視細胞内節外節接合部ラインの不明瞭化とその改善を認めた急性網膜色素上皮炎の1例

Restoration of blurred junction line between inner and outer photoreceptor segments in a case of acute retinal pigment epitheliitis

要約　目的：急性網膜色素上皮炎の症例の報告。症例：29歳男性が数日前からの左眼傍中心暗点で受診した。前駆症状はなかった。所見：矯正視力は右1.2，左0.7で，両眼に強度の近視があった。右眼には異常がなく，左眼の中心窩上耳側に1/3乳頭径の黄白色滲出斑とその中央に灰白色点があった。蛍光眼底造影とあわせ，急性網膜色素上皮炎と診断した。光干渉断層計で滲出斑に一致して脈絡膜の高反射があり，視細胞内外節の接合部ラインが滲出斑の周辺部から中心窩まで不明瞭であった。8週間後にこの接合部ラインは明瞭になり，視力は1.0に回復した。結論：急性網膜色素上皮炎では視細胞内外節の接合部ラインが不明瞭化することがあり，この境界線の明瞭化が視力の改善に関連した可能性がある。

Abstract.　Purpose：To report a case of acute retinal pigment epitheliitis. Case：A 29-year-old male presented with paracentral scotoma in his left eye since a few days before. He was free of prodromal symptoms. Findings：Visual acuity was 1.2 right and 0.7 left when corrected for myopia. An exudative patch of one-third disc diameter across was present superior temporal to the fovea in the left eye. He was diagnosed with acute retinal pigment epitheliitis. Fluorescein and indocyanine green angiography gave compatible findings. Optical coherence tomography showed blurred line of junction between inner and outer photoreceptor segments. This line became distinct 8 weeks later with improved visual acuity to 1.0. Conclusion：Blurring of junction line between inner and outer segments may be present in acute retinal pigment epitheliitis. Improved visual acuity appears to be associated with restoration of the junction line.