強度近視を合併した網膜色素線条症の1例

A case of angioid streaks with high myopia

目的：網膜色素線条が強度近視眼に生じ，脈絡膜血管新生に至った1例の報告。症例と経過：18歳男性に左眼視力低下が2日前に突発した。外傷などの契機はなかった。左右眼とも約－9Dの近視があり，矯正視力は右0.9，左0.3であった。両眼に網膜色素線条があり，左眼中心窩に網膜下出血があった。蛍光眼底造影で色素線条部に低蛍光と左眼中心窩下に新生血管があった。全身合併症はなかった。左眼の黄斑下出血はゆっくり消退し，発症から5か月後の矯正視力は0.6に改善した。結論：本症例では，強度近視による眼軸長延長と弾性線維の脆弱化があるために，若年でも脈絡膜新生血管が生じたと推定される。強度近視は，網膜色素線条症の自然予後に影響する可能性がある。

Purpose：To report of case of high myopia with angioid streaks complicated by choroidal neovascularization. Case and Finding：A 18-year-old male presented with sudden visual loss in his left eye 2 days before. He had no trauma or causative factor. Both eye had myopia of －9 diopters. Corrected visual acuity was 0.9 right and 0.3 left. Funduscopy showed angioid streaks in both eyes. Submacular hemorrhage was present in the left fundus. Fluorescein angiography showed hypofluorescence in the area of angioid streaks in both eyes and subfoveal neovascularization in the left. He showed no systemic lesions. Hemorrhage in the left eye underwent spontaneous resolution,resulting in corrected visual acuity of 0.6 5 months after onset. Conclusion：Choroidal neovascularization in the present young man appears to be secondary to high myopia and angioid streaks. There is a possibility that the natural course of angioid streaks may be modified when high myopia is present.