개의 각막내피세포 변성증에 의한 각막 궤양에 적용한 각막열성형술 2례

Thermokeratoplasty as a Treatment for Ulcerative Keratitis Caused by Corneal Endothelial Degeneration in Two Dogs

  • 박영우 (서울대학교 수의과대학, BK21 수의과학연구인력양성단, 수의외과학교실) ;
  • 김세은 (서울대학교 수의과대학, BK21 수의과학연구인력양성단, 수의외과학교실) ;
  • 안재상 (서울대학교 수의과대학, BK21 수의과학연구인력양성단, 수의외과학교실) ;
  • 안정택 (서울대학교 수의과대학, BK21 수의과학연구인력양성단, 수의외과학교실) ;
  • 이예스란 (서울대학교 수의과대학, BK21 수의과학연구인력양성단, 수의외과학교실) ;
  • 이의리 (서울대학교 수의과대학, BK21 수의과학연구인력양성단, 수의외과학교실) ;
  • 이나영 (노스캐롤라이나주립대학교 수의과대학, 의생명과학교실) ;
  • 서강문 (서울대학교 수의과대학, BK21 수의과학연구인력양성단, 수의외과학교실) ;
  • 정만복 (서울대학교 수의과대학, BK21 수의과학연구인력양성단, 수의외과학교실)
  • Park, Young-Woo (Department of Veterinary Surgery, College of Veterinary Medicine and BK21 Program for Veterinary Science, Seoul National University) ;
  • Kim, See-Un (Department of Veterinary Surgery, College of Veterinary Medicine and BK21 Program for Veterinary Science, Seoul National University) ;
  • Ahn, Jae-Sang (Department of Veterinary Surgery, College of Veterinary Medicine and BK21 Program for Veterinary Science, Seoul National University) ;
  • Ahn, Jeong-Taek (Department of Veterinary Surgery, College of Veterinary Medicine and BK21 Program for Veterinary Science, Seoul National University) ;
  • Lee, Yesran (Department of Veterinary Surgery, College of Veterinary Medicine and BK21 Program for Veterinary Science, Seoul National University) ;
  • Lee, Eui-Ri (Department of Veterinary Surgery, College of Veterinary Medicine and BK21 Program for Veterinary Science, Seoul National University) ;
  • Yi, Na-Young (Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University) ;
  • Seo, Kang-Moon (Department of Veterinary Surgery, College of Veterinary Medicine and BK21 Program for Veterinary Science, Seoul National University) ;
  • Jeong, Man-Bok (Department of Veterinary Surgery, College of Veterinary Medicine and BK21 Program for Veterinary Science, Seoul National University)
  • 심사 : 2011.09.19
  • 발행 : 2011.10.31

초록

13살 암컷 시츄 (증례 1) 와 10살 암컷 요크셔테리어 (증례 2) 가 각막 내피세포 변성증에 의한 각막궤양으로 내원하였다. 안검사 상에서 증례 2의 우안은 각막 외측에 국소적인 각막 부종이 확인되었고, 나머지 3 안에서는 전체 각막에서 부종이 확인되었다. 두 증례 모두 좌안에서 결막 충혈, 국소적인 각막 색소 침착, 각막 신생혈관화, 상피하수포가 관찰되었고, 형광 염색 시 양성 반응이 확인되었다. 각막열성형술은 증례 1 에서, 좌안의 전체 각막에, 증례 2에서, 좌안의 전체 각막과 우안의 각막부종 부위에 실시하였다. 증례 2 에서, 술 후 각막 치유를 촉진시키기 위해 일시적으로 양안 안검 봉합을 실시하여, 11일간 유지하였다. 각막 궤양은 증례 1 에서, 25일째, 증례 2 에서, 11 일째 완전히 치유되었다. 증례 1은 술 후 15 개월, 증례 2는 술 후 10 개월간 각각 각막궤양이 재발되지 않았다. 각막 색소 침착이 수술 전보다 진행되었으나, 그 외 임상적으로 중요한 부작용은 관찰되지 않았다. 각막 내피세포 변성증에 의한 궤양의 경우, 지속성 또는 재발성 양상으로 진행하여 심층 각막궤양 및 포도막염과 같은 속발증이 병발하는 경우가 많다. 그러므로, 본 증례에서 보고한 바와 같이 각막열성형술은 각막내피세포변성증에 의한 각막궤양에 효과적인 치료법으로 생각된다.

A 13-year-old, female, Shih-tzu and a 10-year-old, female, Yorkshire terrier were presented with ulcerative keratitis caused by corneal endothelial degeneration. Generalized corneal edema, conjunctival hyperemia, focal corneal pigmentation, corneal neovascularization, sub-epithelial bullae, and positive fluorescein staining were observed during ophthalmic examinations. Thermokeratoplasty was performed on the overall edematous corneas. Healing of the cornea was completed within 25 days and corneal ulceration has not recurred after healing of the cornea in both cases. Other ocular complications were not observed except for a slight increase in corneal pigmentation. According to this study, thermokeratoplasty could be an effective treatment for corneal ulceration secondary to corneal endothelial diseases in dogs.

키워드

참고문헌

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