목적: 급성 폐쇄각 녹내장에서 안압 하강제 투여 및 레이저 홍채 절개술을 시행한 후 발생한 감압 망막병증을 경험하였기에 이를 보고 하는 바이다. 증례요약: 우안 급성 폐쇄각 녹내장으로 진단받은 67세 여자 환자에게 안압 하강제로 안압을 떨어뜨린 후 레이저 홍채절개술을 시행하 였다. 내원 시 우안 최대 교정 시력 0.3이었고, 안압은 74 mmHg였으며, 안압하강제 투여 2시간 후 안압은 16 mmHg였다. 레이저 홍채절개술 시행 전 안압은 11 mmHg, 시행 전 시력은 0.2였고, 시행 후 안압은 10 mmHg였으나 환자는 레이저 홍채절개술 후 시력 저하와 비문증을 호소하였다. 레이저 홍채절개술 시행 3일 뒤 경과 관찰 시 안압은 정상이었으나, 시력이 안전 수지로 저하되어 있는 소견을 보였고 산동 후 안저검사 상 시신경유두부 주변 및 주변부 망막에 미만성인 점상 및 반상 출혈과 황반부의 망막 앞 출혈을 보였다. 3개월 후 망막출혈과 망막 앞 출혈은 흡수되었고, 시력은 0.7로 회복되었다. 결론: 급성 원발성 폐쇄각 녹내장에서 안압 하강제 투여 및 레이저 홍채 절개 술 후 후극부의 망막 내 출혈 및 망막 전 출혈이 발생하는 감압망막병증이 발생할 수 있다.

Purpose: To report a case of ocular decompression retinopathy after resolution of acute primary angle closure (APAC) subsequent to medical treatment and laser peripheral iridotomy (LPI). Case summary: A patient presented with APAC of the right eye with markedly elevated intraocular pressure (IOP) and a LPI was done after lowering the IOP with medical treatment. On presentation, visual acuity was 0.3 in the right eye (OD) and IOP was 74 mmHg OD. Two hours after medical treatment IOP was found to be 16 mmHg OD. Ten hours after resolution of the acute attack, the patient’s visual acuity was 0.2 OD and IOP was 11 mmHg OD. LPI was subsequently performed in the right eye. The post-LPI IOP was 10 mmHg and the patient complained of visual disturbance and floaters OD. Three days after LPI the IOP was normal but her visual acuity had decreased to counting fingers OD. In addition, scattered retinal hemorrhages including alarge pre-retinal hemorrhage on the macula were found upon dilated funduscopic examination. After three months the retinal hemorrhage had been absorbed and her visual acuity was 0.7 OD. Conclusions: Decompression retinopathy can develop in the posterior pole of the retina in patients with APAC after medical treatment and LPI.

Purpose: To report a case of ocular decompression retinopathy after resolution of acute primary angle closure (APAC) subsequent to medical treatment and laser peripheral iridotomy (LPI). Case summary: A patient presented with APAC of the right eye with markedly elevated intraocular pressure (IOP) and a LPI was done after lowering the IOP with medical treatment. On presentation, visual acuity was 0.3 in the right eye (OD) and IOP was 74 mmHg OD. Two hours after medical treatment IOP was found to be 16 mmHg OD. Ten hours after resolution of the acute attack, the patient’s visual acuity was 0.2 OD and IOP was 11 mmHg OD. LPI was subsequently performed in the right eye. The post-LPI IOP was 10 mmHg and the patient complained of visual disturbance and floaters OD. Three days after LPI the IOP was normal but her visual acuity had decreased to counting fingers OD. In addition, scattered retinal hemorrhages including alarge pre-retinal hemorrhage on the macula were found upon dilated funduscopic examination. After three months the retinal hemorrhage had been absorbed and her visual acuity was 0.7 OD. Conclusions: Decompression retinopathy can develop in the posterior pole of the retina in patients with APAC after medical treatment and LPI.