両眼の脈絡膜新生血管に対し硝子体手術を行った真菌性網脈絡膜炎の1例

Vitreous surgery for bilateral choroidal neovascularization in a case of fungal chorioretinitis

要約　35歳女性が両眼の脈絡膜新生血管で紹介され受診した。2年前に卵巣奇形腫の手術を受け，術後の化学療法中，両眼に真菌性網脈絡膜炎と推定される病変が生じ，抗真菌薬投与で瘢痕治癒したが，ふたたび活性化した。視力は右0.8，左0.4であり，両眼黄斑部に漿液性網膜剝離があり，左眼に網膜下出血があった。蛍光眼底造影などで両眼の脈絡膜血管新生と診断した。初診から4か月後に，硝子体手術による脈絡膜新生血管抜去を左眼に行い，その10か月後に同様の手術を右眼に行った。経過は良好で，最終視力として右0.4，左0.8を得た。真菌性網脈絡膜炎による脈絡膜新生血管に対して血管抜去術が奏効した1例である。

Abstract.　A 35-year-old woman was referred to us for choroidal neovascularization in both eyes. She had undergone ovariectomy for ovarian teratoma 2 years before. During postoperative chemotherapy,fungal chorioretinitis developed in both eyes. Antifungal medications induced scarring of eye lesions. Her corrected visual acuity was 0.8 right and 0.4 left. Both eyes showed serous retinal detachment in the macular area. The left eye showed subretinal hemorrhage. Angiographic findings were compatible with choroidal neovascularization in both eyes. The left eye received vitreous surgery with removal of subretinal neovascularization 4 months after her initial visit. The right eye received the same surgery another 10 months later. The postoperative course was uneventful resulting in visual acuity of 0.4 right and 0.8 left. This case illustrates that removal of subretinal neovascularization may be effective even when secondary to fungal chorioretinitis.