EDI-OCTと眼底自発蛍光が診断に有用であった慢性中心性漿液性脈絡膜網膜症の2例

Two cases of chronic central serous chorioretinopathy diagnosed using enhanced depth imaging optical coherence tomography and fundud autofluorescence imaging

要約　目的：深部強調画像光干渉断層計（EDI-OCT）と眼底自発蛍光が慢性中心性漿液性脈絡網膜症（慢性CSC）の診断に有用だった2症例の報告。症例：症例1は38歳男性。2年前から右視力低下で2箇所の病院を受診するも診断がつかず，半年前からの歪視で受診。蛍光眼底造影で色素上皮萎縮，インドシアニングリーン造影検査で黄斑部に脈絡膜血管透過性亢進，眼底自発蛍光で低蛍光の萎縮巣があった。症例2は75歳男性。5年前から右視力低下で加齢黄斑変性として経過観察されていた。蛍光眼底造影で両眼に色素上皮萎縮，脈絡膜血管の蛇行と拡張，自発蛍光で低蛍光斑があった。両症例にOCTで脈絡膜肥厚を認めた。結論：EDI-OCTと眼底自発蛍光が慢性CSCの診断に有用であった。

Abstract.　Purpose：To report 2 cases of chronic central serous chorioretinopathy which was diagnosed using enhanced depth imaging optical coherence tomography（EDI-OCT）and fundus autofluorescence imaging. Cases：Case 1 was a 38-year-old male complaining of wavy vision of his left eye for 6 months. Visual acuity was 0.1 in the right eye and 0.7 in the left. Fluorescein angiography showed diffuse pigment epitheliopathy in both eyes. Indocyanine green angiography showed choroidal vascular hyperpermeability. EDI-OCT showed marked thickening of subfoveal choroid. Fundus autofluorescence showed granular hypoautofluorescence and a descending tract. Case 2 was a 75-year-old male who had been diagnosed as“age-related macular degeneration”. Visual acuity was 0.3 in the right eye and 1.0 in the left. Fluorescein angiography showed diffuse pigment epitheliopathy in both eyes. Indocyanine green angiography showed dilated choroidal vessels and choroidal vascular hyperpermeability. Fundus autofluorescence images revealed confluent hypoautofluorescences correspoding to RPE atrophy and hyperautofluorescences showing leakage of subretinal fluids. EDI-OCT showed choroidal thickening in both eyes. Conclusion：EDI-OCT and fundus autofluorescence imaging appear useful for the diagnosis of chronic CSC.