| 발표일자: |
2019년 11월 1일(금)~3(일) |
| 발표번호: |
P(e-poster)-163 |
| 발표장소: |
B3 Parking Area
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| 시야 장애를 보인 중심주위 급성 중간층 황반병증 1예 |
| 이화여자대학교 의과대학 안과학교실 이대목동병원 |
| 김유진, 한경은, 조수창 |
| 본문 : The present study is intended to report an unusual case of ‘paracentral acute middle maculopathy’ presenting monocular visual field defect.
A 67-year old male visited the clinic with the symptom of 3 day history of visual dimness in the left eye. He denied any traumatic history and he accidentally recognized the visual symptom during walk 3 days ago. His medical history included hypertension and hypothyroidism. Initial uncorrected visual acuity was 20/20 in both eyes and intraocular pressure was 21 mmHg in both eyes. Anterior segment findings were normal in both eyes except Meibomian gland plugging in both eyes. Relative afferent pupillary defect (RAPD) was absent in both eyes. Fundus examination showed some extra-foveal drusen in both eyes and mild multiple cotton wool patches (CWPs) mainly nearby optic disc and proximal portion of the major arcade in the left eye.
2 days later, he revisited the clinic with the symptom of worsening visual dimness in his left eye. Uncorrected visual acuity was 20/20 in both eyes and intraocular pressure was 18 mmHg in the right eye (OD) and 15 mmHg in the left eye (OS). Anterior segment examination was normal except Meibomian gland disease (MGD) in both eyes. RAPD was absent in both eyes. Fundus findings showed the increasing number and deteriorated presentation of multiple CWPs in the left eye. The color vision test was normal (24/24 in OD, 23/24 in OS). The Humphrey visual field (HVF) test showed within normal limit in OD and paracentral scotoma in OS. Optical coherence tomography (OCT) revealed non-significant finding in OD and multiple hyper-reflective bands mostly in outer plexiform layer/ inner nuclear layer (OPL/INL) region and some in outer plexiform layer/ outer nuclear layer (OPL/ONL) region in OS. OCT angiography (OCTA) showed normal finding in OD and relatively decreased vascular density of superficial and deep capillary plexus in OS compared to OD. He was diagnosed as paracentral acute middle maculopathy in the left eye.
Paracentral acute middle maculopathy can be considered as one of the unusual causes presenting paracentral scotoma. The OCT and OCTA are useful tools for the diagnosis of the disease. |
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