鎌状赤血球網膜症の1例

A case of sickle cell retinopathy

要約　目的：ヘモグロビンSC症から鎌状赤血球網膜症になり，手術を行った症例の報告。症例と経過：ガーナ国籍の45歳男性が飛蚊症で受診した。矯正視力は右1.5，左1.2であり，両眼の周辺部網膜に無血管野と硝子体に突出する扇（sea fan）状の新生血管があった。左眼の耳側下方に網膜剝離があった。増殖鎌状赤血球網膜症の分類で，右眼が第3期，左眼が第5期と診断した。右眼に光凝固を行い，左眼には強膜部分内陥術を行った。術後8か月間の経過は良好で，前眼部虚血はなく，眼圧と視力は良好である。結論：鎌状赤血球網膜症に併発した網膜剝離に対し，強膜部分内陥術は有効な選択肢の1つである。

Abstract.　Purpose：To report sickle cell retinopathy with retinal detachment in a case of hemoglobin S-C disease. Case and Findings：A 45-year-old Ghanaian male presented with seeing flies. His corrected visual acuity was 1.5 right and 1.2 left. Both eyes showed avascular area with neovascularization simulating sea-fan in the periphery. The left eye showed retinal detachment in the inferior temporal sector. He was diagnosed with proliferative sickle cell retinopathy. The right eye was in stage 3 and the left was in stage 5 of disease. The right eye was treated by photocoagulation. The left eye received segmental scleral buckling to avoid ischemia of anterior segment. Both eyes are doing well during the ensuing 8 months. Conclusion：Segmental scleral buckling is one of effective therapeutic choices for retinal detachment in sickle cell retinopathy.