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要約 目的:黄斑円孔と内境界膜下血腫が併発した網膜細動脈瘤2症例の報告。症例:70歳と85歳の女性の片眼に網膜前血腫が発見された。いずれも過去に白内障手術と眼内レンズ挿入術が行われ,1例には統合失調症,他の1例には慢性腎不全があった。2例に対し硝子体手術を行い,内境界膜後方にある血腫を除去し,術中に黄斑円孔が発見された。黄斑円孔は術後数日で閉鎖した。2症例とも患眼の矯正視力は術前0.02,術後0.1になった。病歴と眼底所見とから,網膜前出血は網膜細動脈瘤の破裂の結果であると推定された。結論:網膜細動脈瘤が破裂すると網膜前または網膜下に出血が生じる。本症例では内境界膜下に血腫があったことに加え,黄斑円孔が手術中に発見された。網膜下出血が黄斑円孔をつくり内境界膜下に移動した可能性がある。
Abstract. Purpose:To report two cases of retinal macroaneurysm with macular hole and hematoma posterior to internal limiting membrane(ILM). Cases:Preretinal hematoma was detected in 2 females aged 70 and 85 years respectively. Both had received cataract surgery with intraocular lens implantation. One had schizophrenia and the other had chronic renal failure. Retinal macroaneurysm was suspected as the cause of preretinal hematoma. Vitreous surgery was performed on both cases. As intraoperative finding,hematoma was located posterior to ILM. Macular hole was detected after aspiration of hematoma. The macula hole closed spontaneously a few days later. Visual acuity improved from 0.02 to 0.1 after surgery in both cases. Conclusion:Pre-or sub-retinal hematoma may result from rupture of retinal macroaneurysm. The observed macular hole may have formed by pressure of accumulated subretinal hematoma allowing migration of blood into the preretinal space.
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