Unilateral acute idiopathic maculopathyの1例

A case of unilateral acute idiopathic maculopathy

要約　背景：片眼性急性特発性黄斑症（unilateral acute idiopathic maculopathy：UAIM）は，1991年に報告された疾患で，若年者に好発し，感冒様症状に続き，片眼の急速な視力低下と中心暗点が生じ，黄斑部に滲出性網膜剝離が生じる。数週間で寛解し，視力予後は良好とされている。目的：UAIMの1症例の報告。症例：33歳男性に熱発があり，扁桃腺炎と診断された。その2日後に右眼中心暗点が生じ，黄斑部に滲出性網膜剝離があったという。17日後に紹介され受診した。視力は0.2で標的黄斑の所見があった。網膜剝離は軽快し，蛍光眼底造影で色素漏出はなかった。UAIMの寛解期と診断し，前医からのステロイド投与を続行した。発症4か月後に視力は1.0に回復した。結論：感冒様症状に続く片眼の急速な視力低下があるときの鑑別診断ではUAIMの可能性がある。

Abstract.　Background：Unilateral acute idiopathic maculopathy（UAIM）is characterized by symptoms simulating common cold in young adult,unilateral acute visual failure with central scotoma,and exudative retinal detachment in the macula. Spontaneous resolution may set in within a few weeks with favorable visual outcome. Purpose：To report a case of UAIM. Case：A 33-year-old male had acute fever and was diagnosed with tonsillitis. Central scotoma developed in his right eye 2 days later. Exudative retinal detachment was observed in the macula. When seen by 17 days later,his visual acuity was 0.2 right. The right eye showed bull's eye. Retinal detachment was absent. Fluorescein angiographic findings were inconspicuous. He was diagnosed with UAIM during remission and was given systemic corticosteroid. The right eye recovered 4 months after onset with visual acuity of 1.0. Conclusion：UAIM is a possibility as the cause of unilateral acute visual failure with central scotoma following symptoms simulating common cold.