裂孔原性網膜剝離に網膜新生血管が生じた網膜色素変性症の1例

Rhegmatogenous retinal detachment with neovascularization in a case of retinitis pigmentosa

要約　目的：裂孔原性網膜剝離に新生血管が併発した網膜色素変性症の症例の報告。症例：43歳女性が網膜色素変性症の精査を希望して受診した。主訴は視野狭窄であった。所見：矯正視力は右0.6，左0.9で，右眼に約4D，左眼に約5Dの近視があった。両眼とも眼底に網膜色素変性症に特有な所見があった。右眼には鼻側上方に萎縮性円孔があり，それから下方にかけて胞状の網膜剝離があった。下方の網膜剝離縁に網膜新生血管があり，眼底周辺部には広い無血管野があった。強膜内陥による剝離手術を行い，3か月後に網膜は復位した。網膜新生血管は消退し，視力は0.8に改善した。結論：網膜色素変性症に裂孔原性網膜剝離が生じ，併発した網膜新生血管は網膜の復位後に消失した。

Abstract.　Purpose：To report a case of retinitis pigmentosa associated with rhegmatogenous retinal detachment and neovascularization（NVE）. Case：A 43-year-old female visited us requesting detailed diagnosis for retinitis pigmentosa. Constriction of visual field was her chief complaint. Findings：Corrected visual acuity was 0.6 right and 0.9 left. Both eyes were myopic at 4 to 5 diopters. Both eyes showed typical fundus findings of retinitis pigmentosa. An atrophic retinal hole was present in the superior temporal sector in the right eye with bullous retinal detachment extending inferiorly. NVE was present at the margin of detached retina in the inferior sector. Fluorescein angiography showed extensive avascular area in the periphery. Silicone explant surgery was followed by reattachment of the retina 3 months later. NVE disappeared and visual acuity improved to 0.8. Conclusion：NVE disappeared after reattachment of the retina in the present case of retinitis pigmentosa.