Journal of The Korean Ophthalmological Society (대한안과학회지)

The Korean Ophthalmological Society (대한안과학회)
권호 표지

Infectious Endophthalmitis After Intravitreal Injection of Triamcinolone Acetonide

유리체강내 트리암시놀론 주사 후 발생한 감염성 안내염 2예

Sohn, Hee-Jin;Nam, Dong-Heun
손희진;남동흔

  • Published : 20060000
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Abstract

Purpose: We report 2 cases of infectious endophthalmitis after intravireal triamcinolone acetonide injection which was successfully treated with early vitrectomy. Methods: A 56 year old male patient with chronic cystoid macular edema of right eye and an 84 year old female patient with diabetic macular edema of right eye (pseudophakic) eye were treated with intravireal triamcinolone acetonide injection. Four days after the injection, both the patients complained of decreased visual acuity that had been developed 1 and 2 days prior respectively. Visual acuity was hand motion, inflammatory cells, flare, fibrins and hypopyon were found in the anterior chamber. Fundus was not visible due to vitreous opacity. Results: The two patients were presumed to have infectious endophthalmitis. Anterior chamber irrigation, vitrectomy, intravitreal antibiotics injection, and vitreous culture were performed. Coagulase negative staphylococcus was detected from vitreous culture, Within 1 week of the follow-up procedures, the anterior chamber and vitreous inflammation were improved and visual acuity recovered to the level attained before intravireal triamcinolone acetonide injection. Conclusions: If after intravireal triamcinolone acetonide injection, there is severely decreased visual acuity, inflammation of the anterior chamber and vitreous, flare and fibrin are detected, infectious endophthalmitis must be suspected. If diagnosed early and treated with vitrectomy, a favorable visual prognosis is expected.

목적 : 유리체강내 triamcinolone acetonide 주사 후 발생한 감염성 안내염 2예를 경험하고 조기수술로 비교적 양호한 시력을 얻었기에 보고하고자 한다. 대상과 방법 : 우안 만성낭포황반부종을 보이는 56세 남자와 우안 당뇨황반부종을 보이는 84세 여자에서 유리체강내 triamcinolone acetonide 주사를 시행하였다. 주사 후 4일째 각각 1일, 2일 전부터 시작된 시력저하를 주소로 내원하였다. 시력은 안전수동, 전방에 염증세포와 방수흐림, 섬유소 및 전방축농이 관찰되었고, 안저는 관찰되지 않았다. 결과 : 감염성 안내염 의심하에 내원 당일 유리체 절제술을 시행하였다. 배양결과상 coagulase negative staphylococcus가 검출되었다. 술 후 1주 내에 전방 및 유리체의 염증은 호전되었고, 추후 시력은 주사 이전으로 회복되었다. 결론 : 유리체강내 triamcinolone acetonide 주사 후 심한 시력감소와 전방과 유리체에 심한 염증과 방수흐림, 섬유소가 관찰될 때는 감염성 안내염을 의심해야하며 조기에 진단하고 유리체절제술 등 적극적 치료시 비교적 양호한 예후를 얻을 수도 있을 것으로 생각된다.

Keywords

References

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