正常妊娠後期に発症した中心性漿液性網脈絡膜症の1例

Central serous chorioretinopathy in a case in the late stage of normal pregnancy

目的：正常妊娠後期に発症した中心性漿液性網脈絡膜症の症例の報告。症例：29歳の女性が初めて妊娠し，妊娠38週目に左眼視力低下を自覚した。産院での諸検査で妊娠中毒症など後期妊娠合併症は否定された。その11日後に自然分娩で正常児を出産した。その後右眼にも視力低下が生じ，出産から7日後に眼科を受診した。矯正視力は右0.15，左0.4であり，3乳頭径大の漿液性網膜剝離が両眼の黄斑部にあった。光干渉断層計（OCT）と蛍光眼底造影で中心性漿液性網脈絡膜症に相当する所見があった。その後ゆっくりと網膜剝離が消退復位した。出産から4か月後に矯正視力は右1.5，左1.2に回復した。結論：正常妊娠でも血液の生理的変化により脈絡膜循環障害が起こる可能性があり，これが本症例での中心性漿液性網脈絡膜症に関与していたと推定される。

Purpose：To report central serous chorioretinopathy（CSR）that became manifest in the late stage of normal pregnancy. Case and Findings：A 29-year-old woman noted blurring of vision in her left eye towards 38 weeks of pregnancy. Toxemia of pregnancy was ruled out by laboratory studies. A healthy baby was born 11 days later. She then noted blurring of vision in her right eye. When seen by us 7 days after delivery,her corrected visual acuity was 0.15 right and 0.4 left. Both eyes showed serous retinal detachment in the macular area. Optic coherence tomography（OCT）and fluorescein angiography showed findings compatible with CSR. The macular lesion started to spontaneously regress. Serous retinal detachment disappeared 4months after delivery with visual acuity of 1.2 in either eye. Conclusion：Physiological changes in the circulating blood may occur in the late stage of normal pregnancy,resulting in disturbed choroidal circulation which may have induced CSR in the present case.