목적: 시신경유두소와에 의한 황반부 장액성망막박리에서 유리체절제술, 레이저치료와 가스주입술을 계획하였으나 망막하액으로 인
해 수술 후 외래에서 레이저를 시행한 1예의 임상결과를 보고하고자 한다.
증례요약: 13세 여자가 좌안 중심부 시력장애를 주소로 내원하였다. 내원 당시 교정시력은 0.16 이였고, 안과적 검사상 장액성망막박리
가 동반된 시신경유두소와로 진단되었다. 3개월째 장액성망막박리가 증가되고 시력도 0.1로 감소하여 수술을 시행하였다. 수술은 완전
한 후유리체박리를 유도한 유리체절제술을 시행하였다. 과불화탄소액을 주입 후 되쏘기피리바늘을 이용하여 시신경유두소와 주위로
망막하액의 배액을 시도하였으나 배출되지 않았고 큰 장액성망막박리로 유두소와 주위 레이저가 용이하지 않았다. 가스주입술 후 1주
일간 엎드린 자세를 유지 후 레이저광응고를 시행하였고, 완전한 망막하액의 흡수와 시력의 향상을 보였다. 또한 경과관찰 기간 동안
재발은 관찰되지 않았다.Purpose: To report the clinical results of a planned vitrectomy, laser photocoagulation and gas tamponade for the treatment of
serous macular detachment associated with optic disc pit. However, laser photocoagulation was performed on a postoperative
outpatient basis for subretinal fluid.
Case summary: A 13-year-old women presented with central visual disturbance in the left eye. Her best-corrected visual acuity
(BCVA) was 0.16. On ophthalmic examination, the patient was diagnosed with optic disc pit combined with serous macular
detachment. After 3 months, the serous macular detachment increased and visual acuity decreased to 0.1. Pars plana vitrectomy
combined with complete posterior vitreous detachment was performed. After intravitreal injection of perfluorodecalin, internal
drainage of the subretinal fluid using the back flush needle around the optic disc pit was performed, but the fluid was not
drained. The planned intraoperative photocoagulation was not performed due to a large serous macular detachment. Gas
tamponade was performed and a facedown position was maintained for 1 week followed by laser photocoagulation. The
subretinal fluid was completely absorbed and visual acuity was improved. In addition, recurrence was not observed throughout
the follow-up period.