網膜中心動脈閉塞症の発症9か月後に出現した滲出型加齢黄斑変性の1例

A case of exudative age-related macular degeneration nine months after central retinal artery occlusion

要約　目的：網膜中心動脈閉塞症の発症後に滲出型加齢黄斑変性が生じた症例の報告。症例：80歳男性が左眼に視力低下が突発して受診した。心筋梗塞が12年前，脳梗塞が7年前にあった。所見：矯正視力は右1.5，左手動弁で，左眼に桜実紅斑があった。蛍光眼底造影で網膜動脈の造影開始が著しく遅延し，網膜中心動脈閉塞症と診断した。治療により11日後の左眼視力は40cm指数弁になった。その9か月後に黄斑出血が左眼に生じ，加齢黄斑変性と診断した。硝子体出血が頻発し，ベバシズマブの硝子体注射を行った。22か月後に黄斑は線維性瘢痕病巣になった。結論：網膜中心動脈閉塞症の既往がある眼に活動性が高い加齢黄斑変性が発症することがある。

Abstract.　Purpose：To report a case of exudative age-related macular degeneration（AMD）after central retinal artery occlusion. Case：An 80-year-old male presented with acute visual loss in his left eye. He had had myocardial infarction 12 years before and cerebral infarction 7 years before. Findings：Corrected visual acuity was 1.5 right and hand motion left. The left fovea showed cherry-red spot. Fluorescein angiography showed a markedly delayed start of dye filling and led to the diagnosis of central retinal artery occlusion. Treatment was followed by visual acuity of 40 cm counting fingers 11 days later. The left eye developed macular hemorrhage 9 months later and was diagnosed with AMD. Repeated vitreous hemorrhage had to be treated by intravitreal injection of bevacizumab. The macular lesion turned into fibrous scar 22 months later. Conclusion：This case illustrates that active AMD may develop after an acute attack of central retinal artery occlusion.