular pressure (IOP) was 66 mm Hg in the right eye. Slit-lamp examination of the patient’s right eye revealed diffuse corneal edema, shallow anterior chamber, and mid-dilated pupil. Gonioscopy revealed a grade 0 angle in the right eye, and a relative afferent pupillary defect was noted. Fundus photography showed disc hemorrhage and swelling of the optic disc. Fluorescein angiography demonstrated hyperfluorescence of the optic disc due to leakage. Visual evoked potential of the right eye at the initial visit showed a decreased amplitude of P100 compared with that of the left eye. A diagnosis of NAION following AACG was made. Laser iridotomy was successfully performed to the right eye. Two months later, IOP decreased from 66 to 21 mm Hg. However, visual acuity remained as hand movement and fundus examination revealed a pale optic disc. Conclusions: NAION following AACG may be attributed to an acute IOP rise with resultant perfusion pressure decrease in the vessels which supply the optic nerve. The result obtained from the patient in the present study indicates that evaluation for NAION should be considered in AACG cases. J Korean Ophthalmol Soc 2011;52(6):753-758

키워드

Acute angle-closure glaucoma, Nonarteritic anterior ischemic optic neuropathy