増殖糖尿病網膜症に続発した黄斑円孔が自然閉鎖した1例

Spontaneous closure of macular hole in a case of proliferative diabetic retinopathy

目的：増殖糖尿病網膜症が進展して生じた続発性黄斑円孔が自然閉鎖した症例の報告。症例と経過：47歳男性が30年前に統合失調症，2年前に糖尿病と診断された。初診時の矯正視力は右0.5，左手動弁で，左眼に視神経萎縮，両眼に乳頭前血管新生があった。右眼に汎網膜光凝固を行った。右眼では牽引性網膜剝離が黄斑部に及び，さらに全層黄斑円孔が生じ視力は0.04に低下した。10か月後に硝子体皮質と中心窩との癒着が自然に解除された。その3か月後に黄斑円孔は自然閉鎖し，視力は0.6に回復した。結論：増殖糖尿病網膜症では，増殖膜の牽引が解除されれば黄斑円孔が自然閉鎖する可能性がある。

Purpose：To report spontaneous closure of macular hole in a case of proliferative diabetic retinopathy. Case and Findings：A 47-year-old male had been diagnosed with schizophrenia 30 years before and as diabetes mellitus 2 years ago. His corrected visual acuity was 0.5 right and hand motion left. Both eyes showed disc neovascularization. The left eye showed optic atrophy. The right eye was treated by panretinal photocoagulation. Traction retinal detachment involved the macula resulting in macular hole in the right eye. The visual acuity decreased to 0.04. Adhesion between vitreous cortex and the fovea was spontaneously released 10months later. Macular hole closed 3months later resulting in visual acuity of 0.6. Conclusion：This case illustrates that macular hole may resolve spontaneously following separation of vitreous membrane from the fovea.