8歳時より著明に視機能が向上したstage 5未熟児網膜症術後の1例

Remarkable improvement of vision after eight years of age in an operated case of stage-5 retinopathy of prematurity

要約　目的：8歳時より著明に視力が向上したstage 5未熟児網膜症術後症例について報告する。症例：9歳男児。在胎24週0日，体重602gで出生。両眼に未熟児網膜症を発症，キセノン光凝固，網膜冷凍凝固を行ったが，両眼ともstage 5に進行し，水晶体切除・硝子体手術を施行。網膜は両眼とも復位したが，網膜の高度の萎縮変性を認め，精神発達遅滞もあり7歳頃まで視力は光覚程度であった。8歳時より市販の幼児用教材による訓練を開始した。結果：6か月後には2cm角程度の書字が可能になった。結論：幼児用教材が視覚の発達・評価に有用と考えられた。本例のように網膜萎縮が強く精神発達遅滞のある患児でも，訓練により実用視力を得る可能性がある。

Abstract.　Purpose：To report a case of stage-5 retinopathy of prematurity who showed remarkably improved visual acuity after 8 years of age. Case：A male infant was born after gestation of 24 weeks with birthweight of 602g. Both eyes showed retinopathy of prematurity that developed to stage 5 after xenon photocoagulation and retinal cryopexy. Vitreous surgery with lensectomy induced retinal reattachment. Both eyes showed severe retinal atrophy. The visual acuity remained at light perception, due also to mental retardation, until the age of 7 years. Visual training was started at the age of 8 years Six months later, he could write characters of 2cm×2cm in size. Conclusion：This case illustrates that training may induce improved visual acuity even in a child with retinal atrophy and mental retardation with past history of advanced retinopathy of prematurity.