介達性外傷性黄斑症の1例

A case of acute maculopathy following non-direct ocular trauma

要約　目的：介達性外傷性黄斑症の症例の報告。症例：21歳男性が自動車を運転中に立木に激突し，横転した。シートベルトを着用していた。頭部に挫創があり，CT検査で頭部に異常はなかったという。受傷の3日後に両眼の視力低下を自覚して受診した。所見：矯正視力は左右とも0.1で，眼球に異常所見はなかった。両眼に中心暗点があった。その翌日，左右とも視力が0.4になり，多局所網膜電図検査で黄斑応答の密度低下があり，光干渉断層計（OCT）で中心窩外層に形態異常があった。蛍光眼底造影で異常はなかった。受傷31日目に左右とも視力が1.5に回復した。結論：本症例は介達性外傷による，黄斑部外層を主病変とする外傷性黄斑症と診断される。

Abstract.　Purpose：To report a case of acute maculopathy following extraocular injury. Case：A 21-year-old male was driving a car that turned upside down by hitting a tree. Immediately after the trauma,he had an injury in the skin of the head. Computed tomography（CT）showed no injury to the brain. He noticed impaired vision 3 days after the accident was seen by us. Findings：Corrected visual acuity was 0.1 in either eye. Routine ophthalmological findings,including funduscopy,were within normal limits. Both eyes showed central scotoma. Visual acuity improved to 0.4 in either eye the following day. Multifocal electroretinogram showed reduced macular response. Optical coherence tomography（OCT）showed pathological findings in the outer retinal layer in the macula. Fluorescein and ICG angiography showed normal findings. Visual acuity improved to 1.5 in either eye one month after the injury. Conclusion：The present case was diagnosed with traumatic maculopathy with no direct trauma to the eyes. Outer retinal layers in the macula were chiefly involved.