中心性漿液性脈絡網膜症を生じた糖尿病網膜症の1例

Central serous chorioretinopathy in a case of diabetic retinopathy

要約　背景：糖尿病網膜症と中心性漿液性脈絡網膜症は原因病変の場が異なる別個の疾患である。目的：中心性漿液性脈絡網膜症が発症した糖尿病網膜症の症例の報告。症例：65歳男性が左眼視力の低下で受診した。左眼に核白内障があった。白内障手術で視力は1.5に回復した。16か月後に単純型糖尿病網膜症が両眼に起こり，その3か月後に左眼の変視を訴えた。視力は0.7で，黄斑部に漿液性網膜剝離があり，光干渉断層計でも確認された。蛍光眼底造影で中心窩の鼻側に蛍光漏出があり，網膜色素上皮剝離があった。光凝固で中心性漿液性脈絡網膜症は治癒した。5か月後とその10か月後に中心性漿液性脈絡網膜症が再発し，蛍光漏出点は3回とも別の箇所にあった。いずれも光凝固で治癒し，以後再発はない。結論：本症例での糖尿病網膜症は軽症であり，糖尿病と脈絡膜循環障害の併発は偶然である可能性が高い。

Abstract.　Background：Diabetic retinopathy and central serous chorioretinopathy（CSC）have entirely different pathogenetic factors. Purpose：To report a case of diabetic retinopathy who developed CSC. Case：A 65-year-old male presented with impaired vision in his left eye. He had nuclear cataract. His left visual acuity improved to 1.5 after surgery. He was found to have simple diabetic retinopathy in both eyes 16 months later. He noted metamorphopsia with visual acuity of 0.7 in the left eye another 3 months later. The left eye showed CSC with detachment of retinal pigment epithelium. Photocoagulation to the spot of dye leakage was followed by cure of CSC. CSC recurred 5 months and another 10 months later in the same eye. Location of dye leakage was different in the three episodes. CSC healed after photocoagulation at each occasion. He has been doing well until present. Conclusion：Diabetic retinopathy in this patient was mild and does not seem to be etiologically associated with CSC.