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안와종양제거술 이후 발생한 중심망막동맥폐쇄

Central Retinal Artery Occlusion Occurred after Orbital Tumor Removal

검안 및 콘택트렌즈학회지 2020년 19권 3호 p.67 ~ 71
이상재, 장민욱,
소속 상세정보
이상재 ( Lee Sang-Jae ) - Dongguk University Ilsan Hospital Department of Ophthalmology
장민욱 ( Chang Min-Wook ) - Dongguk University Ilsan Hospital Department of Ophthalmology

Abstract


Purpose: We report a case of central retinal artery occlusion that occurred after orbital tumor removal.

Case summary: A 42-year-old man was admitted to the ophthalmology clinic because a mass (1.1 x 1.7 cm) was found in the left orbit in the brain computed tomography performed after a traffic accident. At the time of the examination, the visual acuity of the left eye was 20/20 and the intraocular pressure was 19 mmHg. Left eye was protruded about 1 mm compared to the right eye. In the orbit magnetic resonance imaging, the optic nerve was displaced to medial by mass (1.5 x 1.3 x 1.5 cm). And visual defect was detected in visual field test. And mass excision was performed using the Kronlein approach. The mass was diagnosed as cavernous hemangioma in histologic examination. On the first day after surgery, the visual acuity of the left eye was measured as 20/80. But in the afternoon, visual acuity was decreased to finger-count with speaking that black line was appeared in center of left visual field. Steroid therapy was started under suspecting orbital apex syndrome. However, due to no improvement, fluorescein angiography was performed. And central retinal artery occlusion was diagnosed. Then anterior chamber paracentesis and emergency orbital decompression were performed. Fluorescein angiography was performed again 10 days after decompression and showed reperfusion, but vision was not recovered.

Conclusions: Central retinal artery occlusion may occur after orbital surgery. Sudden vision loss without pain must be suspected and careful observation is necessary.

키워드

Central retinal artery occlusion; Cherry-red spot; Fluorescein angiography; Orbital tumor surgery; Vision loss

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