목적 : 특별한 질환 없이 망막출혈을 동반하는 경우는 드문 현상으로 저자들은 건강한 15세 남아에서 비정형적으로 발생한 발살바 망막병증 1례를 경험하였기에 보고하고자 한다. 대상과 방법 : 평소 양안 나안시력이 1.0인 15세 남아가 학교에서 극기 훈련 후 발생한 시력 저하를 주소로 전원되었다. 초진 시 좌안의 최대교정시력은 0.2, 전안부 검사 및 안압은 정상소견이었으며, 안저검사 상 양안 황반부에 점상의 망막전출혈이 보였다. 동일 환자가 9개월 후 같은 상황에서 발생한 양안의 시력저하를 주소로 내원하였다. 초진 시 시력은 우안 0.3, 좌안 0.02였고, 전안부 검사 및 안압은 정상소견을 보였다. 안저검사 상 양안에서 다수의 망막전출혈이 관찰되었다. 결과 : 첫 발병 6주후에는 대부분의 출혈이 흡수되었고, 시력도 회복되었다. 두 번째 발병 시 우안은 경과관찰을 하였고, 좌안은 Nd:YAG 레이져로 내경계막절개술을 시행하였다. 4주 후 망막전출혈은 대부분 흡수되었지만 시력은 좌안에서만 0.2로 호전되었다. 결론 : 본 증례의 발살바 망막병증에서는 양안에서 반복적으로 출혈이 나타났으며, 출혈과 회복이 반복되면서 나타날 경우 시력에 나쁜 영향을 미칠 수 있음을 알았다.

Purpose: To report a case of recurrent bilateral preretinal hemorrhages in a healthy male with no previous history of systemic or ocular diseases and to review the relevant literature. Methods: History taking, measurement of visual acuity and intraocular pressure, slit-lamp examination, fundoscopy, and fluorescein angiography were performed in a 15-year-old male who had experienced a sudden decrease in visual acuity in both eyes after a couple of strenuous exercises in school. Results: Best-corrected visual acuity (BCVA) was 0.9 in the right eye and 0.2 in the left, and bilateral premacular hemorrhages were observed. Most of the preretinal hemorrhages were completely resolved by the sixth week and visual acuity in the left eye improved to 0.6. Nine months after the initial event, preretinal hemorrhages recurred bilaterally, worse in the left eye, and BCVA decreased to 0.3 in the right eye and 0.02 in the left eye. We performed Nd:YAG laser disruption of the internal limiting membrane in the left eye. Four weeks after the procedure, most of the preretinal hemorrhages were resolved and visual acuity in the left eye improved to 0.2. Conclusions: Clinical improvement was achieved after Nd:YAG laser disruption of the internal limiting membrane in a case of recurrent bilateral preretinal hemorrhages.

Purpose: To report a case of recurrent bilateral preretinal hemorrhages in a healthy male with no previous history of systemic or ocular diseases and to review the relevant literature. Methods: History taking, measurement of visual acuity and intraocular pressure, slit-lamp examination, fundoscopy, and fluorescein angiography were performed in a 15-year-old male who had experienced a sudden decrease in visual acuity in both eyes after a couple of strenuous exercises in school. Results: Best-corrected visual acuity (BCVA) was 0.9 in the right eye and 0.2 in the left, and bilateral premacular hemorrhages were observed. Most of the preretinal hemorrhages were completely resolved by the sixth week and visual acuity in the left eye improved to 0.6. Nine months after the initial event, preretinal hemorrhages recurred bilaterally, worse in the left eye, and BCVA decreased to 0.3 in the right eye and 0.02 in the left eye. We performed Nd:YAG laser disruption of the internal limiting membrane in the left eye. Four weeks after the procedure, most of the preretinal hemorrhages were resolved and visual acuity in the left eye improved to 0.2. Conclusions: Clinical improvement was achieved after Nd:YAG laser disruption of the internal limiting membrane in a case of recurrent bilateral preretinal hemorrhages.

Bilateral, Nd:YAG laser disruption, Recurrent, Valsalva retinopathy