시신경교차손상을 동반한 외상성 안구탈출

• 영문명: Traumatic Eyeball Protrusion with Optic Chiasmal Injury
• 발행기관: 대한안과학회
• 저자명: 이상미 장기철 장무환,Sang Mi Lee, MD, Ki Cheol Chang, MD, Moo Hwan Chang, MD, PhD
• 간행물 정보: 『대한안과학회지』Ophthalmological Society,volume52,number6, 759~765쪽, 전체 7쪽
• 주제분류: 의약학 > 기타의약학
• 파일형태: PDF
• 발행일자: 2011.06.15

영문 초록

Purpose: To report a case of eyeball protrusion with optic chiasmal injury due to eyeball trauma. Case summary: A 59-year-old male presented to the emergency room for right eyeball pain, eyeball protrusion and decreased visual acuity after collision with a metal pipe. On initial examination, the right eyeball was protruded, the patient could not perceive light, his pupil was dilated and did not respond to the light. The patient had a laceration of the lower canaliculi and the medial, superior and inferior rectus muscles were separated from the eyeball. Abnormal left pupil response was observed, and visual acuity of the left eye was 0.7. He underwent primary repair of the right medial, inferior and superior rectus muscles and reconstruction of the lower canaliculi. Because the visual field of the left eye at post-operative day 1 demonstrated temporal hemianopsia, an optic chiasmal injury was revealed on brain magnetic resonance imaging (MRI). The patient underwent left optic chiasmal decompression because the visual field was aggravated despite the immediate high dose of corticosteroid therapy. At post-operative 2 months, the patient’s left visual acuity was 0.3 and the visual field was stable. Conclusions: Optic chiasmal injury should be considered and promptly diagnosed through visual field test and MRI when ipsilateral optic nerve injury with abnormal contralateral pupil response is caused by eyeball protrusion. Optic chiasmal decompression should be considered when traumatic optic nerve and chiasmal injuries do not respond to high-dose corticosteroid therapy. J Korean Ophthalmol Soc 2011;52(6):759-765

키워드

Eyeball protrusion, Optic chiasmal injury, Trauma