| 본문 : We experienced an unusual patient who reported having phosphenes while moving his eyes laterally. We performed various ophthalmologic imaging studies to identify the origin of these phosphenes. A 38-year-old man visited our hospital complaining of phosphenes in the left eye that began one week prior. He experienced the phosphenes transiently in the lateral gaze. There were no associated neruologic symptoms or signs. With the exception of high myopia, no abnormal findings were observed on routine exams and brain and orbit magnetic resonance imaging. Disc photography revealed no evidence of inflammation or swelling of the optic nerve head(ONH). However, in abducted position, the ONH appeared hyperemic and the margin was blurred. The patient underwent swept-source optical coherence tomography(SS-OCT) exam in both primary and lateral gazes. We used a wide volume scan protocol(12x9mm) that covered the entire optic disc and macula. Then, 3-D reconstructed images were generated automatically by built-in software. On SS-OCT, the ONH had a "volcano-like" appearance in the abducted position from normal cupping in the primary position. Our case suggested that eye-movement phosphenes could be associated with transient ONH strain and strain induced by eye movement could cause transient ONH changes. |