침술에 의한 안구천공과 시야장애 1예

• 영문명: Ocular Perforation and Visual Field Defect Caused by an Acupuncture Needle: a Case Report
• 발행기관: 대한안과학회
• 저자명: 강현승 이동규 임수진 김형은 권오웅,Hyunseung Kang, MD, Dong Kyu Lee, MD, Su Jin Lim, MD, Hyoung Eun Kim, MD, Oh Woong Kwon, MD, PhD
• 간행물 정보: 『대한안과학회지』Ophthalmological Society,volume54,number9, 1475~1479쪽, 전체 5쪽
• 주제분류: 의약학 > 의학일반
• 파일형태: PDF
• 발행일자: 2013.09.15

영문 초록

Purpose: To report a case of globe perforation and linear retinal tear after periocular acupuncture therapy which resulted in persistent temporal field defect with normal retinal function evidenced by multifocal electroretinogram (MERG). Case summary: A 42-year-old female presented with decreased visual acuity and pain in her right eye after a periocular acupuncture therapy for blepharospasm. At initial presentation, the best corrected visual acuity (BCVA) was 0.08 in the injured eye and the intraocular pressure was 15 mmHg. Ultrasonography showed minimal vitreous hemorrhage and fundus examination revealed a linear retinal tear in the posterior pole sparing the macula. Consequently, barrier laser photocoagulation was performed around the lesion. The patient suffered from metamorphopsia and persistent decreased visual acuity even after 3 months. On fundus examination, epiretinal membrane with macular pucker was observed on the macula. Spectral domain optical coherence tomography (SD-OCT) revealed retinal nerve fiber layer defect with a full-thickness posterior wall tear. Multifocal electroretinogram showed normal retinal function; however, Humphrey visual field test demonstrated field defect corresponding to the injury. A 25-gauge pars plana vitrectomy was performed with membranectomy and ILM peeling. One month postoperatively, improvement in BCVA and metamorphopsia was achieved; however, the scotomata remained unchanged. Conclusions: Ocular perforation or retinal tear caused by an acupuncture needle is a rare condition that has not been reported previously in Korea. Furthermore, no case of traumatic visual field defect with preserved retinal function has been reported elsewhere. Hence, the authors present a case of isolated visual field defect without retinal dysfunction following full-thickness retinal tear caused by an acupuncture needle.

키워드

Acupuncture, Globe perforation, MERG, Ocular perforation, Visual field defect