長期間経過後に両眼にみられた網膜色素上皮裂孔を伴う胞状網膜剝離の1例

A case of bullous retinal detachment with retinal pigment epithelial tear affecting the fellow eye after a long interval

要約　目的：網膜色素上皮裂孔を伴う胞状網膜剝離が14年後に他眼にも発症した症例の報告。症例：46歳男性が左眼視力低下で受診した。矯正視力は右1.2，左0.3で，左眼眼底に網膜色素上皮裂孔を伴う胞状網膜剝離があった。フルオレセイン蛍光眼底造影で色素上皮裂孔に一致して過蛍光があり，光凝固を行ったが剝離は改善せず，通院を中断した。61歳になった14年後に右眼にほとんど同様の病変が生じた。矯正視力は右0.4，左0であった。副腎皮質ステロイドの内服と光凝固を行い，眼底病変は鎮静化したが，夕焼け状眼底になった。結論：網膜色素上皮裂孔を伴う胞状網膜剝離が長期の間隔をおいて両眼に発症した症例は少なく，稀有な1例である。

Abstract.　Purpose：To report a case of bullous retinal detachment with retinal pigment epithelial tear affecting both eyes with a 14-year interval. Case and Findings：A 46-year-old male presented with blurring in his left eye. His corrected visual acuity was 1.2 right and 0.3 left. The left eye showed bullous retinal detachment with retinal pigment epithelial tear. Fluorescein angiography showed hyperfluorescence within the tear. The retinal detachment persisted after laser photocoagulation. Essentially the same lesion developed in the right eye at the age of 61 years, or 14 years later. Corrected visual acuity was 0.4 right and no light perception left. Retinal detachment subsided after systemic corticosteroid and photocoagulation, resulting in sunset-glow fundus. Conclusion：It seems very rare for bullous retinal detachment with retinal pigment epithelial tear to involve the fellow eye after such a long interval.