목적 : 99mTc-labeled leukocyte 신티그래피를 이용하여 진단한 low-grade의 hydroxyapatite 안와삽입물 감염을 보고하고자 한다. 대상과 방법 : 34세 남자가 좌안의 각공막천공성 열상으로 일차봉합술을 시행하였으나 안구로로 진행되어 안구내용물 제거술 및 hydroxyapatite 안와삽입술 시행하고 drilling 후에 의안 착용하고 3년 5개월 동안 별 문제없이 지내던 중, 좌안의 동통, 상하안검 발적, 결막의 심한 농성 분비물을 주소로 내원하였다. 약 3주간의 보존적 치료에 잘 반응하지 않아 삽입물 감염 의심 하에 자기공명영상촬영을 실시하였으나 감염을 의심할만한 특이소견을 관찰할 수 없었다. 이에 감염 여부를 확인하기위해 99mTc-labeled leukocyte 신티그래피를 실시하였다. 결과 : 신티그래피 상 좌안 안와삽입물 위치에 labeled leukocyte의 증가된 축적소견이 관찰되었다. 안와삽입물 감염으로 진단하고 삽입물의 제거 후 silicone sphere 대치술을 실시하였다. 이후 염증소견이 호전되어 의안착용이 가능하였다 결론 : 자기공명영상촬영 등을 통해 진단이 어려운 low-grade의 hydroxyapatite 안와삽입물의 감염 진단 시 99mTc- labeled leukocyte 신티그래피가 유용할 것으로 생각된다.

Purpose: To describe a low-grade infection of hydroxyapatite orbital implant diagnosed by 99mTc-labeled leukocyte scintigraphy. Methods: A 34-year-old man diagnosed as phthisis bulbi due to corneoscleral laceration on left eye had been treated with evisceration and hydroxyapatite orbital implant insertion. After drilling for ocular prosthesis, the patient did not have any symptom for 3 years & 5 months. He presented with socket pain, erythematous lid swelling, severe conjunctival discharge. There was no improvement of symptom despite conservative treatment for 3 weeks. MRI revealed no abnormalities so 99mTc-labeled leukocyte scintigraphy was performed. Results: Scintigraphy showed a dense accumulation of labeled leukocyte at the implant site. After diagnosed as hydroxyapatite orbital implant infection, orbital implant was removed and silicon sphere implantation was done. After operation, the inflammation signs disappeared. Conclusions: 99mTc-labeled leukocyte scintigraphy is a useful technique in diagnosing low-grade infection of hydroxyapatite orbital implant undetected using conventional imaging method such as MRI.

Purpose: To describe a low-grade infection of hydroxyapatite orbital implant diagnosed by 99mTc-labeled leukocyte scintigraphy. Methods: A 34-year-old man diagnosed as phthisis bulbi due to corneoscleral laceration on left eye had been treated with evisceration and hydroxyapatite orbital implant insertion. After drilling for ocular prosthesis, the patient did not have any symptom for 3 years & 5 months. He presented with socket pain, erythematous lid swelling, severe conjunctival discharge. There was no improvement of symptom despite conservative treatment for 3 weeks. MRI revealed no abnormalities so 99mTc-labeled leukocyte scintigraphy was performed. Results: Scintigraphy showed a dense accumulation of labeled leukocyte at the implant site. After diagnosed as hydroxyapatite orbital implant infection, orbital implant was removed and silicon sphere implantation was done. After operation, the inflammation signs disappeared. Conclusions: 99mTc-labeled leukocyte scintigraphy is a useful technique in diagnosing low-grade infection of hydroxyapatite orbital implant undetected using conventional imaging method such as MRI.

Hydroxyapatite infection, Leukocyte scintigraphy