急激な眼球突出で発見され保存的治療により軽快した眼窩リンパ管腫の3例

Fair outcome following conservative treatment in three cases of orbital lymphangioma with acute proptosis

要約　背景：眼窩リンパ管腫で腫瘍内出血が生じると，急性眼球突出，視力低下，眼圧上昇，眼球運動障害などが起こり，重篤な場合には手術の適応になる。目的：保存的治療で軽快した眼窩リンパ管腫3症例の報告。症例：症例は8歳男児，35歳男性，35歳女性である。いずれも片眼性で，急性眼球突出，視力低下，眼球運動障害，眼圧上昇で受診した。矯正視力はそれぞれ0.6，0.04，0.3であった。磁気共鳴画像検査（MRI）で眼窩リンパ管腫と診断した。3症例とも手術を希望せず，止血薬や眼圧下降薬による対症療法のみで加療した。約1か月後に視力，眼圧，臨床症状が軽快し，最終的に0.9以上の矯正視力を得た。結論：急性眼球突出で発症した眼窩リンパ管腫でも，手術によらないで軽快する症例がある。

Abstract.　Background：Orbital lymphangioma may undergo intratumoral hemorrhage and manifest acute proptosis,impaired visual acuity,increased intraocular pressure（IOP）and impaired ocular motility. Surgery is indicated in severe cases. Purpose：To report three cases of orbital lymphangioma that resolved following conservative treatment. Cases and Findings：The present series comprised a boy aged 8 years,a male and a female aged 35 years. All were unilaterally affected and manifested acute proptosis,impaired ocular motility and elevated IOP. Corrected visual acuity was 0.6,0.04 and 0.3 respectively. Magnetic resonance imaging（MRI）led to the diagnosis of orbital lymphangioma. Each case refused surgery and received conservative treatment for hemorrhage and elevated IOP. Spontaneous recovery set in about one month later regarding visual acuity,IOP,and clinical manifestations. Each case attained final visual acuity of 0.9. Conclusion：These cases illustrate that orbital lymphangioma may undergo spontaneous resolution following conservative treatment only.