アトピー性皮膚炎に合併した網膜剝離の特徴

Characteristic features of retinal detachment associated with atopic dermatitis

要約　目的：アトピー性皮膚炎に併発する網膜剝離の特徴の報告。対象：過去2年間に受診したアトピー性皮膚炎を伴う網膜剝離14例22眼を対象とした。年齢は16～33歳（平均20.3歳）で，男性7例，女性7例であった。結果：裂孔は6眼では赤道部，16眼では毛様体にあった。両眼発症の8例中7例では裂孔が両眼の毛様体，1例では両眼の赤道部にあった。赤道部に裂孔がある6眼には強膜内陥術を行い，初回手術で復位が得られた。強膜内陥術を行った毛様体裂孔の6眼では，初回手術で3眼（50％）が復位した。硝子体手術を行った8眼では，初回手術で6眼（75％）が復位した。8眼では白内障手術後に網膜剝離が発症した。全例が毛様体裂孔であり，白内障手術から網膜剝離発症までの期間は平均31.5か月であった。初診時の白内障と顔面の皮疹の合併率は毛様体裂孔で有意に高かった。結論：アトピー性皮膚炎に併発する網膜剝離は若年者に好発し，裂孔が毛様体にあることが多い。裂孔が赤道部にあるときには強膜内陥術，毛様体にあるときには硝子体手術が第一選択である。

Abstract.　Purpose：To describe retinal detachment associated with atopic dermatitis. Cases：This review comprised 22 eyes of 14 patients seen during the past 2 years. Their age ranged from 16 to 33 years,average 20.3 years. There were 7 males and 7 females. Results：Retinal break was located in the equator in 6 eyes and in the ciliary body in 16 eyes. In 8 bilateral cases,7 cases had retinal break in the ciliary body in both eyes and 1 case had in the equator in both eyes. The retina became reattached in 6 eyes with break in the equator after scleral encircling. Reattachment was obtained in 3 out of 6 eyes of break in the ciliary body after scleral encircling. Reattachment was obtained in 6 out of 8 eyes of break in the ciliary body after vitrectomy. Retinal detachment developed in 8 eyes after an average of 31.5 months following cataract surgery. All had breaks in the ciliary body. Conclusion：Atopic retinal detachment tends to develop at a younger age and is often associated with break in the ciliary body. Scleral buckling is the first choice for equatorial break and vitrectomy for break in the ciliary body.