胞状網膜剝離および脈絡膜剝離を呈した急性骨髄性白血病の1例

Choroidal and bullous retinal detachment in a case of acute myeloblasatic leukemia

要約　目的：胞状網膜剝離と脈絡膜剝離を契機として白血病の再発が発見された1例の報告。症例：48歳女性が右眼視力低下で受診した。2年前に急性骨髄性白血病と診断され，同種造血幹細胞移植を受け寛解中であった。所見と経過：矯正視力は右0.5，左1.5であり，他に異常所見はなかった。1週間後，右眼視力が手動弁に低下し，非裂孔原性網膜剝離と全脈絡膜剝離が生じた。血液と骨髄検査で白血病の再発と診断し，全身的に化学療法，網膜剝離には放射線照射を行った。2か月後に網膜剝離は消失したが，視力は光覚弁のままであった。結論：白血病の再発時に網膜剝離や脈絡膜剝離が発症することがあり，診断と治療に留意する必要がある。

Abstract.　Purpose：To report a case with choroidal and bullous retinal detachment as initial signs of recurrence of acute myeloblastic leukemia. Case：A 48-year-old female presented with impaired visual acuity in the right eye since one week before. She had been diagnosed with acute myeloblastic leukemia 2 years before. Recovery had set in after similar hematopoietic stem cell transplantation. Findings：Her corrected visual acuity was 0.5 right and 1.5 left. No other pathological findings were present. Retinal detachment and total choroidal detachment developed in the right eye one week later with visual acuity reduced to hand motion. Systemic examinations showed recurrence of acute leukemia leading to chemotherapy. Retinal detachment was treated by radiation. Retinal detachment resolved 2 months later. Visual acuity remained light perception. Conclusion：This case illustrates that retinal and choroidal detachment may be initial manifestations of recurrence of leukemia.