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要約 目的:脈絡膜皺襞を伴った急性後部多発性斑状色素上皮症(APMPPE)の1症例の報告。症例:64歳男性が3週間前からの右眼視力低下で受診した。矯正視力は右0.7,左0.6で,右眼後極部に黄白色の滲出斑があった。光干渉断層計(OCT)で後極部に漿液性網膜剝離と脈絡膜皺襞があった。フルオレセイン蛍光造影での逆転現象からAPMPPEと診断し,初回量としてプレドニゾロン30mgを経口投与し,漸減した。3週間後に右眼矯正視力は1.0に回復し,OCTでの脈絡膜皺襞も消失した。結論:APMPPEでは脈絡膜皺襞が生じることがあり,本症での炎症が高度なときには広範囲に脈絡膜に炎症が及んでいる可能性がある。
Abstract. Purpose:To report a case of acute posterior multifocal placoid pigment epitheliopathy(APMPPE)with choroidal folds. Case:A 64-year-old male presented with impaired vision in his right eye since 3 weeks before. Best corrected visual acuity was 0.7 right and 0.6 left. His right eye showed yellowish-white patches in the posterior fundus. Optical coherence tomography(OCT)showed serous retinal detachment with choroidal folds. Fluorescein angiography showed inverted phenomenon, leading to the diagnosis of APMPPE. Peroral prednisolone at the initial dosis of 30 mg with tapering was followed by improved visual acuity to 1.0 3 weeks later and normalized OCT findings. Conclusion:This case illustrates that choroidal folds may be present in APMPPE suggesting involvement of the choroid by inflammatory process.
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