両眼とも同時期に自然閉鎖した特発性黄斑円孔の1例

Spontaneous and simultaneous closure in a case of bilateral idiopathic macular hole

要約　目的：両眼の特発性黄斑円孔が自然閉鎖した症例の報告。症例：64歳女性が3か月前からの左眼視力低下で受診した。大動脈弁閉鎖不全の手術後にワルファリンを服用していた。所見：矯正視力は右1.2，左0.4で，強い屈折異常はなかった。右眼に第1期，左眼に第2期の黄斑円孔があり，光干渉断層計でもこれが確認された。後部硝子体剝離はなかった。2か月後に左眼視力は0.6になり，黄斑円孔は第3期になった。初診から12か月後に右眼視力は0.3になり，黄斑円孔は第2期になった。15か月後に後部硝子体剝離が生じ，両眼とも視力は1.2になり，黄斑円孔は自然閉鎖した。結論：本症例では，後部硝子体剝離に伴い両眼の黄斑円孔が自然閉鎖した。

Abstract.　Purpose：To report a case of bilateral idiopathic macular hole that spontaneously closed 15 months later. Case：A 64-year-old female presented with impaired visual acuity in the left eye since 3 months before. She had been treated by peroral warfarin after major vascular surgery. Findings：Corrected visual acuity was 1.2 right and 0.4 left. Both eyes were free of major anomalous refraction. The right and left eye showed stage 1 and stage 2 macular hole respectively. Optical coherence tomography（OCT）showed corresponding findings. There was no posterior vitreous detachment. Left visual acuity became 0.6 2 months later with macular hole progressing to stage 3. Right visual acuity became 0.3 another 10 months later with macular hole progressing to stage 2. Visual acuity in either eye improved to 1.2 15 months after her initial visit. Macular hole had spontaneously closed following posterior vitreous detachment. Conclusion：This case illustrates that idiopathic macular hole may undergo spontaneous closure following posterior vitreous detachment.