高齢者強度近視眼に出現した脈絡膜新生血管の自然消退例

Spontaneous regression of choroidal neovascularization in a senile patient with high myopia

要約　目的：強度近視眼に生じた脈絡膜新生血管が自然退縮した高齢者の報告。症例：61歳男性が2週間前からの右眼変視症で受診した。矯正視力は右0.4，左1.2で，右眼に－9.5Dの近視があった。所見：近視性網脈絡膜萎縮が強く，黄斑部に橙赤色の隆起性病変があった。光干渉断層計と蛍光眼底造影で脈絡膜新生血管と診断した。経過中に黄斑部病変が徐々に退縮し，18か月後には蛍光眼底造影などで脈絡膜新生血管は消失と判断され，視力は0.6に改善した。結論：高齢者の強度近視に併発した脈絡膜新生血管は，無治療で寛解することがある。この可能性は治療方針の決定で考慮される必要がある。

Abstract.　Purpose：To report a senile patient who had high myopia and who developed choroidal neovascularization（CNV）that regressed spontaneously. Case：A 61-year-old male presented with metamorphopsia since 2 weeks before. Findings：Corrected visual acuity was 0.4 right and 1.2 left. The right eye had myopia of －9.5 diopters. The right eye showed diffuse myopic choroidal degeneration with elevated macular lesion. It was diagnosed with CNV by optical coherence tomography and fluorescein angiography. The macular lesion gradually regressed and disappeared 18 months later by optical coherence tomography and fluorescein angiography. Visual acuity improved to 0.6. Conclusion：This case illustrates that CNV in a senile person with high myopia may undergo spontaneous regression. This possibility has to be considered in the decision of therapeutic strategy.