強膜開窓術後23年経過し再発したぶどう膜滲出の1例

Recurrence of uveal effusion in a case twenty-three years after initial sclerectomy

要約　目的：小眼球に伴うぶどう膜滲出（uveal effusion）に対して強膜開窓術が行われ，その23年後にぶどう膜滲出が再発した症例の報告。症例：70歳男性が右眼視力低下で受診した。生来視力が不良であり，24年前に右眼，18年前に左眼にぶどう膜滲出があり，いずれも4象限への強膜開窓術で網膜が復位した。所見：＋14Dの矯正で，視力は右0.09，左0.1であった。眼軸長は左右眼とも約17mmで，右眼の下方眼底に非裂孔原性胞状網膜剝離があった。ぶどう膜滲出の再発と診断し，24年前と同じ4象限に，3mm×3mmの拡大強膜全層切除を行った。3か月後に網膜は復位した。結論：真性小眼球に生じたぶどう膜滲出に対し強膜開窓術が有効であるが，長期間後に再発することがある。これに対し，強膜開窓術は選択肢の1つである。

Abstract.　Purpose：To report a case of nanophthalmos who developed recurrence of uveal effusion 23 years after initially successful sclerectomy. Case：A 70-year-old male presented with impaired vision in the right eye. He had had low vision since childhood. He had developed uveal effusion 24 years before in the right eye and 18 years before in the left. The retina became reattached after sclerectomy placed in each quadrant. Findings：Visual acuity was 0.09 right and 0.1 left when corrected with ＋14 diopters. Both eyes had axial length of about 17 mm. The right eye showed bullous retinal detachment in the lower hemisphere and was diagnosed with recurrence of uveal effusion. The affected eye received expanded sclerectomy measuring 3 mm by 3 mm in each quadrant. The retina became reattached 3 months later. Conclusion：Sclerectomy may be effective for uveal effusion with nanophthalmos. This case illustrates that late recurrence may be effectively treated by repeat sclerectomy.