傍乳頭網膜血管腫の1例

A case of juxtapapillary retinal hemangioma

要約　目的：傍乳頭血管腫の長期観察例の報告。症例：43歳男性が左眼視力低下を主訴として受診した。矯正視力は左右とも1.5であった。左眼の乳頭が軽度に発赤腫脹し，黄斑部にかけて滲出性網膜剝離があった。フルオレセイン蛍光眼底造影で乳頭の耳側縁が早期から過蛍光を呈し，後期には網膜剝離の部位に色素貯留があった。2週間後に左眼視力は0.5に低下し，その2週間後に灰白色腫瘤が乳頭の耳側縁に出現した。初診から18か月後に傍乳頭血管腫と診断し光凝固を行った。その後，新たに滲出を伴う白色腫瘤が出現した。発症から5年後に血管腫は2.5乳頭径大になり，乳頭黄斑線維束萎縮が生じ，視力は0.01になった。結論：腫瘤が顕著化する以前から長期にわたって経過を追跡できた本症例は，傍乳頭血管腫の稀有な例である。

Abstract.　Purpose：To report long-term clinical course of a case of juxtapapillary capillary retinal hemangioma. Case and Findings：A 43-year-old male presented with blurring in his left eye. His corrected visual acuity was 1.5 in either eye. His left eye showed hyperemia and swelling of optic disc. Exudative retinal detachment was present in the papillomacular area. Fluorescein angiography showed hyperfluorescence from the early stage on and dye pooling in the detached retinal area. Visual acuity decreased to 0.5 two weeks later. One month after his initial visit, grayish tumor appeared in the temporal edge of optic disc. He was diagnosed with juxtapapillary retinal capillary hemangioma and received photocoagulation 15 months after his initial visit. The initial lesion turned into white mass associated with exudation. Five years after onset, the hemangioma became 2.5 disc diameters across with visual acuity decreased to 0.01 due to papillomacular bundle atrophy. Conclusion：To our best knowledge, there has been no report of juxtapapillary retinal capillary hemangioma followed up from its subclinical stage as in the present case.