黄斑円孔の自然閉鎖例に対する硝子体手術症例

Vitreous surgery for spontaneously closed macular hole

要約　目的：特発性黄斑円孔が自然閉鎖した眼に硝子体手術を行った症例の報告。症例：45歳男性が右眼の視力低下と変視症で受診した。矯正視力は右0.4，左1.5であった。右眼に黄斑円孔があり，光干渉断層計では円孔の大きさは1/7乳頭径であった。右眼を特発性黄斑円孔の第3期と診断した。経過：10週後に黄斑円孔は閉鎖し，視力は0.5になった。視力と自覚症状の改善が乏しいために硝子体手術で内境界膜を剝離し，SF₆ガスを注入した。視力は手術の9日後に1.0，13日後に1.5になった。光干渉断層計では黄斑は正常の形態であった。結論：自然閉鎖した黄斑円孔に硝子体手術を行うことで，早期に視力と自覚症状の改善が得られることがある。

Abstract.　Purpose：To report the outcome of vitreous surgery in a case of spontaneously closed macular hole. Case：A 45-year-old male presented with impaired visual acuity and metamorphopsia in his right eye. His corrected visual acuity was 0.4 right and 1.5 left. Macular hole was present in the right eye. Its size was 0.15 disc diameter when measured by optical coherence tomography（OCT）. He was diagnosed with stage 3 idiopathic macular hole. Clinical Course：The macular hole closed spontaneously 10 weeks later with visual acuity improving to 0.5. He received vitreous surgery due to poor visual acuity and persistent metamorphopsia. Nine days after peeling of internal limiting membrane and intravitreal sulfur fluoride, the visual acuity improved to 1.0, and 4 days later, to 1.5 with no meta-morphopsia. Oct showed normal configuration of the fovea. Conclusion：This case illustrates that early cure may result after vitreous surgery for spontaneously closed macular hole.