家族性滲出性硝子体網膜症に続発した網膜上膜に対し硝子体手術を施行した1例

Vitreous surgery for epiretinal membrane in a case of familial exudative vitreoretinopathy

要約　目的：家族性滲出性硝子体網膜症（FEVR）に続発した網膜上膜に対して硝子体手術を行った症例の報告。症例：36歳女性が視力低下で受診した。右眼は幼少時に鎌状網膜剝離で失明し，左眼はFEVRと網膜上膜として近医で経過観察中であった。父親に網膜剝離の既往がある。所見と経過：矯正視力は右眼0，左眼0.5で，左眼に－9Dの近視があった。右眼は眼球瘻で，左眼に牽引乳頭，網膜血管の直線化と多分岐，眼底周辺部に広範な無血管野，耳側中間周辺部に網膜上膜があり，FEVRと診断した。網膜上膜が進行し，15か月後に矯正視力が0.15に低下し，硝子体手術により網膜上膜を剝離切除した。経過は良好で，2年後の現在，0.4の視力を維持している。結論：FEVRに続発した網膜上膜に対し，硝子体手術と局部的な網膜上膜の切除が奏効した。

Abstract.　Purpose：To report vitreous surgery for epiretinal membrane in a case of familial exudative vitreoretinopathy（FEVR）. Case：A 36-year-old female presented with impaired vision in the left eye. Her right eye had become blind due to falciform retinal detachment during infancy. Her left eye had been diagnosed with FEVR with epiretinal membrane before. Her father had a history of retinal detachment. Finding：Corrected visual acuity was no light perception right and 0.5 left. The left eye had myopia of －9 diopters. The right eye was phthisic. The left eye showed dragged disc, fundus findings compatible with FEVR, and epiretinal membrane temporal to the macula. The left visual acuity decreased to 0.15 15 months later due to progression of epiretinal membrane. The left eye was treated by vitrectomy and peeling of epiretinal membrane. She has been doing well for 2 years until present with visual acuity maintained at 0.4. Conclusion：Vitrectomy and membrane peeling was effective for progressive epiretinal membrane in a case of FEVR.