朝顔症候群に伴う網膜剝離の3例

Retinal detachment in three cases of morning glory syndrome

要約　目的：網膜剝離を伴う朝顔症候群3例3眼に硝子体手術を行った前後の所見と病理学的所見からその成因について考察する。症例と経過：8歳女児，16歳女性，23歳男性に朝顔症候群が片眼にあり，黄斑を含む広範囲な網膜剝離があった。硝子体手術を行い，うち2眼に乳頭の漏斗状陥凹内の萎縮巣に裂孔があり，網膜剝離の原因と推定された。病理組織学的に乳頭陥凹部の中央にある白色組織はコラーゲン線維に富む結合組織であったが，牽引性網膜剝離を示唆する筋線維芽細胞はなかった。結論：朝顔症候群に伴う網膜剝離では，その成因として裂孔形成が関与する事例があり，裂孔形成には網膜の萎縮性変化が関与する可能性がある。

Abstract.　Purpose：To report retinal detachment in three cases of morning glory syndrome and to discuss the pathogenesis based on pre- and intraoperative findings and on histopathological features. Cases and Findings：Morning glory syndrome with retinal detachment was present in a 8-year-old girl,16-year-old female and 23-year-old male. All were unilaterally affected and showed extensive retinal detachment involving the macula. All the 3 eyes received vitreous surgery. Two eyes showed a retinal break located in the atrophic retina within the funnel-shaped excavation in front of the optic disc. Pathological studies showed the white tissue in the disc excavation to be connective tissue rich in collagen fibers. Myofibroblastic tissue suggesting traction retinal detachment was absent. Conclusion：Retinal break may causatively related in retinal detachment in morning glory syndrome. Breaks may be due to atrophic changes in the affected retina.