中心性漿液性脈絡網膜症に類似した加齢黄斑変性の眼底自発蛍光

Fundus autofluorescence in cases of age-related macular degeneration simulating central serous chorioretinopathy

要約　目的：中心性漿液性脈絡網膜症（CSC）に類似した加齢黄斑変性（AMD）2症例の自発蛍光所見の報告。症例：2例とも女性で，年齢は64歳と70歳である。1例には5年前から1眼にAMDがあり，1週前に他眼に中心暗点を自覚し，黄斑部に漿液性網膜剝離があった。蛍光眼底造影では色素漏出はなく，自発蛍光の低下と増強があった。4か月後の再発時には円形の蛍光漏出があり，この部位に自発蛍光の著しい低下とこれを囲む過自発蛍光があった。他の1例には，吹き上げ型の蛍光漏出があり，この部位に枝状の低自発蛍光とこれを囲む過自発蛍光があった。両症例とも，光干渉断層計で1型脈絡膜新生血管（CNV）が推定された。結論：CSCに類似するAMD2症例での眼底自発蛍光検査で，蛍光眼底造影では確認できない網膜色素上皮の情報が得られた。

Abstract.　Purpose：To report fundus autofluorescence in 2 cases of age-related macular degeneration（AMD）simulating central serous chorioretinopathy（CSC）. Cases：Both were females aged 64 and 70 years respectively. One case had AMD in one eye since 5 years before. She noted central scotoma in the other eye one week before. Serous retinal detachment was present in the macula. Fluorescein angiography（FA）showed no dye leakage. The affected eye showed decreased autofluorescence surrounded by hyperfluorescence. CSC recurred 4 months later. FA showed dye leakage. This area showed decreased autofluorescence surrounded by increased one. FA in the other case showed smokestack dye leakage. This area showed decreased autofluorescence surrounded by hyperfluorescence. Optical coherence tomography（OCT）showed findings suggestive of type 1 choroidal neovascular membrane in both cases. Conclusion：These two cases illustrate that autofluorescence studies may give new informations regarding the retinal pigment epithelium inaccessible by conventional fluorescein angiography.