近視性脈絡膜新生血管に黄斑円孔網膜剝離を合併した3例

Macular hole retinal detachment in three cases of myopic choroidal neovascularization

要約　目的：強度近視眼に脈絡膜新生血管（CNV）が発症し，同時またはその後に黄斑円孔網膜剝離が生じた3症例の報告。症例：症例はいずれも女性で，年齢はそれぞれ58，76，79歳であった。2例は片眼性で，罹患眼の屈折は，それぞれ－32.00D，眼内レンズ挿入眼，両眼発症の1例では左右とも－13.00Dであった。いずれも初診時にCNVがあった。黄斑円孔網膜剝離は，1例ではCNVに対するベバシズマブ硝子体内注射の11か月後，1例では眼内レンズ挿入眼でCNV発症から8か月後，他の1例では初診時からCNVと同時に発見された。3例3眼に硝子体手術を行い，網膜が復位したが，黄斑円孔は閉鎖しなかった。結論：CNVがあることは，黄斑円孔網膜剝離に対する手術後の網膜復位に影響しなかった。

Abstract.　Purpose：To report three cases of myopic choroidal neovascularization（CNV）associated with or followed by macular hole retinal detachment. Cases：All were females and were aged 58, 76, and 79 years respectively. Two were unilaterally and one was bilaterally affected. One case was pseudophakic. Refraction of the involved phakic eye was －32.00D in one case and －13.00D in either eye in bilaterally affected case. All the eyes showed CNV at the initial examination. Macular hole retinal detachment developed 11 months after intravitreal bevacizumab in one case and spontaneously 8 months later in another aphakic case. The bilaterally affected case showed CNV and retinal detachment at the initial examination. Vitreous surgery was performed on 3 eyes of 3 cases and was followed by reattached retina. Macular hole persisted in all the eyes. Conclusion：Presence of myopic CNV did not influence the surgical outcome of macular hole retinal detachment.