滲出性網膜剝離を伴った先天性網膜動静脈吻合の1例

A case of congenital arteriovenous communications with exudative retinal detachment

9歳女児が2年前からの右眼視力低下で受診した。矯正視力は右0.1，左1.5であり，左眼は正常であった。右眼の黄斑部が強く拡張蛇行した血管に覆われ，拡張血管の周囲に黄白色の滲出物があった。下方眼底には滲出を伴う網膜剝離と血管瘤があった。先天性網膜動静脈吻合と診断した。網膜剝離に対し冷凍凝固，強膜輪状締結術，ジアテルミーによる強膜穿刺を行った。術後6か月に滲出性網膜剝離は消失した。血管の拡張蛇行は3年後に軽減し，0.1の視力を維持している。

A 9-year-old girl presented with impaired vision in her right eye since 2 years before. Her corrected visual acuity was 0.1 right and 1.5 left. Her left eye showed normal findings. In her right eye,the macular area was covered by dilated and tortuous vessels associated with exudates. Exudative retinal detachment with microaneurysms were present in the inferior fundus. She was diagnosed with congenital arteriovenous communication. The right eye was treated by cryocoagulation,scleral encircling,and puncture by diathermy. Exudative retinal detachment disappeared 6 months later. Dilated vessels became less conspicuous 3 years later with visual acuity of 0.1 in the affected eye.