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要約 背景:悪性腫瘍に対する重粒子線照射では,効果の範囲と深さを限定でき,近接組織への副作用が少ないとされる。目的:上顎洞肉腫への重粒子線治療で放射線網膜症が発症した症例の報告。症例:28歳男性が両眼が見えにくいという訴えで受診した。14か月前に右上顎洞肉腫と診断され,化学療法ののち,10か月前までの1か月間,16回にわたり総量70.4 GyEの炭素イオン線治療を受けた。所見と経過:裸眼視力は左右とも1.0で,右眼底に軟性白斑と網膜出血が散在し,左眼底にも少数の軟性白斑があった。蛍光眼底造影で右眼の網膜に毛細血管瘤と無血管野があった。前医の資料で,右眼の眼底下鼻側と視神経が高線量域に含まれていた。放射線網膜症と診断し,右眼に光凝固を行った。以後8か月間の経過は良好である。結論:上顎洞肉腫への重粒子線治療で放射線網膜症が発症することがある。
Abstract. Background:Heavy particle irradiation allows exact localization of its effect resulting in less injury to the neighboring tissue. Purpose:To report a case of radiation retinopathy following carbon ion radiotherapy to malignancy in the maxillary sinus. Case:A 28-year-old male presented with vaguely disturbed vision in both eyes. He had been diagnosed with sarcoma of the right maxillary sinus 14 months before. He received carbon ion radiotherapy totaling 70.4 GyE divided over 16 sessions for one month until 10 months before. Findings and Clinical Course:Uncorrected visual acuity was 1.0 in either eye. Funduscopy showed numerous soft exudates and hemorrhages in the right fundus and a few soft exudates in the left. Fluorescein angiography showed capillary microaneurysms and nonperfused areas. He was diagnosed with radiation retinopathy and received photocoagulation to nonperfused retinal areas. Conclusion:This case illustrates that radiation retinopathy may develop after heavy particle radiation to the maxillary sinus.
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